Health system
A health system, also sometimes referred to as the healthcare system, is the organization of people, institutions, and resources that deliver health care services to meet the health needs of targeted populations.
There is a wide variety of health systems around the World, with as many histories and organizational structures as there are nations. It is of best options for
governments to invest and develop health systems in alignment with their necessity, which is their needs and resources, although all health systems are primary healthcare and public health measures. Well, in most countries, the health care system is distributed. In several ways, in some states, health system planning is among market participants. Some others are collective effort among governments, trade unions, charities, religious associations, or other co-ordinated bodies to render health services delivery to the individuals they serve. Health care planning has been described as a gradual development rather than a sudden development compared to other social systems. Health systems are likely to depict the history, culture, and economics of the states in which they evolve. The World Health Organization (WHO), The administrative authorities for health in UN system is encouraging a goal of the universal health care system to ensure that medical services are being administered without going through any financial hardship or instability, a system where anyone can access this service without getting to pay for medical services. (Free health care system). According to WHO, healthcare systems’ goals are creating a healthy health care system for the citizens, responsiveness to the expectations of the population, and consider ways of funding operations. The level of achievement is dependent on the four vital signs that are carried out by systems, and this sign includes resource generation, stewardship, financing, and provision of healthcare services. ( Macinko, J. et al., (2011). Other aspects to be considered alongside efficiency, equality, Quality, and acceptability. Although some authors have argued to widen the whole idea of the health system and to be specific about other aspects to put into consideration this includes-
- Health systems should not hold so much on their components only but be willing to connect some other associations
- Health systems should be more concerned about the welfare of the population and not just the institutional part of the health system.
- Health systems must be seen in no other biased ways but in term of their aim/goal which is to make sure that health coverage system is standard in each nation and also health care facilities are being funded in such a way that they become well equipped in accordance to the population request, in addition, respect and dignity with fair financing system should never be overlooked.
- Health systems must be seen under their functions, including a rendering of services directly without discrimination of profession, whether they are medical or public health services.
The objective of this research report is to review and compare the health systems of the high-income country (Singapore) and a low-income country(Kenya) and also using WHO health systems framework which consists of the six building blocks (WHO 2017)
Country Profiles
Singapore
Singapore which is formally the Republic of Singapore is an independent island
city-state located in maritime southeast Asia, which lies about one degree of latitude 85 miles north of the equator, away from the southern tip of the Malay Peninsula, enclosing the channel of Malacca to the west. The country accommodates 5.7 million residents, 61% (3.4 million), and this is all Singaporean citizens. Singapore speaks for different languages, including English, Malay, Chinese, and Tamil, with English being the lingua franca. (Weber, H. et., al 1980). The current population of Singapore as of June 22, 2020, based on world meter of united nations data, is approximately 5,850,342 people.
History has it that Singapore has an increasingly developed market economy on extended trade, Along with Hong Kong, South Korea, and Taiwan. Singapore, as a high-income country, has currently emerged the 7th highest GDP per capita in the world today; this country is also known as one of the four Asian Tigers. It is ahead of its neighboring countries in terms of GDP per capita. Net national pay per capita (PPP) in 2013 was 76, 850 extending to 364.2 billion USD in 2018(World Bank), with 4.4% of the GDP assigned to wellbeing (World Health Organization, 2018; World Bank, 2018). The Singaporean economy is known for its free and friendly nature; in 2015 Economic of freedom ranks Singapore as the second most open economy in the World. (Deterding, D. (2010).
The colonial governments and their military were the first to be introduced to medical services, and the first public hospital was a wooden shed built in the cantonment for armies close to Bras Basah Road in 1821. Singapore has its first general hospital facility built at the early stage of the 20th century, in the year, 1950s patients were not able to spend nights in clinics. They were always moved to other areas in Singapore.
