Pain as thousands of health careers head for dead end
Thousands of graduated health workers and those already in college face a bleak future as authorities say there is no money for hiring.
The state of medical workers was the second biggest issue after financing, at the Kenya Health Forum 2019 held at a Nairobi hotel last week.
The annual forum brought together all players in the sector including the Ministry of Health, counties, NGOs, faith-based organisations, politicians and donors.
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Opening the forum on Wednesday, Cabinet Secretary for Health Sicily Kariuki said the country faces a shortage of 140,000 health workers.
“This state of affairs must not continue. We must curtail it,” said Ms Kariuki.
She said the success of Universal Health Coverage (UHC) largely depends on adequate, efficient, well managed and motivated health workers.
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But that, she said was currently not the case as the sector is characterised with huge shortages, perennial strikes and high rates of worker absenteeism.
However by the second day of the forum, it had emerged that indeed Kenya has no shortage of health workers but lacks finances to absorb thousands of tarmacking cadres.
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For example, the forum was told that when recently Kisii County advertised for 100 nursing positions they received more than 4,000 applications.
Similarly, a recent advertisement for about 500 jobs at the soon to be opened Kenyatta University Teaching, Referral & Research Hospital reportedly received more than 17,000 applications.
“We were similarly overwhelmed when we advertised for just a few nursing positions,” Dr Wilson Aruasa, CEO at Moi Teaching and Referral Hospital, Eldoret told Saturday Standard
at the Nairobi forum.
In group discussions, it also emerged that more than 2,000 general doctors and 100 specialists may be tarmacking.
In a situation never experienced in Kenya before, sacked medical doctors in Laikipia County are currently in court fighting to keep their jobs.
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The doctors have asked the court to stop recruitment of medical officers, dentists, pharmacists, medical and pharmaceutical specialists, because this would cause the sacked workers irreparable harm.
The debate in the Nairobi forum moved from a no-shortage-of-workers to whether the country is over-training medical staff.
Former Director of Medical Services James Mwanzia said there was consensus that counties lacked financial capacity to recruit more health workers.
“We have high rates of qualified but unemployed health workers while hospitals are experiencing critical shortages,” said Dr Mwanzia, who is currently advising the ministry on a specialist doctor’s programme.
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To illustrate the paradox, Moses Mulomi, Deputy Governor Busia County said a third of their budget is going to the health sector and mainly to pay salaries at the expense of other medical needs.
Health personnel, he said, constituted almost a half of the county’s workers, but they were still not enough. “Estimates show we need about 500 more because the current number is greatly overwhelmed by the high number of patients. However, we do not have money to hire,” Mulomi said.
In the final communiqué read on behalf of the Director General of Health John Masasabi, it was recommended urgent efforts be made to employ more health workers.
To facilitate this, the communiqués urged the government to increase funding to the sector and recommended more finances be mobilised through targeted ‘sin taxes.’
But there was a general feeling among participants this was just another of the many recommendations from similar forums that end on shelves.
Meanwhile, the situation could worsen for the more than 30,000 medical workers graduating from various training institutions across the country.
According to the Kenya Economic Survey 2019 there were 21,209 undergraduates and postgraduate medical students in the 2018/19 academic year.
During the same period there were 10,869 graduates from public middle level medical colleges, most who have since joined the tarmacking lot.
The two levels of government are under intense pressure from donors and lenders such as the World Bank, USAID, and US President’s Emergency Plan for AIDS Relief (PEPFAR) to reign in the runaway wage bill, which they say is hurting public services.
The Kenya Health System Assessment published in June 2019 by the USAID and PEPFAR says counties while facing the need to cut the wage bill and address health worker shortages at the same time must bit the bullet.
“Counties could resolve this dilemma by making the tough decision to freeze employment and by becoming more efficient,” said the US assessment.
The report also wants governors to be tough in reigning in absenteeism among health workers, recorded at almost 50 per cent in some counties.
But even the fate of about 10,000 health workers engaged by donors, may be at stake with PEPFAR recently announcing huge aid cuts and intentions of downloading some workers into the government.
Already some 1,562, the assessment says have already been offloaded onto county governments. The US agencies, which have huge influence in Kenya’s medical sector, are skeptical the country is able to adequately finance health in the near future.
“The large proportion of government revenue used to finance debts and wages, coupled with slow economic growth limit the capacity to expand health resources,” said PEPFAR in its Kenya Country Operational Plan 2018.
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