KENYA DEVELOPMENT PRIORITIES 2020 ABBY KEEP, SOPHIE SILVA, EMMA SLOAN, SYDNEY SAMPSON Table of Contents Introduction ​............................... 3 Health ​........................................ 5 Housing ​.................................... 14 Education ​................................ 18 Environment ​.......................... 22 Water ​....................................... 32 Agriculture ​............................. 36 Trade ​....................................... 39​ Tourism ​.................................. 43 Sources​ ​.................................. 48 2 Introduction The Republic of Kenya is home to tower in mountains, blue lakes, and rolling hills. Its people are academics, artists, athletes, and leaders. With the right investment, Kenya can realize its bottomless potential. The wellbeing of our citizens is the priority of the Kenyan government and is enshrined in our national development plan, Kenya Vision 2030. Kenya Vision 2030 has been designed as a blue-print to create a nation held to a global standard of competitiveness and prosperity by the year 2030. Set​ out by the Grand Coalition Government in 2008, the goal to "transform Kenya into a newly industrializing, middle-income country providing a high quality of life to all its citizens by 2030 in a clean and secure environment.”1 To clearly emphasize each goal the pillars of this plan have been set out to be: ● Economic and Macro:​ aiming to achieve an average economic growth rate of 10% per annum and sustaining the same until 2030. ● Social:​ seeks to engender just, cohesive and equitable social development in a clean and secure environment. 1 K​enya Visi​o​n 2030 3 ● Political:​ aiming to realize an issue-based, people-centered, result-oriented and accountable democratic system. These objectives are firmly held in the foundations of macroeconomic stability; infrastructural development; Science, Technology and Innovation (STI); and Reforms; Human Resources Development; and Security and Public Sector Reforms.2 The progress of Kenya continues to be successful with the implementation of our Medium-Term Plan (MTP). First, implementing these goals in 2008-2012, with the feedback, criticism and evaluation given by stakeholders, this has given Kenya the right preparation going into the 2012-2017 goals. Keeping in mind the progress we have made and then looking into the future, we are able to present the improvements needed to create opportunities for the next generation, stimulate economic growth, and improve the overall quality of life. 2 K​enya Visi​o​n 2030 4 Health Kenya has made significant steps in improving the healthcare of its citizens. In the past decade there has been a decrease in HIV-related deaths by 55% and around a 30% decrease in new infections3. We have also seen maternal mortality rates decrease by almost half in that same time frame​ (Figure 1).​ These two examples show how much progress we have been able to make in the past few years. As we head into 2020, we want to keep up this momentum and further address the problems that are plaguing Kenya’s health care system. Poor quality of care and the high levels and occurrences of preventable and treatable disease are symptoms of a larger problem within Kenya’s healthcare system. Our lack of proper infrastructure and low rates of insured citizens have resulted in a stagnation in progress to improving the quality of health of Kenyans. The constitution of Kenya states that all citizens have the right to attain the highest standard of health4. To achieve this goal Kenya needs to invest in better infrastructure to build up and maintain a strong healthcare system. 3 “Kenya” 2018 4 Bartilu et al. 2016 5 5 Figure 1 - Maternal mortality ratio (modeled estimate, per 100,000 live births) – Kenya There are three key elements that need to be discussed when looking at Kenya’s healthcare system. It is important to look at how Kenya has responded to the third Sustainable Development Goal, “Good health and well-being”. We must evaluate the state of Kenya’s medical infrastructure, in order to properly address the needs of the Kenyan medical community. Finally, we need to examine how the novel coronavirus outbreak stands to overrun Kenya’s underdeveloped health system, and how this could affect the future of said system. (1)​ Sustainable​ Development Goal #3: Good health and well-being In the past two decades Kenya has been able to significantly improve the health of its population. Kenya’s cases of infectious and communicable diseases have dropped at a significant rate. Likewise, we have also been able to improve the 5 “​ Maternal Mortality Ratio (Modeled Estimate, Per 100,000 Live Births) - Kenya | Data” 2019 6 health of mothers and children across the country. This impact is the result of improving infrastructure and healthcare coverage in the country. These improvements line up nicely with the United Nation’s third sustainable development goal which seeks to “ensure healthy lives and promote well-being at all ages”6. This goal focuses on reducing cases of communicable diseases such as