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"content": "when you talk about people with special needs that these are individuals with additional health needs and require assistance above the regular health needs at the general population. We are here referring to the people with mental illness, which are additional needs. We are talking about people who are psychologically challenged, marginalized and the disabled. There is a whole clarification of people with needs. When these people with special needs are pregnant, other than the fact that they could visit the health center, who follows them to ensure that they are getting the services that are required of them? Often in our urban centers, even small markets, you see even those who have mental challenges. By local standards, people call them mad for example, a mad woman but they are human. They get pregnant. Who ensures that this woman attends all her clinics? Who follows up on these special needs groups to ensure they visit the hospital for the entire period? This Bill talks refers to this group of people with special needs. In Clause five, Part Two, we are talking about the right to health services. I emphasize that this right, intimates that the services must be timely and appropriate to the person in need. The person must be treated in our health centers and health facilities with dignity, respect and privacy. Some of the rights to health services in this Bill include emergency treatment and essential medicine. They must be entitled to an attainable state of mental and physical health. This right to health services includes promotive, preventative, rehabilitative, and curative care. All these are spelled out in Clause Five. For the enjoyment of this right to maternal newborn and child health, some responsibilities are spelt out for the national and county governments. Health is a shared function; county governments have their role, and the national Government has theirs. These roles are spelt out in Clause 5(3)(a). It states that- “For the enjoyment of the right to maternal, newborn, and child health, the national and county governments shall- (a)respect, protect, and fulfill the right to maternal, newborn, and child health and guarantee mechanisms for its enforcement.\" Madam Temporary Speaker, Clause 6 spells out the services that must be given to non-pregnant women. Pregnancy is a noble occurrence, but there must be an environment that is conducive for that pregnancy. Clause 6 spells out some mandatory services that a non-pregnant woman is entitled to. They include but are not limited to preconception care services as may be prescribed from time to time and appropriate counseling services. If a woman needs those services, they must be counselled and be prepared for pregnancy. They are entitled to health information and education as they make the decision to be pregnant. They are also entitled to referral for certain services that are not limited to services like adoption. The Cabinet Secretary may prescribe standards for the effective delivery of services regarding the safe occurrence of future pregnancy. This Bill spells out the services that a non-pregnant woman is entitled to. Then it goes ahead to prescribe services that a pregnant woman is entitled to."
},
{
"id": 1407832,
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"speaker": null,
"content": "The electronic version of the Senate Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Director, Hansard and AudioServices, Senate."
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"id": 1407833,
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"content": "The Cabinet Secretary shall put in place measures to ensure access, by every pregnant woman, to health services. The health services include early detection of pregnancy. Women, while pregnant, have a right to know as early as possible that they are pregnant. Then, they will get the special care they require. They are entitled to free prenatal care and referral to childbirth preparation classes. If you talk to most young women, you will realize that nobody prepared them for childbirth. There are some who, when they give birth, do not know how to handle a child. These women require this kind of preparation because those children are entitled to quality care. Madam Temporary Speaker, they are also entitled to referral and adoption services, to health care services in the intrapartum period and during the post-partum and post-natal period. There must be a training of even feeding and care of infants, including breastfeeding support practices. As I talk about this, some people might assume that those are skills that people just get to know naturally. We are in an era where our young girls, because of school and other current activities, do not even live with their grandparents. Long time ago, women lived with their grandmothers, and they would train them on some of that care. Therefore, we do not want to assume that they have those skills and that is why this Bill spells out those services. It is on this note that we even applaud the Linda Mama Initiative. We encourage that it goes on because it has been a relief to our women in the past. On this, we go to the neonatal services, the period and services that children under 12 years are entitled to. This Bill spells out that every health care provider shall provide to a child from the time of birth to the age of 12 years. Madam Temporary Speaker, some of these services are spelt out; that is a comprehensive newborn care, including post-natal follow-up as may be prescribed. Additionally, it provides for health services that ensure child survival growth, because that also has been a challenge that we cannot ensure. As I said, every baby born stands a fighting chance to celebrate their first month or first year of life. Therefore, this Bill ensures that there are services that are spelt out for children from when they are born up to when they are 12 years old. As I have said, it spells out that the health services will ensure child survival growth and development including, optimum child nutrition, childhood vaccination, growth promotion and monitoring, developmental promotion and monitoring and child protection service. In some parts of this country, we cannot be sure that children are getting the right food for their growth. A progressive country must ensure that children have access to basic food that ensures that their growth is optimal. I have often seen certain services like food being given to early childhood pupils in some schools. However, there is nothing that compels the schools and Government to provide this kind of nutrition. There are other areas in this country that I have said where children survive on the very basic. However, we are looking forward to a community that grows well and children that will grow into responsible Members of this country and service this country. That is why some of those services are prescribed in this Bill. This"
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"speaker": null,
"content": "The electronic version of the Senate Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Director, Hansard and AudioServices, Senate."
