What awaits new Health CS Deborah Barasa?

For 15 years now, Deborah Mulongo Barasa has held the honorific (Dr) since taking her Hippocratic Oath after completing her studies in medical school.

Starting Thursday, she gets one more title –Cabinet Secretary, curtly referred to as CS. On Thursday morning, she was sworn in at State House, Nairobi, as minister in charge of the Health docket in the country.

She takes the mantle from Susan Nakhumicha, who was fired by President William Ruto after just a year at the helm of the docket.
CS Barasa takes over when the Health sector in Kenya is sick and needs urgent attention from her.

Unlike her juvenile years as a doctor when she walked in the corridors of a hospital with a stethoscope around her neck, donning a white lab coat –she now needs no tool, but new strategies to resuscitate a dying, yet important sector for our country.

The new title goes beyond the Kenyan flag hoisted in the fleet of cars given to CS Barasa and her colleagues, the real task begins when all talk is turned to action. What is at stake for the new CS?

Social Health Authority implementation

When President William Ruto signed new Health bills (now Acts of Parliament) in October last year, it became the most decorated milestone in the Health sector just under one year since the Kenya Kwanza government took over. One of the Acts that came into force was the Social Health Insurance Act, which has provision for the creation and operationalisation of the Social Health Authority (SHA).

When fully implemented, this will replace the National Health Insurance Fund (NHIF). Just before the former CS was ousted, she had overseen the early stages of the registration process for Kenyans. In the driver’s seat now, CS Barasa will now need to ensure that there is a seamless transition.

Her biggest headache will be to ensure that this transition is within the confines of the law because already, the court declared the Social Health Insurance Fund unconstitutional.

Universal Health Coverage

This three-letter word has almost become a sing-song for any top Health official in government. The current regime vowed to ensure it becomes a reality. Past regimes commissioned a pilot program in some of the counties but this has not been achieved countrywide just yet.

As someone who has worked with the World Health Organisation (WHO), who is the proponent of Universal Health Coverage, CS Barasa may at least have the secret ingredient to make UHC achievable this time.

The WHO recommends that the implementation of Primary Health Care is one way to do so. Luckily for the new CS, this process started when the government employed Community Health Promoters to help steer this agenda forward.

It is their sustenance that she needs to look into. During her vetting, the CS said she would support them, and added that it will be a consultative effort that will onboard other partners.

Healthcare workers’ welfare

This publication may not know what motivated Deborah, the little girl, to take up medicine as a career. But, one thing for sure is that when she was young, it was one of the most prestigious courses mostly reserved for razor-sharp students.

Over the years however, it is embarrassing to see doctors striking because a government failed to reach its end of the bargain on different issues; the latest one being the sluggish hiring of intern doctors whose salaries have been reduced by more than half.

If time were to be reversed, Deborah the little girl would be among those crying foul of a failed system. It is her turn to make things right. This is not just for medical doctors but all cadres of the healthcare workforce. She has the task of ensuring that the nitty-gritty in the collective bargain agreements for all cadres are met.

State of Healthcare facilities

One great thing that CS Nakhumicha did during her tenure was to survey the state of Kenyan facilities. The results however showed an urgent need for a revamp in some of the facilities. As the new CS takes over, it will be her duty to ensure that Kenyans get the best services when they visit the public hospital.

Good thing, the Facilities Improvement Finance Act, 2023 was set up to help public health facilities use any money that they make to improve their status.

Maternal Health care under Linda Mama

When the Linda Mama program came into force in 2013, it was hailed as a potential holy grail for saving maternal health access in the country. After its implementation years later, studies have already proven that the program indeed saved the women of Kenya.

This however was not a priority in the new government, at least from past utterances of the former CS. Last week, however, the government mulled over re-introducing the program. Will CS Barasa ensure that this happens?

Mpox and other unprecedented public health crises

Former CS Mutahi Kagwe is known for the tagline; if we treat this (Covid-19) normally, then it will treat us abnormally. He took the hot seat at Afya House when the Covid-19 pandemic was the talk of town.

Now, CS Barasa comes in when another potential outbreak of the Mpox virus has been recorded in the country. While the country has confirmed only one case so far, the CS is up to the task of ensuring that there is heightened public health in the country should a threatening outbreak infiltrate our bodies’ systems.

Healthcare financing

The CS has joined the government when austerity is one buzzword that those in government have to actualize. In the current financial year, the Health Ministry received budget cuts and it will be up to CS and her team at the ministry to find new ways of resource mobilisation that will have services going on in the country uninterrupted.

This year, for instance, children missed out on mandatory routine vaccines because there weren’t any available in the country. To avoid such occurrences in the future, the CS has to plan to ensure that everything works out seamlessly.

Plague of corruption

Afya House has been christened different names, including those that malign the ministry to be the hub of corruption. Last year, for instance, there was a biting scandal from the country’s procurement supplier –Kenya Medical Supplies Authority (Kemsa) which involved the tendering of mosquito nets.

Following an expose from Nation, hospitals were investigated by the Parliamentary Health Committee for misusing NHIF money. When asked what she would do; CS Barasa said that it was important for the government to think strategically and conduct a situational analysis that will unearth existing gaps. She proposed that the government should embrace digitization as one of the ways of reducing corruption.  

Health ministry’s synergy with climate change

Health has been hailed as the human face of climate change. It is therefore impossible for a Health minister not to be directly involved with climate change issues.

The recent floods in the country exposed the gaps in the healthcare system in case of a disaster. The minister should now learn some climate jargon to understand how she can infuse some of the strategies in the Ministry of Environment into the Health Ministry.

[email protected]