By Juliah Atieno
Despite Kenya setting the stage for major heath sector improvements with a strategic focus guided by Vision 2030, the burden of ill-health continues to be felt nationwide, particularly among the urban poor. Mukuru belt has the largest slum settlements in Nairobi encompassing kwa njenga, kwa Ruben, Viwandani, Sinai and Fuata Nyayo and was declared a Special Planning Area (SPA) in August 2017 because residents not only faced constant evictions but also did not have access to basic services at an affordable cost. Often, they were paying five times as much as the residents of formal areas for health, water, sanitation and education services. Being declared an SPA paved the way for the creation of an Integrated Development Plan for all sectors through a participatory process that was community led. One of the main objectives of the SPA is devising ways to promote the health and safety of Mukuru residents.
Adequate, affordable, reliable and well accesible heath services is still a challenge in the entire Mukuru belt. There are utmost four health facilities that receive government support here, two of which are state owned health facilities. One located in Viwandani and Imara Daima each, one of which is a dispensary, while the other is a Health Centre. Currently the two facilities do not provide a 24 hour service for all the residents, they only provide outpatient services and limited emergency care. The Mukuru Health Centre provides maternity care for normal deliveries, laboratories, oral health and referral services. In addition, the Health centre has small number of health workers and at times patients are reffered to private facilities due to lack drugs.
The majority of residents in Mukuru get their health care from private facilities especially the youth who decry lack of youth friendly services in these public health facilities. Most of the youth fear being attended to in these facilities due to fear of being wrongly judged by some of the health workers who are so cruel and never ready to listen and understand.
The Community Health Volunteers who work under NGOs with support from the goverment also face challenges. These include inadequate numbers of workers to meet the needs of the population they have to cover, interrupted supply of commodities, lack of access to specialized services, inefficiency and ineffectiveness of among other health care staff and lack of facilitation and motivation from the ministry of health. There is a burden of cholera outbreak, because of poor sanitary conditions and unreliable garbage collection, which should be considered an urgent issue according to some of the CHVs.
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