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REPUBLIC OF KENYA

COUNTY ASSEMBLY OF LAIKIPIA

FIRST ASSEMBLY SECOND SESSION

REPORT OF THE HEALTH SERVICES COMMITTEE ON THE VISIT TO

OLJABET HEALTH CENTRE AND RUMURUTI DISTRICT HOSPITAL

17TH MARCH, 2014

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TABLE OF CONTENTS PAGE

1.0 PREFACE……………………………………………………………………………………2

1.1 COMMITTEE COMPOSITION…………………………………………………………………………………………..2 1.2 MANDATE OF THE COMMITTEE……………………………………………………………………………………..2 1.3 ACKNOWLEDGEMENT………………………………………………………………………………………………….2-3 2.0 INTRODUCTION……………………………………………………………………………………………………………………………….4 3.0 OLJABET HEALTH CENTRE………………………………………………………………………………………………………………4-5 3.1 OBSERVATIONS……………………………………………………………………………………………………………....5 3.2 VISIT REVIEW………………………………………………………………………………………………………………….5-6 3.3 CHALLENGES…………………………………………………………………………………………………………………6-8 4.0 RUMURUTI DISTRICT HOSPITAL…………………………………………………………………………………………………………9 4.1 OBSERVATIONS………………………………………………………………………………………………………......9-10 4.2 CHALLENGES…………………………………………………………………………………………………………......10-12 5.0 RECOMMENDATIONS………………………………………………………………………………………………………………………13

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1.0 PREFACE

On behalf of the members of the Health Services Committee and pursuant to the provision of

Standing Order No. 191, it is my pleasure and duty to present to the house, the committee’s

report on the visit to Oljabet Health Centre and Rumuruti District Hospital.

1.1 Committee composition

The Health Services Committee comprises the following five members:

1. Hon. Beth Muchiri- Chairperson

2. Hon. Mwangi Maruga- Vice Chairperson.

3. Hon. Dann Ndegwa- Member

4. Hon. Daisy Kirigo- Member

5. Hon. John Ndiritu- Member

1.2 Mandate of the Committee.

The Health Services Committee derives its mandate from Standing Order No. 191 Clause 5.

Which directs a committee to investigate, inquire into and report on all matters relating to the

mandate, management, activities, operations and estimates of the assigned departments.

The committee looks into all matters related to the County Health services in particular County

health facilities and pharmacies, ambulance services, promotion of primary health care, licensing

and control of undertakings that sell food to the public, veterinary services(excluding regulation

of the profession), cemeteries, funeral parlors and crematoria and refuse removal, refuse dumps

and solid waste disposal.

The Health Services Committee is also mandated to make reports and recommendations to the

Assembly as often as possible, including recommendation of proposed legislation.

1.3 Acknowledgement.

On behalf of the Health Services Committee I have the pleasure to present the committee’s

report.

May I take this opportunity to sincerely thank the office of the Speaker and the Clerk of Laikipia

County Assembly for the necessary support provided in the execution of its mandate.

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The committee also wishes to thank and appreciate the firm support of the committee members

for the successful completion and compilation of this report.

The committee also acknowledges the support of the members of staff of the County Assembly

in compilation of the report.

Signed on this day …………………….of February 2014

Hon. Beth Muchiri

Chairperson, Health Services Committee

Signed…………………………………….Date……………………………………

Hon. Mwangi Maruga

Vice Chairperson

Signed………………………………..Date……………………………………..

Hon. Dann Ndegwa

Member

Signed…………………………………Date……………………………………

Hon. John Nderitu

Member

Signed…………………………………Date…………………………………..

Hon. Daisy Kirigo

Member

Signed………………………………….Date……………………………………

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2.0 INTRODUCTION

The Health Services Committee set out on a fact finding mission on the situation of the Health

Facilities in the County. The Committee led by the Chairlady Hon. Beth Muchiri set off to

Oljabet Health Centre then later on to Rumuruti District Hospital.

Upon scrutiny, the committee discovered that these hospitals had a common problem which

hampered the effective delivery of services within the areas covered.

3.0 OLJABET HEALTH CENTRE

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Oljabet Health Centre is located in Marmanet Ward of Laikipia West sub-County. The

delegation kicked off its visit to Oljabet Health Centre where Mr. David Giteri the chairperson

and Mr. Duncan Gachara the Public Health Officer welcomed the delegation to the Health

Facility.

3.1 Observations.

The Health facility was initially an old family house which was inhabited by some of the early

settlers. This facility specializes in Antenatal Care, expanded Immunization programmes, Home

Based care and TB treatment.

The facility has several members of staff some of whom are on permanent basis while the rest

are operating on temporary basis. Some of the employees are under ESP (Economic Stimulus

Package) while the rest are under Global Fund on Contract basis. There is one Clinical Officer,

three Nurses, One Lab technician, a Public Health Officer and four other casual officers.

3.2 Visit Review

Oljabet Health Facility has a large premise which can accommodate the population in the area.

However, Mr. Giteri, the Public Health Officer informed the delegation that despite the facility

having adequate spacing it lacked the ability to cater for the needs of the residents of the area but

pointed out that power supply was not an issue.

He added that the health facility has gained a lot of support from USAID and Aphia Plus which

have provided the much needed medicine for the facility. During the visit, the committee noted

that the last supply of medication was in November 2013 with the drug store being practically

empty and equipped with a few drugs such as ORS for children and Alcohol swabs. The facility

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was in dire need of attention since it lacked basic painkillers such as Buscopan for pain related

ailments.

