Kenya’s malaria control systems not ready for universal care – MOH reports

This poster was only correctly displayed in seven of the 47 referral county hospitals in Kenya.

By Gatonye Gathura

Kenya’s malaria treatment systems are not ready for Universal Health Care, reveals the National Malaria Control Programme at the Ministry of Health.

Though malaria is the second top killer disease after pneumonia all the 47 county referral hospitals are ill prepared to handle malaria in inpatients.

At the same time, the ministry says nearly half of all medicines for uncomplicated malaria are distributed by unregistered and unregulated pharmacies and retail outlets many of dubious quality.

While it is a requirement that malaria treatments be done after a positive blood test only a third of such test are being achieved in the private sector.

Two reports, both involving the head of the National Malaria Control Programme, Dr Ejersa Waqo describe a system that is not ready for the proposed Universal Health Care plan.

The latest published last week, (29th May 2018) in the Malaria Journal had assessed how public health workers in 47 referral hospitals have adapted to a malaria treatment policy introduced in 2012.

The policy had replaced quinine for the treatment of severe malaria with the injectable medicine called artesunate; this in line with World Health Organisation recommendations.

Despite training of health workers across the country, distribution of free medicines, treatment guidelines and extensive support the report says serious gaps still exist even as the country plans to roll out universal health care.

For example, only seven of the 47 hospitals in the 47 counties were found displaying the new treatment guidelines as recommended.

Other researchers in this study were from KEMRI-Wellcome Trust Research Programme, University of Oxford, UK, and the Clinton Health Access Initiative.

The report shows only a quarter of the health workers are being supervised during the transition period.

The team also reports at least more than 10 per cent of children and up to a third of pregnant women with severe malaria are still being incorrectly put on quinine.

During the study period in 2016, up to 21 per cent of hospitals had no artesunate and 15 per cent were found without any injectable antimalarial in stock.

But even more important the study says only 41 per cent of the health workers dealing with malaria inpatients had received any kind of training on the new treatment protocols.

Less than two-thirds of health workers knew the proper dosage for children weighing less than 20 kg.

There was also general overuse of injectable artesunate where oral medication would have been the best.

The other study published in December in the same journal was carried out by Population Services International, US, the National Malaria Control Programme and Kenya’s Pharmacy and Poisons Board.

This study, a nationally representative survey had assessed the progress of an earlier policy requiring malaria testing before treatment in both the public and the private sectors.

The report found one in five public health facilities without the recommended malaria drugs or testing kits

Only half of the public health facilities were found with stocks for treating severe malaria.

In the private sector only one in five outlets with anti-malarials had stocked testing kits with only a third of blood tests being gone.

The researchers recommend these gaps be addressed in order to achieve universal coverage.

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