Annual Scientific conference of Kenya Association of Physicians

Transcription

1 Annual Scientific conference of Kenya Association of Physicians DISPARITIES OF HEALTH CARE: CHALLENGE TO PHYSICIANS Dr. James Nyikal,MBS Director of Medical Services Disparities in health care in Kentya 1

2 Background Challenges to the health sector Finance and financial flows Rapid growth of infrastructure Human resource Emerging diseases Coordination Legal framework Poverty Disparities in health care in Kentya 2

3 Deteriorating indices Infant mortality rate Under five mortality rate Maternal mortality ratio Life expectancy Immunization coverage Disparities in health care in Kentya 3

4 National trends of infant and under five mortality source: CBS IMR <5 MR Year Disparities in health care in Kentya 4

5 Trends in IMR by province Year central coast eastern nyanza north eastern rift valley western nairobi national Disparities in health care in Kentya 5

6 Trends in IMR rural vs urban (per 1, live births) rural urban national Year Disparities in health care in Kentya 6

7 Trends in under five mortality by province Year central coast eastern nyanza north eastern rift valley western nairobi national Disparities in health care in Kentya 7

8 Trends in under five mortality rural vs urban (per 1, live births) rural urban national Year Disparities in health care in Kentya 8

9 HIV prevalence rate by region Central Coast Eastern Nairobi Nyanza North Eastern Rift Valley Western National average Disparities in health care in Kentya 9

10 National trends of maternal mortality ratio (per1,) Year Disparities in health care in Kentya 1

11 National trends of fertility rate Urban Rural National Year Disparities in health care in Kentya 11

12 Trends of fertility rates by province central coast eastern nyanza western north eastern nairobi rift valley national Year Disparities in health care in Kentya 12

13 National trends of life expectancy at birth Year Disparities in health care in Kentya 13

14 Immunization coverage by province 12 BCG Fully imm.(kdhs 23 Fully immun. (kepi) 26 % western nairobi central coast eastern nyanza north eastern rift valley national Disparities in health care in Kentya 14

15 Health institutions distribution by province nairobi western Hospital rift valley north eastern Year nyanza health center eastern coast dispensary central Disparities in health care in Kentya 15

16 Nurses/1, population Distribution of nurses by province nairobi central coast eastern nyanza north eastern rift valley western Disparities in health care in Kentya 16

17 MO/1, population Distribution of medical officer by population (23) Disparities in health care in Kentya 17

18 KES Trends in MoH actual per capita expenditure in Health /8 1981/ / / / /9 1991/ / / / / /24 25/26 year Disparities in health care in Kentya 18

19 % population living below poverty line Regional poverty level nairobi central coast eastern nyanza north eastern rift valley western Disparities in health care in Kentya 19

20 Health expenditure by source % GoK Household Private co. Donors NGOs others Disparities in health care in Kentya 2

21 Challenges to the physician Health reforms Leadership role and head of team Role model Cost of care and poverty Ethics in compromised social environment CPD Curative care/disease prevention and health promotion Perpetual dilemma Disparities in health care in Kentya 21

22 MOH response Paradigm shift in the NHSSPII Emphasis on disease prevention and health promotion Defining essential health package (KEPH) Focus on equity and access to affordable health care Building partnership with community Strengthen health care support delivery systems enhanced sector coordination and partnerships. Disparities in health care in Kentya 22

23 MOH response Actions taken Increased funding Employment of staff Purchase of equipment Rehabilitation of health facilities Strengthening of KEMSA to take over procurement functions Strengthening Regulatory Rapacity Disparities in health care in Kentya 23

24 MOH response Health sector reforms Decentralization Enhanced financial flows Procurement processes Human resource management Result based management Partner coordination Disparities in health care in Kentya 24

25 Way forward Physician leadership in the sector Advocacy for more funding of the sector Advocacy for reforms in the sector Disparities in health care in Kentya 25

26 Way forward Advocacy for better human management and development in the sector Institutionalization of CPD Promotion of accountability Promotion of ethics Disparities in health care in Kentya 26