UHC to address serious challenges in Machakos

Lilian Kaivilu @liliankaivilu

Kasyoka Ngui sits outside their home chatting with her mother Wia Ngui. She remembers the fateful night of  May 16, 2018, when she woke up to immense heat around her right knee. “I immediately woke up and noticed a red snake slithering away. That is when I realised I had been bitten by the snake,” she narrates.

Wia says the 10 pm incident caught her family unaware. With no ready remedy for the bite, she beat a raw egg for her daughter who was already vomiting. “I had heard that raw egg works as first aid for snake bites,” she says. This, however, did not stop the vomiting.

Her first thought was for the duo to hit the dark path that connects their home to the main road since there was no means of transport to the nearest health facility. “I also did not have money to hire a motorbike. At this point, I just wanted us to find help in whatever way. So I started walking with my daughter on my back,” says Wia.

No help

However, a neighbour who had heard their screams came to their rescue. With a motorbike, he ferried them to Nuu Sub-county Hospital located about12 kilometres away.

But at the local health facility, Wia could not get help for her daughter as they were referred to Mwingi Level Four Hospital. “It was already past 11 pm and we could not get any means of transport home. So, we slept at the hospital waiting to be transferred to Mwingi the next day,” she narrates.

Here, the family had to pay for the girl’s stay at the hospital as well as the anti-venom that was administered upon arrival. With no medical insurance or savings for such emergencies, Wia turned to well-wishers to fundraise for her daughter’s medical bill.

Ngui’s family story paints the grim picture of the situation in the larger Nuu ward where at least one case of snakebites was reported every week during the April-May rainy season. Joseph Mbithi Maundu, a clinical officer at the Nuu Sub-county Hospital says children under 15 years are the most affected by snake bites. The majority of the patients, he adds, get the bites at night.


“This means they report in the hospital at night when there are no adequate staff members. This is a challenge because we only have two clinical officers at this health facility.” According to him, stockouts of the anti-venom is also a challenge sometimes, a situation that forces them to refer the patients to Mwingi Level Four Hospital. 

These, among other challenges, are what the government hopes to address by introducing Universal Health Coverage (UHC) programme. The UHC programme is to be piloted in Kisumu, Nyeri, Isiolo and Machakos counties.

Dr David Kariuki, senior deputy director of medical services and the head of UHC coordination, says the choice of Machakos as one of the pilot counties was to see how the country can implement UHC in a situation where sometimes there are dire emergencies such as road accidents. “Through this pilot, we would want to see how our systems will respond to that,” he said.

Health Cabinet Secretary Sicily Kariuki expressed optimism on the success of the pilot programme that targets about 3.2 million Kenyans. She, however, said the pilot would be restricted to public health facilities unless in exceptional cases. 

The CS further pointed out that UHC is a process, urging Kenyans not to expect delivery of all health services at a go after the launch of the pilot programme. “Let us look at UHC as a journey that we are walking and improving continually,” said Kariuki.

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