The menstrual health edition

We know female students need pads to stay in school, so why haven't we fixed their annual distribution 13 years since the government launched the sanitary towels program? We may also be on the verge of an anti-retroviral (ARV) drug taken only once a year and we have another 50+ day strike on our hands.

Here are the main stories in public health this week:

• Clinical officers demand sh3.5bn to end strike
• Health CS unveils new healthcare reforms
• Chinese firm battles government over HIV testing kits

SPOTLIGHT

Healthcare funding in Kenya: counties at a glance

In our last edition, we highlighted the influx of cash from various initiatives alongside money owed by the government to doctors, clinical officers and nurses. Here's how different counties are utilising funds for healthcare.

Tharaka Nithi County

Tharaka Nithi County has allocated Sh1.7 billion for the health department alone to help Governor Muthomi Njuki’s administration achieve his manifesto. Most of the funds will cover salaries while the rest caters for developments like building ICUs in every Level Four hospital within the County.

Budget Committee Chairperson Murithi Gaturo appealed to the National Treasury to disburse county funds on a timely basis. “Most of county staff have stayed for over three months without salaries. There should be efficient and timely release of county monies to ensure smooth running of counties."

Elgeyo Marakwet County

World Vision and partners are investing a combined Sh803.4 million to impact over one million people in Elgeyo Marakwet County over the next decade through the Global Affairs Canada-funded REACTS (gender equality focus) and ENRICH (maternal & child nutrition focus).

The timely projects will also address teenage pregnancy at 12% in the county compared to the national average of 15% and domestic violence against women at 30% compared to the national average of 34%, according to Kenya Demographic and Health Survey 2022.

Elgeyo Marakwet Governor, Wisley Rotich, expressed gratitude for the investment, “With poverty rates at 46% in Elgeyo Marakwet, access to food is a significant challenge, leading to alarmingly high malnutrition rates among our children. Through these pivotal projects, we anticipate a major shift that empowers families to access sufficient food and lead more stable lives."

Kirinyaga County

Since South Ngariama Health Center was opened in October 2023 by Governor Anne Waiguru:

• 250 women have sought antenatal clinic services versus 229 in 2022.
• Postnatal clinic attendance has risen to 359 mothers versus 107 in 2022.
• 658 women have accessed family planning services at the facility.

“Mothers used to journey from South Ngariama to distant locations like Kiumbu, Murinduko, Gathigiriri, or Kimbimbi. The 51 deliveries we’ve conducted would most likely have ended up as home births were it not for this facility. We aspire to achieve zero home deliveries” Evelyn Kahare, the Nurse-in-charge proudly said.

Knowledge exchange among counties on existing infrastructure for different public health issues could end glaring systemic issues so we can focus on innovation. Urgency is imperative.

HEADLINES

The week's main stories

• Clinical officers demand Sh3.5bn to end strike: They accused the government of laxity in developing a workable return-to-work formula as they did with doctors and their plan to absorb Junior Secondary School teachers. “We are not happy to dance in the sun in Bungoma county. We are here because today is the 60th day of our strike,” Peter Wachira, the Kenya Clinical Officers Union Chairperson said.
• Health CS unveils new healthcare reforms: The government has trained over 100,000 community health promoters through a nationwide network of 10,000 Community Health Units, is rolling out cervical cancer screening through Pap smears and visual inspection methods, and exploring community-based HPV self-sampling.
• Chinese firm battles government over HIV testing kits: Guangzhou Wondfo Biotech Co Ltd has sued Health Cabinet Secretary Susan Nakhumicha and Attorney-General Justin Muturi for allegedly wrongfully classifying its HIV testing kits as substandard, resulting in the firm losing the tender aimed at launching a new testing algorithm. The new algorithm requires specific three-test algorithms for both general and antenatal populations to speed up the HIV detection process and save lives.

INSIGHT

Women Reps to take over sanitary towels program

“In this era we should not be having children miss classes because they cannot have access to pads”- Agnes Catherine Okello, parent at Orwamuge Primary School

Yet Mr Charles Dickens Owinyi, district education officer of Abim, says at least 86% of girls in Karamoja don’t finish primary education. Awach Primary School didn’t have a water facility 50 years after its establishment until Absa Bank Uganda and World Vision partnered to build one.

