Kenya’s health private sector is one of the most advanced and dynamic in Sub-Saharan Africa and is the main source of health care even for the nation’s poorest people. The private health sector is larger and more easily accessible than both the public and the non-profit health sectors in terms of facilities and personnel. According to a World Bank report, nearly half of the poorest 20 percent of Kenyans use a private health facility when a child is sick.
Private health facilities are diverse and cater for all economic groups. Hospitals such as the Aga Khan Hospital and the Mombasa Hospital are comparable to many hospitals in the developed world but are expensive and accessible only to the rich and the insured. Many affordable and low-cost private medical institutions and clinics exist and are easily accessible to the poor and the working middle-class.
The unlicensed practice and control of medical practice by laymen through limited liability companies and other artificial legal entities is common and widespread unlike other countries where it is strictly forbidden.
The public health sector consists of community-based (level I) services which are run by community health workers, dispensaries (level II facilities) which are run by nurses, health centers (level III facilities) which are run by clinical officers, sub-county hospitals (level IV facilities) which may be run by a clinical officer or a medical officer, county hospitals (level V facilities) which may be run by a medical officer or a medical practitioner, and national referral hospitals (level VI facilities) which are run by fully qualified medical practitioners (consultants and sub-specialists).
Nurses are by far the largest group of front-line health care providers in all sectors followed by clinical officers, medical officers and medical practitioners. According to the Kenya National Bureau of Statistics, in 2011 there were 65,000 qualified nurses registered in the country; 8,600 clinical officers and 7,000 doctors for the population of 43 million people (These figures from official registers include those who have died or left the profession hence the actual number of these workers may be lower).
Traditional healers (Herbalists, witch doctors and faith healers) are readily available, trusted and widely consulted as practitioners of first or last choice by both rural and urban dwellers.
Despite major achievements in the health sector, Kenya still faces many challenges. The life expectancy estimate has dropped to approximately 55 years in 2009—five years below 1990 levels. The infant mortality rate is high at approximately 44 deaths per 1,000 children in 2012. The WHO estimated in 2011 that only 42% of births were attended by a skilled health professional.
Diseases of poverty directly correlate with a country’s economic performance and wealth distribution: Half of Kenyans live below the poverty level. Preventable diseases like malaria, HIV/AIDS, pneumonia, diarrhea and malnutrition are the biggest burden, major child-killers, and responsible for much morbidity; weak policies, corruption, inadequate health workers, weak management and poor leadership in the public health sector are largely to blame.
According to 2009 estimates, HIV prevalence is about 6.3% of the adult population. However, the 2011 UNSAID Report suggests that the HIV epidemic may be improving in Kenya, as HIV prevalence is declining among young people (ages 15–24) and pregnant women. Kenya had an estimated 15 million cases of malaria.
Women in Kenya
The total fertility rate in Kenya is estimated to be 4.49 children per woman in 2012. According to a 2008–09 survey by the Kenyan government, the total fertility rate was 4.6% and the contraception usage rate among married women was 46%.
Maternal mortality is high, partly because of female genital mutilation, with about 27% of women having undergone it. This practice is however on the decline as the country becomes more modernized, and the practice was also banned in the country in 2011. Women were economically empowered before colonization.
By colonial land alienation, women lost access and control of land. They became more economically dependent on men. A colonial order of gender emerged where the male dominated the female. Median age at first marriage increases with increasing education. Rape, defilement and battering are not always seen as serious crimes. Reports of sexual assault are not always taken seriously.