Country Profile

Kenya

Health Pomotion Developments in Kenya

by Francis Namisi

 

Key Indicators for Kenya, a Developing Country (1998 statistics)

Gross National Product: $320 per capita

Population: 28-30 million

Health status trends: life expectancy 55 years (male 54 years; female 57 years)

Population with safe drinking water in home or easy access: urban 74%, rural 43%

Adequate excreta disposal facilities: urban 69%, rural 35%

Health service: birth attended by trained personnel 45%, women using family planning 33%

 

All African countries have reported a shortage of finances and personnel as obstacles to health promotion. Kenya is no exception. However, the country has mede deliberate efforts to address these problems. Three important principles are taken into account by the Ministry of Health to realize the objective of achieving "Health for All" by the year 2000:

  • Achieving cost-effectiveness and the promotion of health awareness, as individuals and communities are taking greater responsibility for their own health.
  • The belief that responsibility for health provision rests solely with the Ministry of Health must shift toward one that focuses on the responsibility of the individual.
  • With limited government resources for sufficient distribution of health services, those that exist need to be reallocated away from curative to preventive programs, such as environmental health, health education and promotion, reproductive/maternal/child health, and communicable disease control.

 

Structure of Health Services

Kenya is devided into prvinces, districts, dividions, locations and sublocations. The eradication of poverty, illiteracy and disease in all these areas has been a mandate since independence in 1963. Some of this is reflected in primary health car today. Projects and programs through the Ministry of Health include those that promote community-based health care; reduce infant mortality, improve immunization services; increase family planning acceptance; establish mental and dental car services; and strengthen programs for environmental sanitation. An expansionist strategy has seen growth in the number of health centers and hospital beds. In addition, a Division of Health Education (DHE) in the Ministry of Health now exists, and 42 districts have Health Education offices. Educational activities focus on materials production, mass media liaison, shool health, HIV/AIDS, and support and training at the Kenya Medical Training Center.

The operations of the DHE have not been guided by any health promotion policy. However, recently, through collaboration with John Hopkins University and the National Sexual Transmitted Infections control program, the division has drafted a National Health Communication strategy document. Once published, this document will provide guidelines for all future health education and preventions interventions in Kenya. Also, through the government's Health Sector Reform program, the role of the DHE has been recognized as a strategic component in facilitating health development in the country.

 

Educational Programs for Health Promotion

Health education/promotion programs are provided mainly through certificate and diploma courses offered at the Kenya Medical Training College. At Moi University, a diploma and masters degree in health promotion will soon available. In addition to the Division of Health Education, the Health Education Network (HEN) exists and is comprised of government, non government organizations, private individuals, and institutions. Constraints on this wide network of health education have included:

  • lack of planning;
  • inadequate resource;
  • no specific health education policy
  • weak coordination of Health Education and Promotion (HEP) interventions;and
  • lack of research-based HEP interventions.

Some future plans include the re-orientation of the whole HEP organization; strengthening the divisional represantatives at policy level; launching the National Health Communication Strategy; capacity building; restructuring the Division of Health Education for accountability; development of an inventory of HEP interventions; and implementation of research-based interventions to improve professional advocacy.

 

Successful Application

The health promotion concept and its application are gaining more recognition in Kenya than ever before. One such initiative is the innovative Community-Based Education and Service program (COBES) at Moi University. It emphasizes community health studies and the participation in health delivery activities at selected health centers for students being trained as doctors. This attachment to the general primary care training is to expose the physician-trainee to more than a conservative, hospital-based medical focus.

There are numerous challenges to the widespread development of the health promotion concept and its application in Kenya, however with implementation of the current Health Sector Reforms in the country, there is more optimism for future development.

 

Mr. Namisi is a project manager for the African Medical and Research Foundation (AMREF) overseeing HEN and the current president of the All African Health Education/Promotion Network (AAHEP) for the Anglophone countries. He may be reached at P.O. Box 30125, Nairobi, Kenya, phone: 254 2 504661, fax: 254 2 506112

 
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