Empty shelves at the Drug store

3.3 Challenges

1. The biggest challenge for the Health facility is lack of finances for the daily running of

the facility.

2. Lack of a backup power supply when normal supply gets cut off hence affecting normal

functions in the facility such as oxygen machines being faulty.

3. Lack of ambulances for rushing patients to other hospitals such as Nyahururu District

hospital which has better facilities for emergencies.

4. Dysfunctional machines e.g. suction machines and oxygen machine which are crucial for

the well-being of most of the patients especially in the maternity wing.

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Faulty suction and sterilizing machines

5. Unavailability of supplies such as medication. In this case, most of the patients have to

source for medication elsewhere.

6. Lack of basic facilities such as beds and some of the bedding in most of the hospitals

wards are worn out.

7. Staffing- most of the healthcare providers are operating on contract basis.

8. Poor pay for the staff and also delayed monthly payments for the staff hence

demoralizing the staff when it comes to service delivery. The delayed payments were also

due to the transition of Healthcare from the National Government to the County

Governments.

9. Lack of heating in the facility. Marmanet is a cold area yet the health center does not

have the equipment to provide heat in the wards.

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Kerosene lanterns for use as backup during power outage

10. There is Poor drainage of the Health center since the hospital was previously a house

belonging to a white settler before being converted to a health facility.

11. The laboratory is underequipped. There is lack of equipment for performing basic tests in

the facility.

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4.0 RUMURUTI DISTRICT HOSPITAL

Rumuruti District Hospital sits on 52 acres of land at the heart of Rumuruti town. The hospital

started off in 2003 as dispensary, which was later made a health center and eventually to its

current status of a District Hospital.

4.1 Visit Review

Dr. Arthur Mumelo who is the Medical Superintendent at the sub-county took the delegation

round the facility and also highlighted the key areas that needed attention.

Hon. Joseph Suge, the area MCA also joined the delegation during the review of the medical

facility. Rumuruti District Hospital has a theatre which has been set up through the CDF,

according to the superintendent the building project took 7 years to complete. The theatre still

has a long way to go for it to be completed since it requires finishing and also supply of

necessary medical equipment.

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In comparison to it is the children medical unit which was constructed in three months through

donor funding.

4.2 Challenges

1. The committee observed that there is lack of adequate spacing for the offices in the

hospital. The rooms are congested and too

small to cater for the needs of the patients.

For example the labour ward has only one

bed and therefore can only cater for the

need for one patient at a time. This

compels the staff to use the maternity

beds as labour units when such need

arises.

2. There is Lack of up to date equipment.

The machines used are outdated and of

analogue nature thus posing a challenge

in timely service delivery. Lack of enough

equipment is also a setback for the hospital for instance, the facility’s lab has only one

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microscope yet there are many tests that need to be carried out on a regular basis. The

facility lacks equipment for basic tests such as Bio-chemistry tests and blood count tests.

Patients have to be referred to Nyahururu District Hospital for such tests. The hospital

has a total of 3 computers which are not adequate for use in the entire hospital.

3. Lack of frequent water supply.

Considering that water is a basic need,

the facility lacks frequent water

supply whereby it experiences

shortages at certain intervals.

4. Financing for the health facility. The

money that the hospital generates is

ploughed back into the facility to help

in the management of the hospital

needs e. g supply of medication which

is not at all times adequate for the

hospital needs.

5. Corruption has hampered the cash generation of the hospitals income. This is due to the

lack of an electronic payment system forcing the hospital to use receipts that are hand

generated which in turn provides a loophole for those in the finance docket to cash in on

the finances.

6. Lack of community sensitization on the benefits of NHIF cards. Only the rich have the

NHIF cards yet it proves a beneficial way for hospital payment. Most of the locals have

not been sensitized on the benefits of the scheme.

7. Lack of some of the critical medication that is crucial for health e.g. basic antibiotics such

as penicillin, malaria drugs and anti-rabies vaccine are unavailable at the facility.

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8. Periodical Supply of Medication is also a major issue. Due to the transition process,

KEMSA has been unable to frequently supply medication to the hospital prompting the

facility to depend on support from USAID.

Inset from the left, the children’s medical wing and the CDF constructed theatre wing.

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5.0 Recommendations

Due to need for a healthy County, the County government should ensure that the

hospitals should have a frequent supply of basic medication in a bid to meet patient’s

needs.

The County government should ensure that the hospitals within the County are equitably

staffed in order to cater for the high number of patients.

Maternity health in the County is in deplorable condition and the government should

construct and equip hospitals with basic machines to address maternity and general health

needs in the County.

The County should look towards automating health facilities to discourage corruption and

promote efficient collection of funds in hospitals.

Due to the fact that most hospitals are underfunded, the government should equitably

distribute finances and resources to such facilities to enable them to be self-sustaining.

The county could look at the possibility of having measures to install generators or solar

power lighting system to provide power back up supply to those health facilities that do

not have back up supplies. This will help to avoid bringing the equipment to a standstill

once power goes off in turn saving patients’ lives.

Community Health Workers need to be motivated and facilitated since they help the

individuals in the communities on awareness of the benefits of healthcare and they also

help them access healthcare e.g. They encourage expectant mothers deliver in hospitals

rather than at home where there are better facilities.