Over the years, Singapore made tremendous progress in decreasing adult mortality, about 40years ago a recent study enunciated in the medical journal Lancet that the risk of dying after the 15th birthday but not before the 60th birthday for both Singapore men and women has drastically decline by about 64% to 68% respectively between 1970 and 2010. Singapore has the lowest adult mortality all over the World, the main cause of early death in this country are cancers and cardiac diseases, Singapore needs to keep up with the energy to combat the associated risk factors.( Phua, H. P. 2015)
The age-specific fertility rate over the years in Singapore has a decreasing rate below 30years of age while slighting increasing for the older age above 30years, in the 1980’s studies has shown that fertility rates in females within their late 20’s are high. The fertility rate has become highest among females in their 30’s. (Guo, Z. et., 2015)
Kenya
Kenya is located in the eastern part of Africa, with coastline on the Indian Ocean, it is known for it scenic view of landscape and intensive wildlife preserves e.g. elephants, lions, and rhinos, along it coast hold most of it finest beaches, Savannah, Lakelands, the dramatic great rift valley and mountain highlands. Kenya has boundaries between these countries Sudan, Uganda, Somalia, Ethiopia, and Tanzania. As of 2019, Kenya has a population of 53.771,296 million (Bateta, et., 2020) and also an official language of Swahili, English.
Kenya’s economy has driven drastically over the past few years as a result of several key factors, Kenya is the main pathway for goods traveling down to countries in East Africa and Central Africa, and Central Africa interior, the country benefits to some specific factors, Kenya is known for an exceptional well-educated labor force. Kenya’s GDP of KSHS still stands up to date, recording (us$ 77.492 billion) and growing T 4.9% in 2017. However, agriculture is known to be Kenya’s selling point, an essential contributor to Kenya’s GDP at 24.9%, Tea and Horticulture exports were highly recognized at KSHS (1.473 billion), and 113.3 billion respectively, its main exports to foreign countries are tea, coffee, and cut flowers. (Dasbach, E. J. 2001).
The maternal mortality rate of births of 2010 in Kenya is 100,000 per rate, which is 530, compared with 413.4 in 2008 and 452.3 in 1990. The under 5 mortality rate per 1000 births is 86; its neonatal mortality has a percentage of 33 of under 5. Kenya women undergo a high risk of death during child delivery due to a lack of midwives as of 1994. Malaria is the leading cause of high death rate in Kenya, has a record of one-thrid of all new cases reported, another leading cause of high rate morbidity is respiratory diseases, skin diseases, intestinal parasites, diarrhea, etc.
The ministry of health (MOH), developed the Kenya health policy framework implemented action plan and established the health sector reform secretariat in 1996.
Driving purposes behind sudden going in Kenya are HIV/AIDS, wilderness fever, tuberculosis, lower respiratory pollutions, and diarrheal diseases. A total of 78.3% of DALYs are set up by extensive stretches of life lost due to sudden passing (Frings et al., 2018; Burton et al., 2011). The leading national risk components of abrupt passing consolidate sick wellbeing, hazardous sex, perilous water, hand washing, and sanitation (Frings et al., 2018).
Methods
Composition of this report involved a collection of reliable, relevant, and well-dated secondary sources, such as Google Scholar, Web of Science, WHO website, and Science Direct, books, and reports, the internet was the leading source for the collection of the resources for this health system comparison. The catchphrases used were” Singapore” and “Kenya,” Leadership and Governance, Service delivery, Healthcare workforce, Healthcare financing, Medical products & technologies, information, and research. The sources derived from other country backgrounds and health systems of Singapore and Kenya, disseminated from 2010 onwards, ensuring that only recent information was used. The aim is to review the current countries to know its growth rate in both Singapore and Kenya. The Keywords played a role in the natural search of sources that were of high need to the objective of this comparative report.
Findings
The health systems of Singapore and Kenya are comprehensively analyzed and examined to compare any similarities. Utilizing WHO system building blocks information in every subsection where necessary.
Healthcare Financing system
Healthcare financing can be put as the management of funds for medical resources on an individual level; this service can also be called out-of-pocket medical expenses where patients are free not pay after receiving health care service from any health financed facility, it works as a credit. (Donaldson et.,al 1993).
