The Kenya Medical Association (KMA) now wants the government to take charge of regional hospitals that serve several counties whose governments don't provide any input hence overburdening the host counties in the catchment areas where the facilities are situated.
Former Director Medical Services Prof Richard Muga said the group of hospitals are silent yet they have not been able to fit well in the devolved governance of the health systems.
"There is a group of hospitals that used to be called provincial hospitals. In the new dispensation of the Constitution of Kenya 2010, they have not been defined. Only Kenyatta National Hospital and the Moi Teaching and Ref-feral Hospitals have been classified by an Act of Parliament. The others have been left hanging without proper indication of where they fall and how they should be financed in the devolved health systems," he said.
Examples of teaching and referral hospitals include Jaramogi Oginga Odinga, Mt Kenya, Coast, Kakamega, Nakuru, Embu, Garissa among others.
"Counties are running to invest several millions to make these hospitals meet the state of the art criteria but still they are overwhelmed owing to inadequate resources," Muga said.
He gave an example of Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) that serves almost ten counties with an overall population of about 10 million yet it is only financed by Kisumu county alone.
"JOOTRH serves Kisumu, Vihiga, Homa Bay, Migori, Siaya, Kisii, Busia, Nyamira and Kericho. They all bring their patients here. So if you call them county hospitals and make one governor to be in charge then our health system is in trouble. It is a challenge to have regional hospitals accountable to one county which clearly indicates a mismatch,” he said.
Mr Muga cited the health workforce at the JOOTRH and other regional hospitals which currently stands at 800 to 1,000 inclusive of health professionals and non-medics.
He said these cannot meet the demands of the populations and are always overstretched.