Closer to home, County Women Representatives will now oversee Kenya's free sanitary towels for school girls programme. Over the years, the programme has rotated in various ministries but none seemed to get consistent distribution right. Right now the programme is shifting from the Ministry of Education to the State Department for Gender. What will be different this time?

NGAAF CEO Roy Telewa says, “Women members of Parliament, who advocate for menstrual hygiene can amplify their voices more effectively. The Ministry is developing a framework based on the number of schools in each county, which has been the basis for previous distributions.” In his opinion, the discrepancies in the number of girls receiving pads have been more of a budgeting problem.

The sanitary pads programme was rolled out in 2011 and women representatives were first elected in 2013. In May 2019, Janet Mbugua filed a petition demanding MPs to implement the Menstrual Health Management Policy to ensure the distribution of sanitary pads. Her Inua Dada Foundation, established in 2013, received a sh.15 million grant from USAID in 2023 to fight period poverty. Let's see what the women representatives can accomplish with a budget of sh.940 million and their voices.

Learn more about the World Menstrual Hygiene Day here.

PAUSE

NEWS

What else we learned

• Gladys Njaka from the Catholic Medical Mission Board says community health promoters have significantly increased Tuberculosis contacts referred to health facilities, rising from 65% in 2022 to 77% in 2023. The government is urged to allocate more resources for training CHPs after the successful pilot programme was conducted in Makueni and Migori counties.
• A group of scientists at the University of Nebraska Medical Centre in the US discovered a novel anti-retroviral (ARV) drug taken only once a year. Led by Kenyan Professor Benson Edagwa, the team desired a drug that replaces the daily reminder of living with HIV for patients.
• Only three African countries have eliminated malaria; Algeria, Mauritius and Cape Verde while the current prevalence in Kenya is 6%. UNICEF, in partnership with the Gavi Vaccine Alliance, has commenced the distribution of a new malaria vaccine for infants, R21.

QUICK

One-liners

• Jubilee Health Insurance launches program that allows teleconsultation [Business Today]
• Menstrual hygiene fete brings hope to Samburu [The Standard]
• Kenyan startup Thalia Psychotherapy awarded at VivaTech 2024 in Paris [KBC]
• Hope for patients as once-every-two-months ARVs show promise [The Star]

REGION

What's happening next door?

[UG] Dr Aceng urges world to raise commitment to pandemic preparedness [Nile Post]

[UG] Govt to enforce ban on Traditional Birth Attendants (TBAs): Dr Richard Mugahi, the Acting Commissioner for Reproductive and Child said some TBAs don't use gloves thus spreading infections. However, Dr Angela Akol, asks the government to consider why expectant mothers prefer TBAs given the abuse they face in some health facilities. [Monitor]

[TZ] Jubilee Allianz General Insurance supports malnourished children at Mwananyama Hospital [Daily News]

[TZ] Rukwa cuts maternal mortality rate by 17.4%: Ms Rose Kasaila, a nurse, attributed this achievement to the government's initiatives that bring health services closer to the people but called for better working conditions, uniforms and additional staffing of nurses. [Daily News]

[RW] OB-GYN residency training set to enhance maternal, child healthcare: The programme intends to quadruple healthcare worker production within the next four years to meet the WHO recommendation of at least 4 healthcare professionals per 1,000 population density. [The New Times]

[SA] A new breed – The thinking behind building a new medical school in North West province [Spotlight]

[SA] HIV treatment for kids has improved and there is more to come: Dr Moherndran Archary is part of a team running a LATA (Long-Acting Treatment in Adolescents) living with HIV in South Africa, Kenya, Uganda and Zimbabwe. They're testing whether long-acting formulations administered through injections work as well as antiretrovirals taken in tablet form. [Spotlight]

EXTRA

AI meets healthcare in Kirinyaga County

Kirinyaga County Director of Health and Medical Services, Dr. Hesbon Gakuo said,

“The AI program will assist radiographers to detect TB more accurately and curb human error misdiagnosis. It will act as an assistive device, detecting abnormalities in the lungs, such as TB, COPD, and cancer. It also encompasses integration into the digital X-ray machines as well as training of staff on use of the software.”

Read all about it here.

For every announcement of fresh funding, new programs with long names and even more detailed implementation steps, it's refreshing to see some counties walking the talk. Particularly innovating through people (Community Health Practitioners) and tech (AI).

What are your thoughts? Please share any feedback and wishing you a month full of innovation. Don't just dream it, get it done.