Articles

The Kenyan healthcare system is at a crossroads. The demand for quality healthcare is rising even as the workforce responsible for delivering these services is facing immense challenges. Inequitable distribution of healthcare professionals (HCPs), few training and employment opportunities, poor working conditions, and the amplifying issue of brain drain are straining the Kenyan healthcare system. Achieving Universal Health Coverage (UHC) will remain an uphill battle if these pertinent issues remain unaddressed.

Recognising these pressing concerns, the Kenya Medical Association (KMA) has contributed to the Healthcare Professionals Policy 2025. This policy aims to remodel how healthcare professionals are trained, employed, deployed, and retained.

At the heart of KMA’s recommendations is the establishment of a National Health Services Commission, a body structured to bridge the gap between the health workforce and government policy implementation.

What’s Going Wrong?

Kenya’s healthcare workforce faces perpetual challenges because of:

1. Poor Coordination Between National and County Governments. Leadership turnover at the county level erodes institutional memory. Additionally, there is poor collaboration between National and County levels of government, leading to the stagnation of health policy implementation, particularly at the grassroots level.
2. Inadequate Planning and Financing. Training programs don’t align with population health needs, and resources are often misallocated, with health facilities understaffed and under-equipped.
3. Shortages of Trained Professionals. Medical schools aren’t producing enough HCPs to meet the healthcare needs of all Kenyans. Career progression for HCPs in government employment also remains unclear, leading to poor employee retention and high turnover.
4. Poor Employment Conditions. Counties lack adequate budgets to hire and pay healthcare workers on time, making job security a major concern.
5. Healthcare Worker Migration. Brain drain is worsening due to poor working conditions, lack of career growth, and inadequate compensation for services rendered.
6. Weak Professional Regulation. Some HCP cadres operate without oversight from instituted regulatory bodies, leading to malpractice and unethical behaviour.
7. Lack of Reliable Data on Human Resources for Health. There is no centralised system to track healthcare professionals, leading to inefficiencies in healthcare workforce planning.

The Kenya National Health Services Commission: A Potential Solution to Kenya’s Healthcare Workforce Crisis

To address these challenges, KMA proposes the institution of a National Health Services Commission that would oversee the management of the entire Kenyan healthcare workforce.

The Commission would:

1. Improve Governance and Coordination. The Commission would act as a link between HCPs and the government, streamlining healthcare leadership and preventing delays in policy implementation.
2. Ensure Adequate Staffing and Retention. By tracking training and workforce needs, the Commission would facilitate better planning for HCP education, employment, and career progression.
3. Strengthen Health Regulatory Frameworks. A HSC would develop and enforce policies on licensing, training, and professional development for HCPs across all cadres.
4. Address Brain Drain. The Commission would support the retention of skilled HCPs by advocating for better working conditions and employment incentives.
5. Strengthen Workforce Data Management. The Commission would oversee a centralised HCP information system that would help in tracking workforce distribution, training needs, and deployment strategies.

The Way Forward

Kenya’s healthcare system can’t function without a well-supported workforce. A National Health Services Commission, through supporting better healthcare planning, could significantly contribute to building a more resilient health workforce that meets the healthcare needs of all Kenyans.

Written by Dr. Wairimu Mwaniki. KMA Policy Advocacy and Communications Committee Convener.