Mathari hospital equipment failure blocks care for 82,000 patients

A failure in key medical equipment, including a CT scanner, disrupted care at Mathari National Teaching and Referral Hospital and denied thousands of patients access to inpatient services during the 2024/25 financial year, new disclosures show.

The breakdowns contributed to an estimated 82,000 patients missing admission slots, even as demand for mental health services continued to rise at the country’s only public psychiatric referral hospital.

Mathari National Teaching and Referral Hospital serves as Kenya’s sole national facility for specialised mental healthcare. In recent years, it has widened its scope beyond inpatient psychiatric treatment to include outpatient services such as counselling, psychotherapy, pharmacy services, physiotherapy, orthopaedics, laboratory testing, rehabilitation, dental care and general outpatient clinics.

Data from the National Treasury indicates that the hospital handled 228,700 inpatient admissions against a planned target of 310,418, representing a 26 per cent gap between demand and actual service delivery.

Outpatient services also fell slightly short of expectations. The facility recorded 181,212 visits compared to a target of 192,453.

A major challenge during the period was the failure of imaging equipment, including a CT scanner and radiology systems. These tools are essential in mental healthcare because doctors must first exclude neurological or other medical conditions that may present as psychiatric symptoms.

Without reliable diagnostic services, patient evaluation and discharge processes were slowed down. This led to longer hospital stays, with the average inpatient duration rising to 50 days, above the intended target of 46 days.

The situation reflects wider weaknesses in the health system. The 2024 Kenya Health Facility Assessment found that only 61 per cent of hospitals across the country had adequate equipment to deliver effective care. Earlier findings from audits of Level Four hospitals showed that just 35 per cent consistently had a working X-ray machine.

Funding pressures also weighed heavily on Mathari Hospital during the financial year. The facility received Sh1.05 billion, far below its stated requirement of Sh3.6 billion.

The budget gap forced administrators to spread limited resources across competing needs, including equipment repairs, staff salaries, essential drugs and day-to-day operations.

Despite the operational challenges, demand for mental health services continues to grow. National clinical guidelines estimate that one in every 10 Kenyans is affected by a common mental health disorder, yet access to services remains limited.

Mental health care is currently available in only 29 of the 284 Level Four and above hospitals across the country.

The shortage of specialists further worsens the situation, with 17 counties reporting no psychiatrists at all. As a result, all patients requiring inpatient psychiatric care are referred to Mathari, regardless of their condition or distance from Nairobi.

The hospital itself is under pressure, handling about 64,000 inpatient cases annually while operating with just 366 staff members, far below the recommended 1,416, leaving significant gaps in service delivery capacity.