In Singapore, public hospitals are more freestanding than government hospitals in some other countries which has generally led to a better service delivery in Singapore and which has in turn creates competition in the public market, this also encourages already existing private hospitals and clinic services to deliver a top-notch healthcare in Singapore.( Khoo et.,al 2014). Singapore has a major source of funds by taxes, which covers one-fourth Singapore’s health expenses. However, there are a mandatory life insurance schemes and deductions from the (CPF) compulsory savings plan where individuals and their employers are debited automatically maybe monthly or annually. Singapore funds health care is through a basic structure called ‘S + 3M’; where S speaks appropriations and built around 3M known as Medishield, Medisave, and Medifund, (Sturny., 2019), let’s focus on the two basics
- Medishield – Singaporeans are not limited to accessing Medishield life account for significant expenditures, the Medishield is a basic health insurance scheme all Citizens and permanent residents are capable of using in payments of large bills including diagnoses that are way beyond the facility plan or expenses e.g. Kidney dialysis. Medishield is a clinical practice that was adopted since the year 1990, and it’s insurance scheme covers approximately 80% of Singapore’s total population, intending to render financial assurance to individuals against expenses of complicated medical health challenges, (Ramesh and Bali, 2017).
- Medisave – A compulsory state-run health insurance scheme account that consumes between 7 and 9.5 percent of a worker’s salary, this scheme also gives Singaporeans the access to make payment to specific routine care, it has an equivalent rent for both bosses and laborers. (Ramesh and Bali, 2017).
Medisave and Medishield are the basics of Singapore’s health insurance system. A regular course of procedure where Citizens and Permanent residents pay consequently and if things for out of place, they hit their deductible and begin to access their Medishield account. However, if you are not a citizen or doesn’t own a registered permanent resident, you won’t be able to access any health coverage system, including private health insurance, payment is required for treatments and doctor’s visit out of pocket which can be very expensive compared to Singapore citizens. (Hussaini et al., 2016).
Historically, the kenya’s healthcare financing system differs from that of Singapore greatly, after independence in 1963, an overarching policy provided for equity health care plan has subsequently failed over the years, after the official announcement of the new constitution in Kenya 2010, Kenya’s financing system has been changed; therefore Kenya has three core financing sources which are, Government use, out of pocket expenditure (households), and philanthropist (Donors) (Luoma et al., 2010). The Government funds health care through its national insurance scheme, the national hospital insurance fund (NHIF) (Munge et al., 2018). The private insurance scheme covers up to 4% of the community, and NHIF covers 11% of the total Kenya population of about 4.5 million. Recent healthcare financing improvements have been characterized by a move away from OOP payments towards universal access to health care with financing through the national health insurance fund. (Chuma and Okungu 2011; Wamai 2009b), 3years after the progress towards improving the universal access to health care coverage through the expansion of NHIF faces great challenges. (Nation 2013).
However, in contrast with Singapore health financing system, their core source of funds is jointly by the Government and the individual through insurance, incomings from taxes and also savings from individual’s medical account (e.g Medisave) which covers one-fourth of Singapore’s health expenses, although there is a mandatory life insurance schemes and deductions from the (CPF) compulsory savings. (Kimani et al., 2004).
Kenyan’s core source of funds is out of pocket payments amounting to 78% of the total expenditure on inpatients and outpatient services. In Singapore, non – citizens tend to spend more from their pockets in other to access health care services. Kenya spends more regardless. Both private and public hospitals charge user fees, and private hospitals are used more often by the rich, which usually expensive. (Munge et al.,2014). Emergency services at public hospitals are subsidized equally for all, but this is not the same for Kenya’s.
Health service delivery
In Singapore, the first point of contact with patients is the Government polyclinics and private medical practitioner clinics, they provide the basics of primary healthcare. However, the management of severe diagnosis in the primary healthcare sector in Singapore has never been balancing this is as a result of receiving lower health care services about 20% from 18 polyclinics. In comparison, 2000 medical clinics provide the remaining 80%. (Khoo et al., 2014).
A complete arrangement of medical care for both acute and chronic medical conditions is provided by policlinics, including medical facilities and comprehensive health care services, including outpatient medical care, X-ray and laboratory services, health screening education and vaccination etc.
