Hits and misses

Mombasa health spending story should use data to identify whether pledges match needs

Mombasa plans to spend Sh1billion on health training, which ran in The Star on April 14, provides important details on the county government’s plan to spend Sh1billion in various categories to improve healthcare.  The data, while often precise, lacks the context data and visualisations that would enable readers to decide if the new healthcare plan will be effective in addressing the needs of the community.

Budget Data

  • Sh1bn for health improvements (not just training as suggested by the headline).

Missing contextual data

  • How much is this in comparison to the overall Mombasa health budget for 2013-2014? Can the increase or decrease be visualised in a bar chart?
  • Where is this money coming from and is it in addition to or part of the county health budget for 2014-2015?
  • When will the money be spent by and how can the public track the progress of the projects?
  • How has the Sh1bn been allocated among the different priority areas mentioned in the article?

Staffing Data

  • The types of specialists to be trained
  • The qualifications for doctors to receive specialised training
  • The existence of a health audit of medical institutions in the county that may have indicated the need for certain specialists at certain institutions
  • The patient capacity and number of specialists and nurses at Coast General Hospital
  • The number of nurses at the Coast General Hospital maternity wing versus the number at Kenyatta National Hospital’s maternity wing

Missing contextual data

  • Did the health audit show that the specialist training the government plans to fund are the most needed specialists?  What are the top five specialists needed in the county?  How many patients do each of them serve now?
  • How much will it cost to train each specialist?
  • How many doctors qualify to apply for the training program?
  • How does the ratio of these specialists to patience compare to the national number?
  • How many patients would be served by each of these specialists based on the target training number and current patient demand?
  • What is the nurse-patient ration in maternity wings in all Mombasa hospitals and in Coast General Hospital and how does that compare to Kenyatta National Hospital’s ratio?

Infrastructure Data

  • The hospitals to be renovated
  • The number of operating theatres at the Coast General Hospital, functioning and non-functioning
  • An estimated cost of equipping the needed number of operating theatres at the Coast General Hospital

Missing contextual data

  • How much money has been allocated to each hospital and how much money will that come out to per patient based on capacity of the facility?
  • How many people can be operated on in the current operating theatres and how many people need to be operated on in each year?  Can the gap be visualized?
  • How many surgeons would be needed to fill the renovated operating theatres and how many does the hospital currently have?

Why does the data matter?
Imagine a few hypothetical scenarios in which healthcare money could be misspent because people didn’t have all the facts:

  • A politician claims to be making a huge investment in healthcare, but it is actually less than was spent on healthcare the previous year.  Check out if this is happening in your county here.
  • A committee decides to invest in training specialists for a disease that is uncommon in the county instead of specialists for widespread diseases
  • A hospital invests in specialized equipment but then doesn’t have technicians who know how to operate them

Data can help journalists fill their watchdog role by investigating the public interest impact of politician’s promises, rhetoric and budget decisions.  If you are interested in investigating healthcare spending in your county contact [email protected]

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