HIV/AIDS, infectious diseases like Malaria, and improving maternal and child mortality rates. Over the past twenty years, the Kenyan government has worked tirelessly to reduce the number of these cases. We can work to further lower these numbers in the next decade with collaboration with NGOs and donor agencies. The Kenyan government has worked tirelessly in the past twenty years to reduce the cases of HIV; moreover, we have similarly worked to improve the quality of life of those who are HIV positive. Since 2000 we have been able to reduce the HIV cases from around 9% to 4.7% in 2018. This data correlates with the number of people who are now receiving treatment for HIV, which increased from 41.6% in 2015 to 49.1%7. The Kenyan government with the help of aid donors and NGOs have been able to reduce the cases of HIV/AIDS in Kenya as well as the rate of transmission, especially from mother to child. The Kenyan Government’s introduction of a generic antiretroviral drug in 2017 further helped to not only reduce the number of future cases, but improve the quality of life of countless HIV positive Kenyans. The drug, Dolutegravir, is a cheaper but just as effective version as drugs in higher-income countries, and with it Kenya has been able to work to 6 “​ Goal 3.: Sustainable Development Knowledge Platform” 2019 7 “Kenya” 2018 7 reduce HIV/AIDS8. Reducing HIV/AIDS and improving the lives of those infected is of the the millenium development goals, and Kenya has been able to make great strides in the effort. The introduction of a generic treatment to HIV as well as preventative measures has allowed Kenya to make great progress in improving the quality of lives of its people. 9 Figure 2 - CDC's Impact in 2018 Kenya has been vigilant in its fight against communicable and noncommunicable diseases. Malaria has especially been a fight due to the prevalence of the disease-carrying mosquitoes in Kenya. Nevertheless, progress has been made through the partnering of the government and numerous charities, NGOs, and donor agencies. Malaria decreased from 11% to 8% between 2011 and 8 “Kenya to Introduce Better Treatment For People Living With HIV - Unitaid” 9 “CDC’s Impact In 2018 - 2018 Annual Report - Center For Global Health” 2018 8 2015 throughout the entire country, and the Lake Victoria region, which has the highest number of cases in Kenya, saw an 11% decrease of Malaria cases10. The key to keeping these numbers low to non-existent is expanding access to antimalarial medication as well as ensuring that preventative methods are cost effective available to everyone. In order to continue this progress, it is pertinent that the Kenyan health services continue to be able to provide treatment and preventative equipment to people. Maternal health and mortality has been a top health priority by the Kenyan government. We have worked to improve the quality of health of our mothers both pre and postnatal. Most maternal deaths are related to complications from childbirth, but there are a number of deaths that are due to complications from malaria, hepatitis, and other diseases11. While we have been able to lower deaths related to childbirth at a near exponential rate, as seen in Figure 1, there is still more work to be done to protect the lives of expectant mothers. Access to education and quality care can save thousands of lives. Expanding health care and health insurance in order for more Kenyans to get reduced care costs that patients incur at hospitals. This can help encourage more women to give birth at health facilities under the care and supervision of trained doctors and nurses. Furthermore, comprehensive and accessible family planning can have a large impact on women’s health12. The best path forward to tackling the issue of maternal health is implementing comprehensive maternal health programs that 10 “In Kenya the Path to Elimination of Malaria is Lined with Good Preventions” 2017 11 “Maternal and Child Health: Kenya” 2012 12 Addressing Maternal Health in Kenya – The Center for Global Health and Development (GHD), 2018 9 inform women of all aspects of pregnancy, provides contraceptives, and includes insurance that covers costs incurred in hospitals. The biggest problems facing maternal health is a lack of medical infrastructure that can adequately support expecting mothers. (2)​ Healthcare​ Infrastructure & Insurance Currently, the biggest impediments to ensuring adequate healthcare to all Kenyans is the lack of good infrastructure. This has caused a myriad of problems such as hospitals and health centers not having enough bed spaces per people in their respective regions, a lack of centralized communication between healthcare providers and emergency services, and a lack of trained professionals and advanced medical equipment13. Our biggest concerns at the moment are improving and creating proper infrastructure and providing affordable insurance to our citizens. In terms of infrastructure we want to tear down and rebuild numerous health facilities that are in near dilapidated conditions so we can safely address the needs of our community.