In the year 2010, 8,797 doctors are amazingly effective in Singapore and 5,362 in the public sector and 3,435 in private practice. (Khoo et al., 2014). The secondary and tertiary care is provided by the eight national specialized centers and seven acute hospitals. So, therefore, the unique difference between the Polyclinics and private clinics is that patients are not allowed to select from a group of medical doctors that will personally attend to them as requested, but the reverse is the case of private clinics, who are entitled to a particular physician ensuring that people have been able to access health care. A family physician for private clinics cannot see more than 30 patients per day but differs for polyclinics. (Khoo et al., 2014).
MOH and it planning committee are in charge for managing Singapore’s healthcare system, all healthcare facilities are obliged to apply and obtain the license under the Private Hospitals and Medical Clinics (PHMC) Act/Regulations. These facilities are required to maintain a good standard of medical/clinical services under the PHMC Act/Regulations. (Ministry of Health, 2019). MOH has been working handy with GP’s in other to ensure that quality healthcare are been accessed in the community about 1,700 GP clinics which covers about 80% of the other primary healthcare demand.
In Kenya, the first point of contact are the dispensaries such as health technicians and dressers, pharmacist etc. In contrast to health service delivery, Singapore health system is managed by the Government, Kenya’s healthcare delivery is quite different from Singapore’s which has combined management, coming from the public and private hospitals. Basically, these private hospitals are been own by individuals that are medical practitioners, as it has various level of healthcare delivery ranging from (level 1-6), level 1is the community service, level 2 are the health centers, level 3 the facilities (Mostert et al., 2015), level 4 are the district hospitals, level 5 are the provisional hospitals, level 6 are the national referral hospital and bigger private teaching hospitals (Muga et al., 2012). In comparison to Singapore, primary health care services have been administered at level 1 -3, whilst the Public health care are governing by health facility members. In Kenya there is a leading sum of about 4700 healthcare facilities, 51% of those being public health facility, conclusively Singapore still has the best operation route in delivery of health care services, compared to Kenya. (Muga et al., 2012)
However, the Kenya Health Sector Strategic plan III (2012–2017) revised the service delivery structure into four tiers. Tier 1 is the Community Health Services that were previously referred as Level 1. It comprises all community-based activities, mainly health promotion, disease prevention, and identification of cases that require reporting to higher levels of care. Tier 2 is referred to as the Primary Care Level that encompasses the previously known Levels 2 and 3. It includes maternity homes, dispensaries, and health centers. Tier 3 is the county referral hospital and refers to health facilities staffed by a county. It comprises facilities previously known as Level4. Tier 4 encompasses national referral hospitals that were previously Level 5 and Level 6.
Healthcare Workforce
Prior to history, MOH in Singapore has declared the 2020 healthcare workforce plan to incur the employment of 30,000 healthcare workers by 2020, to improve and sustain a better quality of health delivery among the Singaporeans aged people. The healthcare workforce is low with regards to the increasing rate of older people amounting to 8.5% aging population and still rising. Singapore ratio in 2019 has 1000, per population, the Nurses has the highest proportion of
(7.5) in healthcare workforce, followed by the pharmacist (6.5), the optometrists and opticians has a equal ratio of
(0.4) and (0.6) for doctors, amounting to 2,781 and 58% works in a public sector, The number of employed nurses are very low, history has it that most of the nurses in Singapore are foreigners but there is a high percent of trained foreign doctors 2/3 in Singapore (Tay et al., 2014). Singapore was ranked by the World health organisation as the best healthcare system in Asia, (WHO) ahead of Hong and Japan. Around the World.
The health professionals in Kenya have been of great contribution towards ensuring the growth of health workforce based on four qualities which are Accessibility, availability, acceptability, and Quality this is due to the shortage of health workforce, the country has channeled a lot of
finances for training of health workers and also increased the number of training centres, The increase in health care training institutions, training programs, and registration of health professionals in Kenya are all signs of positive growth as this will help to facilitate the career workload and nurses and clinical officers through its system of upgrading from diploma- to degree-level training(Rodgers, et.,al 2012). However, it is unclear whether these trends are adequate to match the growing population and healthcare needs in the country, given the rising population. Statistic of Kenya health workforce has it that the ratio of health workers in Kenya has amounted 10,000 population, decreased number of professionals, 2.2 medical laboratory officers, 0,5 of a pharmacist, 1.5 of doctors, 0.2 of dentists, and 1.2 of pharmaceutical technologists (Ministry of Health, 2013), including the active nurses’ workforce of 103.4, making a total of 250 health care workers recommended by World health organization.