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"id": 1407835,
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"speaker": null,
"content": "Bill prescribes a comprehensive assessment, a diagnosis, a treatment, rehabilitation, referral and follow-up as may be prescribed. Madam Temporary Speaker, as a country we should not have a problem with follow-ups because just recently, we provided community health workers in our counties that are paid. These are some of the services that they will be providing to our populations. Clause 9 talks about services for women with special needs. I already referred to these cohorts of special needs, that we have women who have mental and psychological problems and we must cater for them when they are pregnant. They must receive appropriate pregnancy-related services as may be prescribed even at their state of mental needs. It basically means that there must be extra care that is taken on these special needs cohorts above the normal health needs that we deal with on an everyday basis. Maternal health services that are responsive to the needs of pregnant women with special needs must be provided. There must be diagnosis, treatment and follow-ups of mental health problems, both acute and chronic, including emotional and learning disorders. In the case of pregnant adolescents, we must speak them out because we know they are younger people who might not be privy to certain knowledge. This Bill spells out the services that are entitled to them. We must provide adolescent friendly health services, counselling and anticipatory guidance because we anticipate that being adolescents, they also have peculiar needs that will need peculiar care. In the case of women with disability, we must provide disability-friendly services. This Bill spells out the role of two levels of Government; that is the national Government and county governments in their functions in contributing to the health care of maternal, newborn and child health. The county governments have the major functions in health. The national Government remains with the standards, the guidelines, collaboration, public participation, monitoring and education. This is because people need to know some of these services that are provided in this Bill. We have a monitoring and evaluation unit in Part IV because it would be important that as a country, we are able to pick where these people are. We should ensure that these services are given and where they are not given, then we should be able to make corrections in time. This Bill talks about quality assurance. That, the Cabinet Secretary shall ensure the implementation and adherence to standards and guidelines in quality in maternal, newborn and child service in our hostels, institutions and referrals hospitals. That is what will make a difference from what we have been doing in the past. This Bill spells out certain punitive measures in the general provisions. For example, in Clause 24 2A, it spells out that a person offering these services, who knowingly contributes or commits an offence is entitled to some fine not exceeding Kshs500,000. They are talking of a hospital or a health facility offering these services. There is a punitive Clause that spells out a fine not exceeding Kshs1 million or imprisonment if some of the services that are spelt out are not offered."
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"speaker": null,
"content": "The electronic version of the Senate Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Director, Hansard and AudioServices, Senate."
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"speaker": null,
"content": "Madam Temporary Speaker, this Bill concerns counties because health is devolved. County health services are devolved under Part 2 of the Fourth Schedule of the Constitution. County health facilities offer maternal, newborn and child health services. Therefore, the Bill affects county governments. This is not a money Bill according to Article 114 of the Constitution. The Bill deals with matters other than those listed within the definition of a Money Bill under Article 114(3) of the Constitution."
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"speaker": null,
"content": "(The red light was turned on)"
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"speaker": null,
"content": "Madam Temporary Speaker, as I wind up, kindly allow me one minute more to call the Seconder."
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"type": "speech",
"speaker_name": "Sen. Veronica Maina",
"speaker_title": "The Temporary Speaker",
"speaker": null,
"content": " Senator, you can proceed to invite the Seconder."
}
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