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"id": 915798,
"url": "https://info.mzalendo.com/api/v0.1/hansard/entries/915798/?format=api",
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"type": "speech",
"speaker_name": "Ndhiwa, ODM",
"speaker_title": "Hon. Martin Owino",
"speaker": {
"id": 13449,
"legal_name": "Martin Peters Owino",
"slug": "martin-peters-owino"
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"content": "facilities to assess their status. Some of them are in a horrible and pathetic condition. That is why a Member was thanking them. I also add my voice to thank the practitioners in these facilities. Why are we talking about referral hospitals and why they are congested? The health structure in this country is in six levels: Levels 1, 2, 3, 4, 5 and 6. The Report that we have put before the House is about national hospitals. If we could invest more money in the lower levels, Levels 1, 2, 3 and 4, and leave the county referral hospitals for now, then we could be able to decongest the facilities that we are talking about. Level 1 is where health seeking behaviour is. We call it three delays. Why do people delay to go seek for medical assistance? One, it is because of decision making in the household. You can even testify about yourself. When you feel a headache, you self-medicate sometimes, but you do not know what you are treating. So, Level 1 needs to be supported. That is why I will bring a Bill on community health workers. People need to be supported to do something. Please go to hospital. When you are pregnant, you need to go to a clinic. If this does not happen, that is why we have complications and disease progression up to the highest level. The dispensaries at Level 2 need to be equipped so that minor ailments can be managed well. Level 3, which is health centres also need to have diagnostic equipment. What happens is sometimes without this, we have wrong diagnosis. If you have wrong diagnosis, chances are that you are going to prescribe wrong medicine. That means the disease is missed, the progression is on and that is a candidate for a tertiary level which is very expensive. If we can manage diseases at this lower level, we can save the higher facilities from congestion. That is point number one. People tend to focus more on the higher facilities rather than screening and managing conditions when they are still at a lower level, for example, diabetes. Complication of diabetes is renal failure. As a country, we may put aside money for dialysis. That is the higher end on something which could have been diagnosed early, the patient treated, supported and continued to live their lives. So, we pay higher in dialysis. It was also talked about here, which we captured in our Report that these facilities need to be independent. For KNH, MTRH, Mathari National Teaching and Referral Hospital and Spinal Injury Hospital to be independent and funded directly, we need to change some of our Acts, especially the Public Finance Management Act. The problem we have is that their funding has to go through the ministry and there are delays and all that. I also want to talk about mental health. The Mathari National Teaching and Referral Hospital is a very old institution, but as we have seen somewhere else, we have to decentralise mental health. The reason is that there are some ailments that are managed well in the local setting and family support than if you put the patients in a more restricted area. You do not expect me to bring patients with mental health complications in my constituency to Mathari National Teaching and Referral Hospital. It is too far for them and their families. We should decentralise this and the spinal injury treatment centres to the counties, so that we have trauma centres in every county. It does not make sense. Nairobi was the capital City when we had no devolution, but with devolution, we also have to change as well. Decentralisation of these services will be very key. When we were in Cuba, we saw how they integrated mental health issues in the polyclinics which are clinics within the communities. They are made up of parents and families who have their own part to play with regard to patients unless they are violent. If they are violent, that is another story. Most of the mental cases that we currently see result from alcohol The electronic version of the Official Hansard Report is for information purposes only. Acertified version of this Report can be obtained from the Hansard Editor."
}