Audit show hospitals ill-equipped and understaffed

With the advent of devolved units and decentralisation of the health sector, many expected services will improve.

But a report by the Office of the Auditor General paints a grim picture  at the Level 4, 5, and 6 hospitals. Less than half of the 184 Level Four hospitals audited offer essential services surgery, paediatric, gynaecology and radiology.

The 2023/2024 audit on 147 Level 4 hospitals revealed that they had 278 newborn unit incubators and cots against the required 1,360.

The report noted 176 Level 4 hospitals had a collective requirement of 17,776 healthcare workers, but only have 5,687 staff.

According to the Kenya Quality Model for Health, the recommended capacity for the level is 101 per hospital, including 16 medical officers, two anaesthesiologists, two general surgeons, two gynaecologists, two paediatricians, two radiologists, and 75 nurses, alongside other essential professions.

A majority of the hospitals were also below the recommended 150-bed capacity, with 126 Level 4 facilities having 6,231 beds compared to the required 18,900.

Level 5 hospitals also experience staff shortage.   the audit reveals the standard requirement is that it should have 50 medical officers, 7 anaesthesiologists, four General Surgeons, four Gynaecologists, four Paediatricians, four Radiologists, and 250 Kenya Registered Community Health Nurses, among other professions.

Garissa County Referral Hospital, as per the audit, has 67 staff in place with a shortage of 256. Samburu Teaching and Referral Hospital has 130 staff and a shortage of 193.

“Data collected from ten (10) hospitals, which required 3,230 healthcare workers, showed that they only had 2,023 staff, resulting in a shortfall of 1,207 workers,” read the audit in part.

The audit revealed that nine Level 5 hospitals had 32 functional Intensive Care Unit beds against the required 76. Additionally, ten hospitals had 28 High Dependency Unit beds against the required 120 beds.

Mbagathi County Referral Hospital has zero ICU beds, Nyeri County Referral Hospital one, Pumwani Maternity Hospital does not have, Embu Level 5 hospital has only six ICU beds, Garissa 6, Isiolo County and Referral Hospital 2, and Jaramogi Oginga Odinga Teaching and Referral Hospital 6.

The report noted that according to the Kenya Quality Model for Health checklist for Level 5 hospitals, a Level 5 hospital should have, among other equipment, 12 functional ICUs, 12 functional HDUs, 7 operational theatres, and a newborn Unit with 10 Incubators.

Embu Level V Hospital has no HDU beds, Machakos Level 5 Hospital has two, Mbagathi County Referral Hospital has no available HDU beds, and Pumwani Maternity Hospital has zero.