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Sh400m debt affects health care services in Nairobi County

A Sh403 million deficit to the national pharmaceuticals supplier has halted the supply of pharmaceutical supplies to Nairobi City-major County’s hospitals.

Nairobi Metropolitan Services (NMS) CEO Mohamed Badi told a Senate committee that the county’s delivery of pharmaceutical products has been halted due to a Sh403 million debt owed to the Kenya Medical Supplies Authority (Kemsa).

He explained that Sh186 million was the amount owed to the agency by the county government until February 2020, when the NMS took over the health services.
Kemsa also had Sh195 million in overdue bills from the Nairobi County Government for medical products that were invoiced in March of last year but never delivered to NMS.

As of last August, NMS owed Sh21.7 million to hospitals Mama Lucy Kibaki, Pumwani Maternity, Matuini, and Dandora II Health Centre, all of which are under his supervision.

“The Nairobi County Government is facing a Sh403.1 million Kemsa debt, which has resulted in a shortage of resupply of medical supplies,” Major General Badi told the committee yesterday.
Senator Johnson Sakaja of Nairobi pressed the NMS boss to explain what the organization is doing to ensure a consistent supply of pharmaceutical and non-pharmaceutical supplies at the hospital, as well as the reason for the shortage of key health care personnel and the steps being taken to address the situation.

Mr Badi stated that both the county government and NMS are working on repaying Kemsa’s debt, and that NMS has appointed numerous committees that have approved the payment plan.
“The payment procedure is projected to be completed by the end of October 2021, and once paid, this bottleneck will be eliminated,” he told Senator Michael Mbito of Trans Nzoia.

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Maj Gen Badi and Mr Sakaja also disagreed on the number of critical care nurses in hospitals, with the congressman claiming that the capital does not have enough to meet the high demand for their services.

The squabble between the two began when the lawmaker dismissed Maj Gen Badi’s response to the Senate committee on Health, which detailed the state of the Mbagathi Referral Hospital’s facilities and patient care.

There are 244 nurses at Mbagathi Hospital, including seven ICU nurses, eight anaesthetists, 33 medical officers, and 29 consultants.

Mama Lucy Kibaki employs 261 nurses, 13 of whom work in the intensive care unit; 12 anaesthetists, 42 medical officers, and 43 consultants.

The senator, on the other hand, dismissed the figures, telling the committee that the response was inadequate since it lacked precise information on the nurses.

Mr Badi had combined anaesthetists and anaesthesiologists in the document he presented, which the lawmaker used to cast doubt on the accuracy of the information.

While both professions require the same skill, there is a significant difference between them. Anaesthesiologists are medical doctors who administer anaesthesia, whereas nurse anaesthetists are registered nurses who may assist or collaborate with doctors in administering anaesthesia, or may work entirely independently.

According to the senator, Mbagathi had only one ICU nurse, one anaesthetist, and three anaesthesiologists serving all of Nairobi’s health institutions as of September last year. He pressed Mr Badi to clarify whether extra nurses had been hired in the time since he filed the question in the House.
He demanded that NMS provide a list of the supposed nurses to the House as verification of the figures he provided in his submission.

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Mr Badi said that the number of ICU nurses he supplied was correct because they were hired through the Public Service Commission (PSC) in anticipation of the extra health facilities being developed, primarily in Nairobi’s informal settlements.

Mr Badi told the committee, “We have a scarcity of anaesthesiologists,” even as he promised to deliver a list of all vital caregivers, replete with their service numbers.

He told the committee that NMS hires people through the PSC rather than directly.
“Anaesthesiologists are in limited supply across the country. Although it is not unique to NMS, we have made a special request to the PSC, and the only thing we can do now is ask the commission to expedite the process.”

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