Kenya has a national structure designed to oversee public health, but experts warn that gaps in implementation are hampering its effectiveness.
According to Brown Ashira Olaly, Secretary General and CEO of the Kenya Environmental Health and Public Health Practitioners Union (KEH&PHPU), while the framework exists on paper, operational issues limit its ability to deliver services to communities.
"I want to thank the government that we have a National Public Health Institute," Ashira said during an interview with Radio Generation on Thursday.
"But if you look at the management of that Institute…70% of those functions are supposed to be public health oriented, but they are actually being manned by doctors who do clinical care," he added.
Ashira explained that public health functions, from policy to execution, follow a chain that starts with the Ministry of Health, through the Principal Secretary for Public Health and Professional Standards, and down to the Director General and the State Department of Public Health and Professional Standards.
Within this department, the Directorate of Public Health and Sanitation oversees environmental health and other divisions that reach county governments.
Health is devolved, but Ashira emphasized that the Ministry still sets policies, while counties implement them according to their local frameworks.
"Each county has its own structure…for example, some have a Directorate of Environmental Health, others a Directorate of Public Health. The whole idea is to have a Directorate of Public Health led by a registered public health officer," he said.
Despite this structure, Ashira identified weaknesses in financing and staffing.
"We have it in papers. But the guy managing the structure…we don't have a structure that’s fully working," Ashira stated, pointing to gaps that prevent public health programs from being effective.
At the community level, public health outreach is carried out by Community Health Promoters (CHPs), formerly known as community health volunteers.
These officers link households to healthcare facilities and provide education on sanitation, malaria prevention, and treatment adherence for diseases like tuberculosis. One CHP typically supports around 100 households.
Ashira noted that while the government has provided some incentives for CHPs, including equipment and allowances, the numbers and terms are insufficient.
"Even the 2500 being donated by the national government is not enough…They need to be given permanent and pensionable terms so that they can effectively discharge their duties," he said.
