Healthcare Systems and Their Structure

Constantly under review and scrutiny, the issues on healthcare Systems have become international.

Made up mainly of organizations and individuals, these healthcare structural systems are designed to meet a target population’s need for health care. On an international level, there is a diverse variety of health care systems. In some countries the planning of the health care systems are market driven and participated in by the private sector. In other countries the systems are composed of government and non-government entities such as religious groups, trade unions charities and or other coordinative bodies that are centrally run and planned, to enable the delivery of healthcare services to the populations they target. In other words, health care planning has evolved.

According to a World Health Organization report in 2000, the main goals of health systems are the ability to provide a responsive health service alongside considerations of fair financial contributions. In order to appraise overall health care systems, a proposed two-dimensional approach was conceived. The first dimension consists of equity and the second is composed of efficiency, quality and acceptability.

Several proposals have come from the Senate in the United States and the White House. Health care system issues according to President Obama are issues that should be addressed immediately and placed them on a top priority list. A universal health care system does not exist or is practiced in the United States. Some countries subsidize their universal healthcare directly from government coffers. This kind of universal healthcare is called socialized medicine, which is a combination of private and public delivery systems, with most countries spending public funds for this service delivery. Government taxes plays the role of funding this system supplemented and strengthened with private payments.

The World Health Organization (WHO) report of 2000 ranks each member country’s health care system. Discussions on the positive and negative aspects of replacing health care systems with insurance systems use this report’s quotation. However, the WHO has remarked that as ranking healthcare systems is a complex task, these ranking tables will no longer be produced. Infant mortality and life expectancy are two main variables that are used in the ranking. Out of 198 countries, Canada ranks thirtieth and the US ranks thirty seventh. The World Health Organization ranks France, San Marino, Italy, Andorra, Singapore, Malta, Spain, Austria, Oman and Japan as the world’s top ten.

With the founding of the UN (United Nations), there was planning and discussion on the need for a single entity to serve, observe and assess global health care system trends. Thus the World Health Organization was formed in 1948 on April 7th with headquarters based in Geneva, Switzerland. Annually the WHO is recognized by the celebration of a World Health Day. The WHO is the coordinative and directive authority for United Nations’ member countries individual health systems. Member countries of the United Nations are allowed WHO membership through the acceptance of the WHO constitution. To date there are a total of 198 member nations participating in WHO programs.

Local Healthcare Systems in Kenya

The public health system in Kenya is in dire state often marred with cartels, corruption, strikes by doctors and nurses, inadequate medical supplies, high maternal and child-mortality rates, long waiting times and poor access especially in marginalized areas in northern and eastern Kenya. Despite efforts to transform the healthcare system, no significant progress is evident with the exception of a vibrant private health sector.

Although you may need to dig deeper into your pocket, you are better served in private health facilities than in public ones in Kenya. The Kenyan government needs to get its act together to not only provide universal healthcare for all, but to ensure accessible, affordable and acceptable quality healthcare in its public sector.

Structure of Health System

The structure of health systems is designed in such a way that basic primary care is offered at lower levels while complex cases are being referred on higher levels. From the lowest level, the structure includes:

Health dispensaries and privately-owned clinics – Offering outpatient services for minor ailments like colds
Health centers – Catering to cases referred by clinics and dispensaries
Nursing homes and sub-district hospitals – Offering secondary care
District and private hospitals – With resource capacity to offer comprehensive medical services
Provincial hospitals – e.g., Rift Valley Provincial Hospital, etc., with capacity to offer specialized care such as life support
National Hospitals – Such as Kenyatta National hospital and Moi Teaching and Refferal Hospital-offers third level care
Privately-run and mission hospitals – Function to fill in gaps left in the health system

The highest percentage of resources and time in the Kenyan health system is spent treating:

HIV/AIDS
Tuberculosis
Malaria
Pneumonia
Road accidents
Diabetes

Options of healthcare for locals and foreigners

Other than the public health system, varied healthcare options are open for locals and foreigners.

Herbal Medicine

Herbal medicine, a form of alternative medicine, has played an important role in promoting health among Kenyans in rural and urban areas and across the social classes. From treating flu and acne, to complex diseases such as arthritis, diabetes and high blood pressure, etc., herbal medicine is central in health promotion in Kenya. Although issues of safety and efficacy have been cited, herbal medicine remains a major healthcare option for locals and foreigners.

Private Health System

This attracts the largest percentage of patients and clients given the deplorable state of the public health systems. Despite the high charges, many even those who cannot afford prefer this system because of:

Ease in accessibility
Quality health services
Availability of adequate medical services
Limited delay and waiting times

Dental Health

Dental health in Kenya is in poor state given the limited number of dental specialists and limited public awareness about the importance of oral health.

A mere 0.0016% of the health budget is allocated to oral health
More than 90% of adults have a gum condition
Decayed, filled, broken and missing teeth is a norm among Kenyans
Less than 5% of Kenyans access dental health
Dental health is a privilege of the middle and upper classes, and the fact that dental health insurance is costly, and that a majority of dental clinics and specialists are located in urban areas, does not help matters

Cosmetic Coverage / Aesthetic Medicine

A third-world nation it may be but Kenya is not left behind in embracing aesthetic medicine. Often offered by private hospitals, procedures in aesthetic medicine are registering increased number of clientele. From BOTOX, liposuction and facial chemical peels to mesotherapy and breast implants, cosmetic coverage in Kenya is sizeable and growing.