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Kenyatta National Hospital in Nairobi is the country’s major hospital. Other hospitals include Mombasa Hospital and Aga Khan Hospital, and private hospitals include Nairobi Hospital, Karen Hospital, Diani Beach Hospital and the Mater Hospital.
In 2014 a new collaborative strategy aiming to provide health insurance for the poorest families of Kenya began its first phase. The Kenyan government hopes that its successful implementation can provide subsidies for inpatient and outpatient health care for those in need across the country. The World Bank has lent support in the form of US$20 million.
The Kenya Health Policy 2012–30 aims to attain a consistently high standard of health care service that responds to the specific needs of the Kenyan population.
Communicable diseases along with maternal, perinatal and nutritional conditions in Kenya accounted for an estimated 63% of all mortality in 2012. The prevalence of HIV in Kenya, as a percentage of people aged 15–49 years, was 6% in 2012. In the period 1990–2013 the prevalence of HIV rose overall and it is now approximately twice that of 1990, although it has been falling since a peak in the mid-1990s. Between 2002 and 2011 the number of confirmed cases of malaria rose significantly, whereas confirmed deaths from the disease fell in the same period, with the most dramatic decline occurring since 2010. Estimated incidence of tuberculosis (TB) almost doubled overall in the period 1990–2013, whereas estimated mortality (when mortality data excludes cases comorbid with HIV) has remained the same overall in this period, despite some fluctuation. Non-communicable diseases (NCDs) in Kenya accounted for an estimated 27% of all mortality in 2012. In 2008 the most prevalent NCDs were cardiovascular diseases (9%). Cancer, diabetes and non-communicable variants of respiratory diseases contributed 7%, 2% and 1% to total mortality, respectively (2012).
The rate of infant mortality in Kenya was 37 deaths per 1,000 live births in 2014, with an under-five mortality rate of 71 deaths per 1,000 live births in 2012. Following a gradual increase in the 1990s, and since peaking in 1997, the under-five mortality rate in Kenya has been decreasing. Although this decrease is encouraging, the under-five mortality rate is still a long way off the country’s target of 33 deaths per 1,000 live births, as defined by Millennium Development Goal 4 (MDG 4).
Kenya’s public spending on health was 1.8% of GDP in 2013. In the most recent survey conducted between 1997 and 2011, there were 18 doctors, and 79 nurses and midwives per 100,000 people. Additionally, in 2009, 44% of births were attended by qualified health staff and in 2013, 93% of one-year olds were immunised with a dose of measles. In 2014, 63% of people were using an improved drinking water source and 30% had access to adequate sanitation facilities. The most recent survey, conducted in the period 2000–11, reports that Kenya has 16 pharmaceutical personnel per 100,000 people.
Only a third of health care in Kenya (38%) was government funded in 2012. The remaining 62% was paid for by patients or funded by other non-governmental entities, such as private insurers, charities or employers. Total health expenditure constituted 4.7% of GDP in 2012.
Kenya was not an original signatory to the International Covenant on Economic, Social and Cultural Rights, but acceded to it in 1972 and has written the covenant into law. It includes ‘the right of everyone to the enjoyment of the highest attainable standard of physical and mental health’. The covenant commits signees to providing healthy and hygienic environmental conditions, controlling epidemic diseases, improving child health and facilitating access to health services without discrimination.
Pharmaceutical companies are a large part of the medical and health care sector in Kenya. Well known pharmaceutical manufacturers and distributers include DAWA limited, and Sai Pharmaceuticals; both are located in Nairobi.
Kenya is the largest producer of pharmaceutical products in the Common Market for Eastern and Southern Africa (COMESA) region (Kenya Association of Manufacturers, 2013). In 2010 pharmaceutical products represented USD$1.38 million worth of Kenyan exports, equivalent to 0.02% of Kenya’s total annual exports. Imports of pharmaceutical products made up 0.11% of all imports for the same year, totalling $9.6million (Observatory of economic complexity, 2010).
The local pharmaceutical industry in Kenya consists of three segments, namely manufacturers, distributors and retailers. Public sector procurement in Kenya is both centralised and decentralised. Centralised procurement falls under the responsibility the Kenya Medical Supplies Agency (KEMSA), which is the primary public procurement agency for pharmaceutical and related products.
For public distribution of pharmaceutical products in Kenya there is a government central medical store, with eight public warehouses. While national guidelines on good distribution practices have been produced there is no licensing authority that issues good distribution practices licenses. As such a list of good distribution practices-certified wholesalers and distributors does not exist (WHO, 2010).
Pharmaceutical research companies in Kenya include international researchers, Quintiles. Research undertaken by Quintiles in Kenya includes initial research, clinical development, and clinical research trials.
The Kenyan Medicines Regulatory Authority (MRA) is responsible for the regulation of pharmaceutical products, companies and suppliers in Kenya. All pharmaceutical products are required to go through stringent market authorisation and regulatory inspection measures. As well as this legal provisions are in place in the country to regulate imports, licensing, quality control, marketing and clinical trials (WHO, 2010).