Where’s the Voice of Wanjiku in This Debate

July 8, 2015

By Frederick Wekesah, Research Officer, APHRC via Daily Nation 

I have been keenly following the debate on the Managed Equipment Services programme rolled out by the Kenyan government.

According to Asteral, a company that specialises in MES, the concept is described as “outsourcing of all aspects of medical equipment to a third party company that specialises in providing this type of service.”

One would think that this is a great initiative for several reasons. First, the equipment is not only sophisticated but lifesaving and used to be found only at the national referral hospital, Kenyatta.

The Sh38 billion spent on the capital funding of the equipment is way higher than what the counties can afford. Plus, such equipment run on technology that becomes obsolete quite fast, hence leasing makes more sense than buying.

However, the governors whose counties are set to benefit have come out strongly to question the implementation of the project, saying they were not consulted. They say the procurement was shrouded in secrecy and that they had not seen the contract between the government and the supplier.

The government insists that since the governors are not buying the equipment, they have no business dealing with the procurement process.

Doctors too, through the Kenya Medical Practitioners and Dentists Union, have argued that the counties are not yet ready for this sophisticated equipment. Their members and hospital personnel have not been trained on how to use the equipment, there is no space to fit it, and the health facilities lack resources to run the machines.


Perhaps pertinent questions that need to be asked are: Has the MES scheme or capital funding for medical equipment worked elsewhere in similar environments? How has devolution impacted this essential sector? Does equipping county hospitals amount to duplication of efforts? Who determines the counties’ priorities when it comes to financing health care? And is the deal a sustainable investment?

The governor, doctors, and government all have different opinions, but there are parts of their argument that have remained consistent over the past few weeks. Most importantly, though, is what does the end user have to say about the whole idea?

Doctors are not pleased with the way the counties have handled the health sector — with blatant ineptitude and little concern. They have cited cases of delayed salaries and suggest that the sector be taken back by the central government.

The biggest debate should not be on whether the central government should determine the priorities in health care financing or whether county governments should focus on service delivery.

Will these efforts lead to good healthcare for Wanjiku? Will this mean that Kenyans can get access to better healthcare equipment at a lower price? Will it save them from walking long distances in search of treatment?

Having the voice of Wanjiku in this debate is the only possible solution. Though the ongoing debate is healthy, someone needs to talk to the people. Let the people’s voice be heard.