Abstract
BackgroundKenya’s human resources for health shortage is well documented, yet in line with the new constitution, responsibility for health service delivery will be devolved to 47 new county administrations. This work describes the public sector nursing workforce likely to be inherited by the counties, and examines the relationships between nursing workforce density and key indicators.MethodsNational nursing deployment data linked to nursing supply data were used and analyzed using statistical and geographical analysis software. Data on nurses deployed in national referral hospitals and on nurses deployed in non-public sector facilities were excluded from main analyses. The densities and characteristics of the public sector nurses across the counties were obtained and examined against an index of county remoteness, and the nursing densities were correlated with five key indicators.ResultsOf the 16,371 nurses in the public non-tertiary sector, 76% are women and 53% are registered nurses, with 35% of the nurses aged 40 to 49 years. The nursing densities across counties range from 1.2 to 0.08 per 1,000 population. There are statistically significant associations of the nursing densities with a measure of health spending per capita (P value = 0.0028) and immunization rates (P value = 0.0018). A higher county remoteness index is associated with explaining lower female to male ratio of public sector nurses across counties (P value <0.0001).ConclusionsAn overall shortage of nurses (range of 1.2 to 0.08 per 1,000) in the public sector countrywide is complicated by mal-distribution and varying workforce characteristics (for example, age profile) across counties. All stakeholders should support improvements in human resources information systems and help address personnel shortages and mal-distribution if equitable, quality health-care delivery in the counties is to be achieved.
Highlights
Kenya’s human resources for health shortage is well documented, yet in line with the new constitution, responsibility for health service delivery will be devolved to 47 new county administrations
Of the 16,371 nurses deployed in the public, non-tertiary sector that are the main focus of this study, 12,474 nurses (76%) are women and 8,741 nurses (53%) are registered nurses
Community health nurses mainly work in the community setting as public health nurses, and they are usually skilled in general nursing, midwifery, and community nursing
Summary
Kenya’s human resources for health shortage is well documented, yet in line with the new constitution, responsibility for health service delivery will be devolved to 47 new county administrations. According to the World Health Organization’s World Health Report 2006, based on data in the Global Atlas of the Health Workforce for 193 member states, there are currently 57 countries including Kenya with critical shortages. These together have a deficit of 2.4 million. Another study done using data in 49 countries found that the combined density of doctors and nurses to population is positively and significantly related to coverage of three vaccines when controlling for other health determinants [12]. The correlation between the availability of health workers and coverage of health interventions suggests that the public’s health suffers when health workers are scarce [11,13,14,15,16]
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