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{
"id": 1485038,
"url": "https://info.mzalendo.com/api/v0.1/hansard/entries/1485038/?format=api",
"text_counter": 300,
"type": "speech",
"speaker_name": "Nairobi City County, ODM",
"speaker_title": "Hon. Esther Passaris",
"speaker": null,
"content": "pandemic and in anticipation of the next pandemic, we must recognise that the team of community health promoters are engaging right at the grassroots level with the community. They know where the community is, who is ailing or who needs services. We need to create structures that create linkages between the community health promoters and the nearest medical facilities where they are recognised. I understand that right now in Kenya, we probably have 200,000 personnel providing health services across the line, including nurses, medics, administrators, doctors, surgeons, etcetera. Community health promoters are about 100,000. I feel that we are going in the right direction to provide a stipend for them. However, if we are going to engage and have high expectations from them, including getting certified, being called upon, and making sure they look after about ten houses in their area, then we are actually underpaying them. At the end of the day, what is Ksh2,500 in today's economy for somebody you expect to be servicing the entire estate and understanding where the PWDs are, cerebral palsy children, the sick, older people, hypertension cases and women who are about to deliver? We think that they do not need transport because they have to walk. But even walking is energy consuming, which needs to be compensated. A community health worker has to leave their house in the morning because somebody called them to check on a sick woman. In Nairobi City County, I have to commend our Governor, Hon. Sakaja, because when you dial 1508, an ambulance comes to your aid and almost immediately takes you to a facility. How can we create structures in such a way that even the community health promoters have desks within the facilities that are nearest to them? If they have desks within the facilities where they operate, they can also help because you sometimes find so many people in the reception area and nobody is there to look after them. We know that most of our facilities are under-staffed. When this Bill goes to the Senate, they have to recognise that when we devolved health in Levels 1, 2, 3, 4 and 5, we ended up having many facilities deteriorating in standards. We built so many facilities under the NMS in Nairobi, but they are under-staffed. What is the best way to do that? When we have the legislation, it will obviously be a Money Bill. We need to have the legislation in place because, if we are looking for universal health care, then there is no way we are going to attain it if we do not have the structures in place from the grassroots, where you can visit somebody who is sick and understand how you can provide the services to them. We need to set a standard. If we set the standards in terms of legislation, I believe we can get many people who are interested in that particular career. At the end of the day, we have a huge unemployment rate. We need to look for ways to incorporate those community health promoters into the health structure and ensure they become permanent and pensionable. How do we compensate them for the job? We can have different grades. You can come in at an entry point where you only do X services and earn a stipend every time you are called upon to offer the service. If we are looking for universal healthcare as a country, there is no way we will attain it if we do not have structures from the grassroots in place. You can talk to those structures. You can go to them, visit somebody who is sick, and understand how you can provide services to them. We need to set a standard. We will get many people who are interested in this career, if we set the standards in legislation. At the end of the day, we have a huge unemployment rate. We need to look at how we can incorporate them into the health structure and ensure they become permanent and pensionable. How can we compensate them for the job? We can have different grades. You can come in at an entry point where you only do X services and earn your stipend whenever we call you to do a specific job. However, it is not structured, and there is no recourse to say we will pay you Ksh2,500 and then have all the counties not wanting to engage or pay you. It exploits the citizens who are trying to do the work out of empathy, compassion and passion for wanting to be in that space. The electronic version of the Official Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Hansard Editor."
}