Kenya AIB

  • Created by: Megan
  • Created on: 27-05-15 12:37

Suggest reasons for low access to health care in K

  • Only 30% have acess to medicines, many die from preventable diseases
  • Shortage of healthcare professionals as they emigrate or work for private companies - 1 doctor per 10 000
  • Shortage of infrastructure - Hospital:Population = 1:60 000
  • Only 25% of Kenyans have access to medical facility within 8km
  • Cultural traditions - many HIV/AIDs patients cared for at home
  • Lack of political will - transport and logistics are not the main focus of international pressure (MDGS)
  • Poor infrastructure - only 14% of Kenya's roads are paved
  • 40% of national transport budget was unspent in 2006
  • Most people can't afford retroviral drugs
  • Healthcare is expensive - not free at the point of delivery
  • Poor road conditions = breakdown of vehicles = need for riders
  • 70% of population live more than 2km away from a paved road
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Important notes Item 1

  • IMR: 40.7 per 1000 (under 1)
  • Total External Debt - $13.5 billion
  • Over 60% live in rural locations, but only 14% road networks paved (not suitable for normal cars)
  • Healthcare delivery vehicles out of use for want of US$3 part
  • Riders for Health became an NGo in 1996 - works in the Gambia, Zimbabwe, Nigeria, Kenya, Malawi, Zambia and Lesotho
  • Kenyan program began 2002, 8 staff manage 77 vehicles
  • Works with African Infectious Disease Clinics
  • Grassroots iniatives - healthworkers from community based organisations provided with transport
  • 2011- opened International Academy for Vehicle
  • Before - 60 people reached a week by a rider, now 450 reached a week per rider
  • Travel time cut from 4 hours to 1
  • Can travel up to 80km away rather than 20km away
  • Society for Women with Aids - stigmitization reduced - MDG 3 & 6
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Important Notes Item 2

  • Most of South-West is over 1000m
  • Central region 200-1000m
  • Coastal region under 200m
  • High rainfall in areas of higher relief due to relief ranfall
  • High rainfall in Mombasa due to tropical storms
  • Areas of higher precipitation suitable for crop growth, allows a continuous growing season
  • Areas of high population density developed around cropland 
  • No cropland in national park and no people
  • Coast quite densely populated
  • Poverty in main cities - areas with high population density
  • Areas in North Kenya have high population density but lower poverty
  • Should we concentrate medicines in area of greatest poverty? Dense population -> infectious disease
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How has physical geography reduced development?

  • Mountainous terrain makes access difficult - areas of high relief
  • High precipitation = more mass movement of land
  • High preciptation = malaria = hours lost, high IMR
  • National parks prevent corridor of development from capital
  • Large country with many small villages requires large road network but only 14% are paved
  • Low precipitation areas are unsuitable for cropland
  • Low precipitation = uneven water distribution = cost of irrigation
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Why will investing in transport infrastructure ben

  • Inequality of healthcare provision due to poor infrastructure
  • Over 60% live in rural locations, only 14% road networks paved - unsuitable for normal cars so hard to deliver healthcare
  • Allows better access to education = improved hygeine = reduces spread of disease
  • Better road systems could encourage urbanisation 
  • Better access to pregnant women - reduce the IMR and maternal mortality rate
  • Resources can be distributed according to need not population size
  • Cost-benefit analysis?
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Economic, Environmental and Social impacts of inve


  • more people with HIV go public and receive treatment
  • treatment improves quality of life
  • more hospitals - decrease in incidence of poor health
  • less absences from school - better education - more opportunities


  • Less absence from work


  • Farms could fall into disrepair and lead to desertification
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Bottom-Up Aid

  • Most effective
  • Those at bottom know what they need
  • More tailored to specific needs - different needs in different places
  • Might not have infrastructure to support it - appropriate technology? - How do Bikers get petrol?
  • Top Down - needed to distribute medical supplies to whole country - not efficient to have an effective system for only one area
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Are motorbikes appropriate technology?

  • Kenya has roads, only 14% are paved but bikes are suited to dirt roads
  • One bike per doctor - need more bikes, could fit 4 in one car before
  • People can be trained to ride/repair/maintain the bikes
  • Can't carry as much medicine
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Can the Riders help Kenya improve their healthcare

  • Seen improvements on a small scale in the areas they operate - 20 000 more people reached
  • Inappropriate distribution of supplies + loss of workers currently
  • Start with demand at the bottom - requires some kind of database, work with supply and demand
  • Would require efficient IT system - high set up costs - would Riders fund this? The governemnt can't afford it.
  • If they miss the deadline day, do they wait another month?
  • Riders may not be sustainable - funded by donations - not guaranteed income
  • Kenya could follow a riders style system, introducing tax to pay for the improvements
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Important Notes Item 4


  • 2005 - unlikely to achieve goals due to lack of resources - poor transport, healthworkers, supplies, ICT, poor communications etc
  • Set a policy for the next 10-12 years to work towards goals - all public investment toward it
  • Strengthening Service Delivery Systems - human resources, infrastructure and management capacity
  • 500 hospitals, 611 health centres, 3310 subcentres/dispensaries
  • Each health centre serves 6887 people. Hospital:People =1:60 000
  • Only 25% of Kenyans have access to health serices within 8km
  • Urban population only 20% but spending there is 70% - easiest to distribute money there
  • Low quality of care - lack of supplies plus poorly accessible
  • 10% of govs annual budget for healthcare spent on drugs - antiretroviral drugs
  • Low utilisation of healthcare due to high cost - not free at point of delivery- rural population isolated
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Suggestions for MDGS

  • Money available 2005-2007 should focus on improving human capacity -
  • 42% personnel - training teachers, healthworkers, agricultural extension workers
  • 39% operations and maintenance - teaching materials, anti-malaria drugs, mosquito nets
  • 19% costs for building infrastructure to increase capacity of economy
  • Medium Term - 2007 - 2015 - sustaining additional human capital and investing in infrastructure - major trunk roads, rural access roads, education and healthcare buildings
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Georgia Roberts


Life saver...

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