and Quality. Data collected by health regulatory agencies are crucial in measuring how a country is performing in these areas, determining the scope and nature of gaps, guiding how interventions can improve health workforce regulation, and measuring the success of this intervention In response to the shortage of the health workforce, the country has invested heavily in training various cadres as evidenced by the increasing number of training institutions distributed across the country and approved by various boards and councils, resulting in increasing numbers of newly registered health professionals entering the workforce. Nearly 36 (77%) of the counties now have at least one health training institution. Kenya has not only scaled up the training of the health workforce but also has facilitated career progression for nurses and clinical officers through its system of upgrading from diploma- to degree-level training. The increase in health care training institutions, training programs, and registration of health professionals in Kenya are all positive signs. However, it is unclear whether these trends are adequate to match the growing population and healthcare needs in the country, given the rising population. (Rodgers, et., al 2012)
Leadership and Governance
Recently, the health care service act (HCSA) will act in place of the current private hospitals and medical clinics act (PHMCA) to govern the provision of mainstream health services in Singapore. However, the Ministry of Health (MOH) is the branch of the country government responsible for policies and Quality of health care services in Singapore. The Government sees the affairs of the public health care system through the MOH to ensure the reduction of illness and an affordable health care system of delivery for the Singaporeans. Preventive measures have been observed to ensure that no Singaporean is derived from accessing the health care system. Health care services authority is also in charge of monitoring and introduction of clinical equipment that always meets up to standard and universal quality principles. (Ramesh et., al 2017). In contrast to Kenya’s governing system, which is also overseen by the ministry of health (MOH) and national governing bodies, the department of health in Kenya has a role with all curative services, professional regulatory, and medical training centers. Kenya’s has 47 province governments and aims for better management and an individual’s commitment to administration. (Davis et al., 2019).
Kenya’s medical supply association is in charge of the supply of medical/clinical equipment, hardware, etc and govern by the MOH (Ministry of health, 2013).
Medical products and technology
In 2008, a scientific study entitled “Healthcare Systems and Pharmaco-economic Research in the Asia -Pacific region” published in Singapore, the writers were of opinion that the system involves a simple cost-benefit analysis (CBA), this technique compares the relative cost which was a give and take, despite lack of staffs level at pharmaco-economics and drug utilization unit, including how fast the Drug Advisory Committee gives a positive response to their opinion.
Singapore government maintains a standard drug list (SDL) of a well reasonable price of drugs. However, there is a commotion concerning the list with issues of unclarified decision-making processes. `
The Government maintains a Standard Drug List (SDL) of a well reasonable price of drugs. However, there are some issues of transparency concerning the List and decision-making processes, in as much that it’s much easier to discover, ( WHO) standard drug list and every other nation worldwide compared to Singapore. Secondly, there has been a lack of communication on detailed information about how the Drug Advisory Committee goes about their concerns before acting (final decisions), e.g., the cost-effectiveness of each drug. In other to resolve such issues non- transparency, the building of websites should be a significant concern. On this platform, such sensitive information of process decision-making is publicly displayed, giving comprehensive details stating reasons why drug is not included with clinical data to back up conclusions.
The Singaporeans standard drug list is divided into the SDL 1 and SDL 2, SDL 1 reflects well with WHO’s necessary Drug List. (Ministry of Health, 2020). SDL 2 got along with the sponsors that paid heavily for medication. (Tan et al., 2014). About 570 prepared medications are recorded and it takes $1.40 per drug for a financed patient in standard drug list amounting to a large portion for the cost of prescription of drugs in SDL2, (Liu et al., 2014). A patient not sponsored spends completely on the recorded medication in SDL1, but this is not the same for a patient.
