The urban poor in Kenya, especially those living in slum districts, spend two times more on health than other residents living in formal settlements.
Health experts say poor living conditions and lack of access to health facilities coupled with low income make the urban poor spend more on health care.
“They averagely spend two times more on health than other residents living in formal settlement,” notes Dr Alex Ezeh, the Executive Director of the African Population and Health Research Centre (APHRC).
“If someone living in a middle-income estate uses 21 U. S. dollars a year on health, the urban poor ends up spending twice that amount in a year or even more,” he adds. “
Kenya National Health Accounts report of 2009/2010 released recently shows families averagely use 34 dollars per person annually on healthcare. This is a sharp increase from 28 dollars, which families used to spend on healthcare per person about a decade ago. The report attributes the rise of health costs to a decline in government expenditure on health from eight percent of its total revenue a decade ago to less than five percent currently. The survey notes that the amount of money Kenyan families spend on healthcare will rise steadily as the sector continues to be dominated by the private sector.
According to Dr Ezeh, poor living conditions in informal settlements make residents prone to diseases that include pneumonia, diarrhoea, diabetes and malaria. “Most of the people in slums, especially children, suffer from diarrhoea. This is because of the food they eat, the water they use and lack of proper sanitation facilities,” he says. Many of the slums in Nairobi do not have clean piped water. Residents have to buy water from vendors, which most of the time is not clean, making them vulnerable to diseases.
Water Aid, an international organization that advocates for better sanitation, estimates that over 2,000 children under five years die every day across the world due to diseases resulting from unsafe water and poor sanitation. “We carried out a study on children diseases in slums in Nairobi and found out that one in every three children suffer from diarrhoea,” says Ezeh. Similarly, he notes that many children, especially those who are less than five years, suffer from pneumonia and are prone to injuries. “The children suffer from pneumonia because of poor living conditions. Most residents have houses constructed with timber, mud and iron sheets. Those who are badly off live in shanties constructed from cardboards,” he says. These materials, according to the health researcher, cannot shield residents, mostly children, from diseases like pneumonia in particular during cold weathers.
With the poor living conditions, many people living in slum districts fall ill often, increasing the number of times they have to seek treatment. The burden, however, rises because many residents live on less than a dollar a day thus they cannot access quality healthcare. They will go to unregistered health facilities scattered in their locality where they will get treated by unqualified personnel. “The diseases will not be cured. Residents will keep on going back to health centers for treatment, each time paying for the cost in small proportion thus end up spending more money and when the disease becomes severe, they will get admitted in hospitals,” says Ezeh.
Other residents, because of lack of money, do not seek medical treatment putting their lives at risk. “I have not sought medical treatment for a long time though I have been having persistent chest pains,” Nancy Wanjiru, a resident of Korogocho said during a recent health camp organized by APHRC in Korogocho, the third largest slum district in Kenya. Statistics from Kenya’s Ministry of Health indicate that close to 44 percent of people in the East African nation do not seek medical care because of high costs.
The 23-year-old mother of two babies says she does not seek treatment because she does not have money. “It is very difficult for me. Sometimes my children and I fall sick at about the same time. But since I am an adult, I give preference to my children who I take to a government clinic,” she said. At the clinic, run by the government, every patient has to pay 0.25 dollars. “This is the consultation fee. You will get treated but they do not provide drugs. You have to buy them from chemists, which becomes expensive,” she said. She notes that most of the time she waits for free medical camps various organizations run in the slums to seek treatment. Ezeh observes that one way of alleviating the plight of the poor is by strengthening accreditation of health facilities so that residents get better medical care.
In a move to boost healthcare for every citizen, Kenya’s government last year proposed to raise contributions from salaried workers to the National Health Insurance Fund. The country’s health minister said the plan would improve medical services, making healthcare more accessible to the poor. The move, however, met sharp opposition from workers who felt they will be burdened by more deductions from their salaries. (Xinhua)
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