In actualizing the government’s commitment to the attainment of universal health coverage for essential services through the ‘BIG FOUR’ agenda, healthcare providers (ministry of health, private sector, faith-based organization among others) must play to a crucial role in strengthening the primary health care (PHC) system. This resolution is with respect to the Kenya Health policy (2014-2030) whose aim is to “support the provision of equitable, affordable and quality health and related services at the highest attainable standards to all Kenyans” aligns with the goal of the Primary care network (UHC-PCN PROJECT).
The primary health care system has three indispensable components: (i)meeting people’s health needs through comprehensive promotive, protective, preventive, curative, rehabilitative and palliative care throughout the life course, (ii)systematically addressing the broader determinants of health (including social, economic and environmental factors, as well as individual characteristics and behavior) through evidence-informed policies and actions across all sectors, (iii)empowering individuals, families and communities to optimize their health, as advocates of policies that promote and protect health and well-being.
Role of Private Sector i.e. Gertrude Hospital
The ministry of health is actively developing an improved primary healthcare strategy through a collaboration of public hospitals and private hospitals so as to increase access to healthcare and promote health equity,
A massive injection of resources from donors, who forms the not for profit private sector, allow access to the would-be too expensive medical equipment to the general public. Moreover, the donors could provide basic needs to the poor such as food, clothes, shelter and education scholarships that have all been known to have an incremental benefit to the health and wellbeing of the community.
The higher supply of healthcare workers in the private sector as compared to the public sector alludes that the private sector has a larger capacity to disseminate professional and specialist advice to a bigger population than their public counterpart that would play a crucial role in achieving the primary healthcare strategy.
Gertrude hospital promotes primary health care synergistically with the surrounding public hospital. For instance, having state-of-art diagnostic equipment, a patient in a local hospital where the magnetic resonance imaging (MRI) scan is not working efficiently or unavailable can be sent to Gertrude hospital and the diagnostic results mailed to their healthcare provider in public hospital.
Additionally, Gertrude hospital engages on free exchange of information on a particular topic or issue with the public hospitals for the mutual benefit of the community for instance through hospital pharmacists association of Kenya (HOPAK) pharmacists from both the private and public hospitals engage in forums and conferences on how to best serve the community and any issue regarding safety profile and efficacy of drugs.
Being a renown children hospital, Gertrude hospital receives referrals from lower institutions in public sector such as dispensaries and health centers to optimize healthcare service delivery. Also, for cases which prove too complex for Gertrude hospital to handle or manage efficiently it does refer them to Kenyatta National Hospital for further treatment.
For previously undiagnosed retro positive patients presenting with another illness after management of the illness they must be sent to public hospital where their antiretroviral therapy is issued. The level 5 or level 4 hospital can further encourage them to join program in the neighboring health centers and dispensaries for a closer monitoring of medication. This is especially so in the case of HIV/AIDS patients.
Role of Faith-based Organization i.e. Kikuyu Hospital
Faith-based organizations (FBO) refer to nonprofit organizations with or inspired by religion or religious beliefs. Currently, they account for up to 40% of healthcare services in Sub-Saharan Africa. They often have a good understanding of the local context, deliver higher quality services, provide energy and resources, contribute to consensus-building, speak out for the disenfranchised and connect local communities with higher authorities. They have close links to communities and a stronger influence over them. This provides them with an ideal opportunity to promote social and behavioral change communication and address other cultural factors contributing to high child morbidity and mortality.
FBOs focus on the moral compass of the community and as such may mitigate the spread and transmission of diseases especially those geared by promiscuous behaviors for instance premarital sex and the spread of HIV/AIDS. It is worth noting that FBOs play an enormous role in providing health information and health care in Kenya since they are often the most respected and trusted health care providers in communities of all sizes. The vast religious infrastructure in many countries can make it possible to mobilize large numbers of people to take individual responsibility towards the realization of universal health coverage by tailoring the desired message to the faith-based organization.
The faith-based organization thus has an impact on all the eight components of primary health care but even more principally to the promotion of mental, emotional and spiritual health; provision of essential drugs, family planning, maternal and child care; immunization; prevention and control of locally endemic diseases.
Kikuyu hospital interacts with other public institutions through referrals from neighboring lower institutions such as dispensaries, level 2 and health centers, level 3 or even subcounty hospital as the hospital is accredited with better management of eye diseases. Kikuyu hospital can also refer patients to higher institutions such as Kenyatta National Hospital where more specialized healthcare services are required.
For patients presenting with disease conditions that can be easily managed in public hospital and lacking the financial resources to foot the Kikuyu hospital bill they can be referred to these public hospitals to ensure a more cost-effective primary healthcare plan.
Like private hospitals, FBO i.e. Kikuyu hospital do not issue out antiretroviral drugs for management of HIV/AIDS and therefore any positive diagnosis must be sent to the public hospitals which enroll and maintain the patient to their antiretroviral program.
Kikuyu hospital have a health week in which they offer free screening of chronic conditions such as diabetes screening, breast cancer screening, free computerized eye screening and checking of blood pressure which all play a crucial role in early diagnosis of most chronic diseases and therefore offer better prognosis. Following these screening and diagnosis, patients are given appointments to Kikuyu hospital or even referred to lower or higher institutions depending on their health needs.
Being a FBO receiving good trust from the public, Kikuyu hospital can join the public sector in shedding light the role of vaccination in prevention of disease especially the controversial vaccination of 9-year-old girls against Human Papilloma virus which could cause cervical cancer.