Meru politics have been interesting in the last two years. We have witnessed three impeachments of the Meru Governor Mwangaza Kawira. She has had three reprieves, twice by Senate and the last one now before a court of law.
The Kenya Medical Association (KMA) on 12th and 13th September 2024 hosted the 2nd training of KMA-YDA researchers that focused on developing a research proposal. During the opening session I asked my Young Doctors Academy (YDA) research students about what they thought the problem in Meru was. Some said that the Governor was reported as not working well with the Executive and The County Government MCAs. One of the young researchers hypothesized that the Governor was a victim of sexism. That hypothesis caught my ear. This was an interesting angle considering the YDA students were developing research protocols to research on issues that adolescents were facing in the space of Sexual Reproductive Health Rights (SRHR).
As a result of the Meru County Government ongoings, the health workforce of Meru County Referral Hospital are on their sixth week of an industrial action, protesting a raft of issues affecting health service delivery in Meru CRH. The issies include delayed salaries and poor working conditions in the hospitals. The dire health situation have been aggravated by the political fights between the Meru Governor and the Meru County Assembly. It was on this background that I suggested to one of the young researchers to carry out research in Meru titled
‘The effect of sexism on sexual and reproductive health service delivery on adolescents in Meru’.
Going further, the stoppage of work at Meru County Referral Hospital has back consequences on medical training. Kenya Methodist University (KEMU) medical school has Meru CRH as its teaching hospital. As a result of the industrial action of health workforce of Meru CRH the academic programs training medical doctors in clinical rotation at KEMU have stalled. KEMU initially banked on the issues being resolved quickly but this did not happen. Because the situation is fluid, KEMU have now decided that the medical students would be reallocated to other hospitals to complete their clinical rotations. The effect of the industrial action is a delay by six weeks to date of the academic program. I had been scheduled to preside over KEMU Finalists Dinner in September as the Kenya Medical Association (KMA) President. As a result of the delay in completion of the finalists resulting from the politics in Meru, this has since been postponed. Politics thus directly affects health service delivery as well as training of medical personnel.
Unfortunately, without a centralized system for management of health human resources in the country the health workforce in Meru is stuck with their problems. Prior to devolution the health workers would report their situation to the Public Service Commission and would be able to get a transfer to a station that valued their service. In devolution the Meru workers are stuck. They must fight it out with their county government. They have reached the end of their wits and have decided that a strike is the only way out. It would be nice for the Kenya Health Human Resources Advisory Council (KHHRAC) to make its voice heard. It would also be important for the Kenya Medical Practitioners and Dentists Council (KMPDC) to intervene because KMPDC indexes medical students and follows up the quality of their training.
All in all, it is important for all to see that governance or misgovernance has a direct and indirect effect on health service delivery. The impeachment proceedings of Governor Kawira Mwangaza is not just a political issue for the Ameru. Its effects go beyond local politics including affecting the practice and training of medical personnel. It’s thus important to do research on the causes political discord.
The Meru case is a good case research study for the KMA – YRA study that is supported by SRHR fund of HIVOS and hosted by TC4A on their Medical Learning Hub platform. Young Researchers may just be what we need for evidence-based governance.
Dr Simon Kigondu
President Kenya Medical Association.