In contrast with Kenya, The medical product and technology ( Kenya essential medicines have been in existence since 1977, and usually get updated every two years, in the 21st century the recent version of the WHO essential medicines list (EMls) ranks 7th of WHO essential medication for the list of children. Therefore KEML 2019 reassures the efforts of reviewing the Kenya medical list and also ensures that the appropriate medicines have been given in other to improve the easy health coverage system that goes in line with the ministry of health govern by Universal Health Coverage (UHC). (Jaguga et al. 2017).
However, in Singapore, the populace complains of non-transparency which has been a the main bone of contention in delivery of standard drug list, due to lack of proper (Robertson et.,al 2016)
communication in making final decisions, but the reverse is the case in Kenya because the Ministry of Health goes through NMTC, set up a multidisciplinary team of professionals, the KEML analyse TWG to spearhead the constant efforts of assurance that the KEML is well updated with the most recent information worldwide, the series of the meeting was honored by various professional personnel are internally and externally including medical specialist with the aim to obtain final effort. (Robertson et., al 2016). Besides, Kenya’s authority (KEMSA) supplies medication that reaches out to various sectors in Kenya and has a rigorous determinant rule. (Luoma et al., 2010). The residents of both countries are not entitled to free essential medicine, except for a few cost-sharing products and services.
Information and Research
The integrated health information systems (IHIS) also called (i-his )
collects health data and provides information technology infrastructure for the public health sector ( Technology agency). A multi-award-winning healthcare IT leader, integrated health information systems modify, analyses and connect Singapore’s health ecosystem intending to transform and improve the populace health record by integrating highly analytical, intelligent, productive and of course, less expensive technologies that can facilitate the processes transforming health care system through smart technology. (Taylor et., el 2017)
IHIS supports more than 50, 000 healthcare users in Singapore’s health ecosystem and has been awarded more than 80 times ever since it’s invention through the electronical application of clinical computer science, comprehensive standard-based IT , this allows effective communication and cross boundary workflows, statistical and methods in learning techniques to discover more value. The IHIS advocates for the continuous learning, where everyone is given the equal privilege to learn and grow and develop their relevant capabilities and interests, achieving dual goals, both business and personal goal, this system two potential career path, the Technical track, and management track. (Taylor et., el 2017)
Singapore also uses the National Electronic Health Record (NEHR), which was launched in 2011, this system has a direct link to patient health care data across multiple health facilities that are well equipped and resilient in health delivery all over Singapore. (Sinha et al., 2012; Wee., 2015)
Conversely, In Kenya, the district health information system software 2 (DHIS2) is a transparent health management data platform used by countless organizations, including the European Union (EU) and governmental body worldwide. (Karuri et a l., 2014) This platform is used to total statistical collection, validation, presentation, and analysis. It also functions in monitoring patient health, specific in detecting disease outbreaks, and creates an efficient work environment for easy health data access for health facilities and governmental parastatal. Since the release of (DHIS2) in 2006, over 54 countries are deploying on a national scale, half of which are in the Pilot phase or early phase in their movement. (Karuri et an l., 2014)
This open-source software platform is found by Health Information Systems Program (HISP) and was massively supported by the department of informatics, University of Oslo. Although before today, the HISP) is focused on Community information systems and grassroots health committees in the South African health district. Notwithstanding, both Singapore and Kenya has a little similarity in the sense that they have the same aim in mind while creating these platforms ( Smart Technology ) where there is easy access to every data needed. DHS’s was launched in 2010 while (NEHR) in 2011. A study on the Strengths of DHIS2 shows that because of its technical feature of the software and proper management of data, it became increasingly too easy to access information and satisfies all other associates, but this is different from Singapore’s. (Karuri et al., 2014; Dehnavieh et al., 2019). DHIS2 can be deployed using the web interface to support an integrated HIS system usable (Singapore) by all levels of a health service or as a standalone mobile reporting system.
