Health sector workers need continuous training

By PASCHAL MANYURU

Over a billion people worldwide cannot enjoy quality healthcare, mainly due to a shortage of skills and uneven distribution of health workers.

This crisis has had disastrous implications on the health and well-being of millions of people, yet not enough health workers are being produced to bridge this gap.

Besides, lack of access to regular and quality continuous professional development by practising health workers especially in rural areas has resulted in perennial migration of workers to urban areas.

DECENTRALISATION

A visit to health facilities outside major towns gives a clear picture of the inequitable distribution of health workers. While it is easy to find specialised health workers in Nairobi and Mombasa, it is normal to find nurse aids, pharmacy assistants and community health workers prescribing, dispensing and administering injections in rural areas.

The Central Government had embarked on the supporting decentralisation of workers by posting human resource officers to all counties and large hospitals to address this discrepancy.

It is not clear how much success was achieved but a new challenge has now emerged with health workers not keen on being devolved.

As Kenya grapples with the challenges of devolution, there is need to ensure that medical training institutions produce health workers who are well-equipped to work in the challenging and evolving workplace. Speaking to practicing pharmaceutical technologists gives an understanding of the challenges encountered in their early years of practice.

After graduating, one is taken aback by the gap between the theory taught in college and the actual practice. To start with, there are changes in the treatment guidelines which can be attributed to both time lapses and uninformed lecturers. Colleges lay emphasis on theory and provide minimal exposure to practice.

Considering the huge class numbers and the limited number of facilities that offer internships, few health workers feel well qualified to offer services after graduation. The situation is made worse when mentors who are supposed to guide students during internships take advantage of their presence to engage in private businesses.

NEVER ENDING CYCLE

In some cases, hospitals collapse when health workers who lack any form of training on management and administration are promoted to head them. 

After graduation, the practice has been to post entrants to areas with severe staff shortages. These health workers hardly last as they go back to urban centres in pursuit of higher learning and to escape the harsh environment in these areas. These regions are, therefore, perpetually in a cycle of fresh graduates who require continuous training to close the gap between college training and field practice.

GUIDELINES

It is for these reasons that continuous professional training is critical to the delivery of quality health care. While this is so, in-service training in the health sector is not very well coordinated.

Data on courses offered and the number of trainees is scanty. Most medical regulatory agencies have continuing professional development guidelines but are yet to enforce them due to the limited capacities.

The Mission for Essential Drugs and Supplies (Meds), embraces training as an ongoing feature in a care worker’s continuing professional development.

To ensure health workers have access to ongoing training, the organisation has to date trained over 20,000 health workers including doctors, clinical officers, nurses and pharmacists in various aspects of healthcare provision.

This is done by increasing access to in-service training and linking trainees with professional bodies to earn continuous professional development points.

Capacity building calls for stronger partnerships between health facilities, health workers, development partners, regulatory bodies and training institutions.

Notably, with the support of the Division of Malaria Control under the Ministry of Health, Meds has trained various 1,390 frontline health workers across the country on malaria case management.

In partnership with Funzo Kenya, a USAid funded project, the organisation is also set to implement the pioneer e-learning programme on Laboratory Commodities Management.

KEY BARRIER

This innovative programme will enable health workers across the country to access reliable, quality and affordable training from the comfort of their work stations.

The Kenya Health Sector Strategy Plan (III) notes that lack of mechanisms to link training institutions with service needs in the sector is a key barrier faced by the Ministry of Health. Unless health workers undergo continuous professional development to be up to speed with this dynamic field, achieving quality, reliable and affordable healthcare for all will remain an illusion.

The writer is Managing Director, Mission for Essential Drugs and Supplies (Meds). Kipkoech Tanui’s column will return soon.