By KPC Reporter

Nyamira County has defended the state of its dialysis services, announcing plans to procure additional machines even as concerns persist over access, costs and capacity.

This information was availed in a detailed interview by KPC following our investigative story that identified gaps in the critical unit of healthcare.

County Executive Committee (CEC) Member for Health Donald Mogoi said the county currently operates seven dialysis machines, all of which are functional.

Interviews had shown that some machines were not working and others had become obsolete, causing long queues of patients and forcing some to seek dialysis services elsewhere.

Also captured during the investigations were rising patient costs and inconsistencies in health coverage.

“We have seven machines and they are all functional,” Dr Mogoi said, adding that the county government is moving to scale up capacity.

“We intend to purchase 20 more—13 for Nyamira and seven for our sub-county hospital in Keroka. Procurement will start by next week with an advert for the same.”

Should the county implement this plan, the renal unit to be established in Keroka will serve several patients mainly from Kitutu Masaba and Borabu constituencies.

The whole matter was ignited by Health Cabinet Secretary Aden Duale, who claimed that the county’s healthcare system had collapsed under Governor Amos Nyaribo, remarks which were vigorously countered.

It emerged that Nyamira had declined to receive specialized medical equipment through an arrangement spearheaded by the national government and deemed extravagant by the Nyaribo administration.

Duale had painted a picture of a county government that had refused to welcome high level equipment at no cost, a claim that turned out to be untrue.

“Health is devolved and the national government doesn’t give free things,” Dr Mogoi said.

“Actually even what they are talking about is not free… they deduct the money per service at SHA level.”

Dr Mogoi explained that under the current model, facilities receive only a fraction of the dialysis reimbursement.

“For dialysis, the share is at 18 percent for the facility and 82 percent for the vendors,” he said, a breakdown that may partly explain the financial strain reported by facilities and patients alike.

Dr Mogoi also dismissed suggestions that Nyamira could face penalties for declining the equipment, reiterating that healthcare is a devolved function under Kenya’s constitution.

“I don’t think there are penalties… it’s up to a county to see how best to provide services to its people,” he said.

Dr Mogoi further questioned why Nyamira has been singled out, arguing that similar gaps exist in neighbouring counties.

“Some of our neighbouring counties don’t have functional CT scans… have they been supplied or have they picked one?” he posed.

“Similarly, some counties don’t have renal dialysis equipment—have they picked any?”

He suggested that the heightened attention on Nyamira may be politically driven.

“Generally Nyamira is in the news simply because someone wanted to score some political points, by” he said.

Dr Mogoi challenged stakeholders to broaden the conversation beyond Nyamira, calling for comparative data on medical equipment distribution and patient referrals across counties.

“Maybe you can ask how many machines have been supplied to our neighbouring counties and how many Nyamira patients have gone to those public facilities… then we can have a good conversation,” he said.

Despite the foregoing concerns, Dr Mogoi maintained that Nyamira is making progress in strengthening its health infrastructure, citing existing investments in specialized equipment.

“The specialist machines we have at the moment include CT scan, ultrasounds, mammogram, dental X-ray machines, X-ray machine, renal dialysis equipment, and theatres including orthopedic and urology,” he said.

He also pointed to plans to expand into more advanced diagnostic services, suggesting that Nyamira could be ahead of some counties in certain areas.

“If we are planning to acquire high-end imaging equipment such as MRI machines, which remain scarce in many county hospitals, then we are ahead of many counties,” the CEC said.

Our earlier report had also indicated that patients in Nyamira face rising out-of-pocket costs and uncertainty over coverage, even as demand for dialysis services continues to grow.

Dr Mogoi attributed the growing demand for dialysis to a broader national trend—an increase in non-communicable diseases such as diabetes and hypertension, which are leading causes of kidney failure.

“Generally in the country there is an upsurge in non-communicable diseases, particularly diabetes and high blood pressure,” he said.

“The most common complication for these diseases is kidney failure.”

He emphasized prevention as a key pillar of the county’s strategy, pointing to the need for lifestyle changes, early diagnosis and better disease management.

“The whole prevention strategy is around change of lifestyle practices in terms of diet, exercise, early diagnosis and control to avoid complications,” he added.