Discussion
The burdens on the Singapore health system have never been more dangerous, despite being rated as the second-best most efficient health care system around the World by the Economic Intelligence Unit, (Ramesh & Bali, 2017). Singapore today is faced more challenges, chronic diseases such as cancer, heart disease, stroke, hypertension and this has mostly be linked with the aging population which has become a must look into a factor in Singapore, according to the UN’s 2017 World population aging report, there are over 886,00 aged people within 65 of years, and there is a high tendency that 10years from now (2030) it might increase to be over 1million. Currently (2020), the health workforce Ministry of health in Singapore has declared the 2020 healthcare workforce plan to begin the employment of 30,000 health workers, this is because there has been a shortage of health practitioners in the healthcare system. The number of employed nurses are deficient, history has it that most of the nurses in Singapore are foreigners, but there is a high percent of trained foreign doctors 2/3 in Singapore (Tay et al., 2014), more health practitioners form different disciplines is to be employed in other to ensure that health care delivery is for all at all times.
Conclusively, Singapore population has grown drastically over the years and this is a impact in the health sector technology as the cost of health increases ( Lim, 2017), The Government of Singapore should make more efforts to see that they improve subsidy packages especially for the more aged people and improves primary health care.
The Kenya healthcare system faces many critical challenges, notwithstanding, but has also made significant improvements despite being a low-income country, problems such as increasing workforce, implementing a referral system from primary health care facilities to secondary, tertiary or private hospitals, issues of incompetent leadership, aspects of healthcare finances. The era of the new constitution in Kenya took place in August 2010; The health sector has always been the most significant service sector to be transferred under the new governance arrangement. The aim of devolving is for the Government to design an innovative plan and act immediately according to the country lacks and basically to always encourage every citizen participation, making a self-governing arrangement and decision making to be willing and always ready to manage potential issues. However, the an-all-inclusive right-based approach is needed to reassure and to guarantee health service delivery is its proper institutionalization to ensure good governance and active community participation, accompanied by broader governance report as demonstrated in the news constitution. (Kimathi, L. et.,2017).
According to World bank, there is a lack of investment in the infrastructure; this is a severe implication considering the lack of proper funding in the health system, GoK invests only 4.6% GDP, (World Bank, 2018b). A reasonable amount of funding should be invested on the healthcare sector and Government should see this as a priority as this will lead to the betterment of all in Kenya; also the stakeholders should implement new programs for health education and training of professionals to be dispatched all over Kenya. Research shows that between 2004 to 2015, a total of 669 health professionals, including Doctors, Nurses, pharmacists, and so on. Intended to work in other countries. (Gross et al.).
Conclusion
Singapore healthcare systems are among the few in the World that has a long-standing history of delivering health care to all citizens, comprising of the equity standard healthcare (free). However, the difference between Singapore and Kenya, as discussed throughout this report, will give us a better understanding in regard to how these two countries’ health care system works. The fundamental principles of Singapore remain the same to deliver practical, safe, equitable, cost-efficient, high-quality healthcare, but this is not the same for Kenya. However, there has been a drastic improvement compared to some years back. Kenya’s healthcare system does’nt secure the health of its Citizens and does’ nt give a working case of a very much incorporated framework which the World can be confident enough to talk about.
Limitations
This report was centered around the difference between a high-income country and a low-income country. There was a limitation in getting sources at some point of this research e.g information and research, but notwithstanding a lot of this information relies upon on already existed fact. There is a lot already unveiled in this report.
Reflection
This article examines the unique challenges facing Singapore and Kenya, comparing health systems between a high-income country and a low-income Country, this study has helped me to understand how various healthcare system functions. I was able to outline different sections of this study, and the six building blocks were a big help in figuring out and understanding every component, knowing how fundings and healthcare delivery services have been carried out. So many points touch my heart, I was able to compare the first point contact in a health system between both countries, and well, I was able to differentiate between both the major sources of healthcare information delivery and which are The integrated health information systems (IHIS) for Singapore and district health information system software (DHIS2) for Kenya. In the conclusion of this study, I was able to understand the fact that, despite Singapore is more advantageous compared to Kenya, but they all have their disadvantages/challenges. Lastly, after many studies from over the years, Kenya seems to be a growing process and will be accomplished in years to come.
Working as a group was the begining of my inspiration as I was able to achieve this task through relating ideas and consistent analytical thinking with this case study that requires several literature reviews, I enjoyed working with my partner as a team as he was analytical and helpful both in part A and B of this assessment. I must say getting resources for Singapore was more comfortable for me than Kenya.