Kenyan healthcare workers above WHO target

Kenya has surpassed the World Health Organization's (WHO) requirement of balancing the number of health workers available to the population, but faces a crisis in staff distribution, health officials said on Wednesday. Kenyan Public Health Ministry official Hannah Kimemia said the East African nation had deployed 17,000 nurses and health workers to a population of about 40 million, above the WHO's recommended ratio of 15,000 health workers. The health authorities are currently working to re-direct the workload appropriately to avoid over-burdening the available healthcare workers, who have moved to other countries in search of better paying jobs and better equipped medical facilities. WHO workload analysis guidelines will help us to re-direct the staff where they should be," Kimemia said, when asked to explain the reason for shortage of health workers, amid the reports that the country has over-deployed health workers. He was speaking during a three-day conference in Nairobi which brought together stakeholders in the health sector from public, private and Faith Based Organizations (FBOs). The objectives of the conference are to avail a platform for placing the health workforce as a priority in the health strategy and national development agenda towards Vision 2030 and devise ways and means to mitigate the negative effects of health worker migration on the national health system,. Shahnaz Sharif, the Public Health Director at the ministry, told a conference on human resources for health, the focus on health workers shortage was to ensure the 16 essential items listed by the WHO as critical to healthcare services were met. "Some of these may not be under our control but some are under our control," Sharif said. The factors which affect the healthcare workers include lack of adequate housing, poor working environments, including lack of essential supplies like gloves. "I was at a hospital in Kilifi, (coastal region of Kenya) and the situation at most hospitals are pathetic. The doctors do not have gloves. This makes exposure to diseases more critical to the healthcare workers," said a medical doctor, who sought anonymity. The medic said in some cases, mothers cannot be assisted during delivery by medical personnel, fearing contracting diseases. However, some medical practitioners said the crisis facing the healthcare industry in Kenya was not just the lack of supplies, but the poor attitude of the health workers. "Some interns cannot face a patient without their gloves on. It is a question of the system failing to conduct a proper vetting of trainees for the medical profession," said one nurse. In the delivery of quality health services, analysts say Kenya faces many challenges just like other health facilities across the globe. Kenya's human resources for health situation is characterized by a severe shortage of health workers, inability to attract and retain health workers especially in the public sector, performance management issues, unequal distribution of staff and diminishing productivity among the health workforce. The health facilities in medical institutions have a high turnover of heath workers especially doctors and nurses who are leaving the service for greener pastures. Health officials cite the interference of politicians in the transfer of certain categories of health workers to serve in most semi-arid areas as a factor leading to the lack of medical workers in certain locations and an over-concentration of workers in some areas. Kimemia said her office was regularly bogged down by the inability to transfer some politically-well connected public health officers. Despite having more than adequate staff to manage the facilities, the Kenyan public health workers are grappling with a shortage of pharmaceutical staff at its facilities. "We have a critical shortage of pharmaceutical technologists. The nurses are forced to do the work of pharmacists," Kimemia revealed. Maurice Middleberg, an international consultant and head of CapacityPlus/IntraHealth, a medical think-tank currently implementing a 300 million U.S. dollar agreement with the U.S. Agency for International Development (USAID), the success of every country is not measured by its numerous medical staff, but by its ability to provide staff to local clinics in remote rural areas. "We are living through remarkable public health determinants.. these include technologies and the broader sense of organizing service delivery strategies," Middleberg told the conference. Those key determinants include the growth of the population, which means that countries which had more than adequate healthcare staff have been forced to hunt for better qualified staff, without investing in their training. Sharif said efficiency in the training of health workers should be marched with the gains derived by the countries investing in the training. He said the discussions in Nairobi were staged as a follow up to a ministerial meeting in 2007, at which African ministers of health and planning decided to boost the training of healthcare workers, to avert a public health crisis. Sharif said the WHO recognized the proper training of healthcare workers as a key determinant that was ignored when the Millennium Development Goals (MDGs) were crafted in 2000, although the flaw was only discovered in 2006. "We have formed a committee to discuss the human resources and their distribution. The Ministry is working to include these resources in the healthcare delivery systems," he said. Meanwhile, the Kenyan authorities have been unable to employ adequate nurses to plug the shortage of staff in the remote areas due to the lack of the qualified personnel.