Health workforce shortfall bites as government makes strides towards UHC

Health CS Susan Nakhumicha (right) with her Malawian counterpart Khumbize Kandondo Chiponda at a dinner during the Africa Climate Summit in September 2023. [Elvis Ogina, Standard]

It has emerged that Kenya is still grappling with a shortage of healthcare workforce, as the country gears towards the implementation of Universal Health Coverage (UHC).

Senate Health Committee Jackson Mandago said with Kenya adopting UHC, the country is grappling with an acute shortage of health providers which should be addressed for smooth operation.

However, Mandago said even with the shortage, hundreds of trained Kenyans are travelling abroad in search of employment due to unemployment in the country caused by a lack of resources.

"It is worrying that more trained health senate committee for health and labour, we know that it would have been good to employ health workers in the country, but we must admit we do not have adequate resources to recruit them, this is why we are still addressing this issue," said Mandago.

According to the senator, among professionals struggling with unemployment are 8,000 healthcare providers who were trained by the government to jump-start UHC.

Also, health workers employed to handle the Covid-19 pandemic were not absorbed.

"...those employed during Covid-19 when nobody was willing to go near where a sick person was must be rewarded. These are brave soldiers of this nation who risked their lives to save lives. We must have a conversation," said, added Mandago.

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As a solution, he said there is a need to create a framework for employing trained health professionals for a smooth employment process.

"What happens to a nurse who graduated five years ago, and the skills are fading away? Why not keep them in a working environment, and work in an environment where they will be employed in a clear framework, on the years they are expected to serve," he said.

But in a quick rejoinder, the Health CS Susan Nakhumicha said the shortage is being addressed through the Human Resource Advocacy Council.

Nakhumicha said when the Kenya Government ascended to power, there was a Health Act 2017 that gave birth to the Human Health Advisory Council.

The council, she said, will guide on employment of healthcare providers at both national and county levels, and address employment disparity currently witnessed across the country.

"Most doctors are employed by county governments, but there is no patient, or Kenyan who is a patient for national and that of county government," said the CS,

The CS, however, sounded a warning to underperforming healthcare providers at a time when Kenyans are struggling to access service, saying action will be taken against them.

"You cannot be the doctor who comes in, and puts a jacket in the chair and when patients are coming to see you, you are nowhere to be seen, and at the end of the day, you expect otherwise. It doesn't happen. It will not happen as we move forward.

...you cannot be the kind of nurse whose role is circulating content instead of taking care of us and expecting us as we look at you and applaud you for that? Posed Ms Nakhumicha added that every healthcare provider must play their role to boost service provision across the country.

Public Service Felix Koskei acknowledged myriads of challenges facing healthcare in the country namely staff mobility, training, retooling and personal development, staff welfare and career advancement, performance management and motivation, and healthcare worker safety and well-being.

Bit amid challenges, he said Kenyans seem to have lost respect for the medical profession because of corruption and misconduct.

"In the village, a long time ago, when a nurse was in a uniform, she wouldn't pay the fare, and everybody respected them because they were saving lives. But what is happening now?" posed Koskei.

The CS added, "Nowadays, people don't respect the profession because those we know have not kept the profession high. They are always fighting in bars...nobody cares if you're a doctor, or a nurse and even they cannot pave the way for you, because they know you'll be hurrying to go kill and not treat,

He maintained that corruption in the medical profession should be addressed and curriculum looked at.

"Is it the space that has allowed the entire structure of profession to be infrared by corruption? Those admitted to medical schools have stolen exams and are not undertaking any vigorous training," said the Koskei.

Speaking during the ongoing UHC conference in Kericho where he was the chief guest Koskei maintained that health is a key agenda in the Kenya Kwanza administration.

He said primary health will reduce the resources patients and the country spend on curative services.

"...many years ago, while in secondary school, we were to about prevention. We were moving from one home to another constructing toilets, trying to teach them little knowledge taught in primary schools on the importance of washing hands when eating food

Though greetings is a good thing and African, we were warned that you can be infected with diseases, and someone who doesn't bathe well because you would force parents to sell a cow a goat to get money for services," said the CS.

The CS said the Kenya Kwanza government, unionists and development partners are keen on the implementation of UHC.

"Issues here are to bring solutions and as a government we are happy," said Koskei about UHC. We have to act and sing Afya Mashinani because this what this administration wants to invest in," re-affirmed the CS.

During the conference, the Ministry of Health and healthcare workers signed the Kericho Declaration on Human Resources for Health in Kenya, to help address challenges affecting health workers across the country.

Also during the conference, Mandago raised an issue on training institutions, saying there is confusion on training modalities where hospitals are now turning into training institutions despite their core mandate being the treatment of patients.

On his part, CS Ministry of Public Service, performance and Delivery Management Moses Kuria also acknowledged the importance of human resources in improving healthcare across the country.

"I want to compare health workers with a car, let's assume our bodies are motor vehicles, if a car is broken we need tools and commodities to fix the car and money to fix the car, but more importantly we need a mechanic. Without a mechanic, the money and the tools are not important," said Kuria.

Kuria said in addition to the establishment of the UHC bills, the Kenya Kwanza government has put much emphasis on health, in the past 11 months to guarantee access to services to all Kenyans.

He asked unions to have positive engagements at both county and national government and improve systems that are not fully functional.

"As CS, I know we've issues with the Collective Bargaining Agreement (CBA). This is a conversation that we should continue to have, but should be shared undervalues of shared responsibilities," said Kuria.

Further, the CS said all government employees at both national and county governments will be required to sign performance contracts for quality work delivery.