Kenya

The Kenya Treatment Access Movement has mobilized healthcare workers from across the country to facilitate formation of a national network for HIV-positive healthcare workers. The network’s mission is to act as an advocate for all healthcare workers living with or affected by HIV, helping to reduce stigma and discrimination, increase their visibility, and expand access to treatment, care, and support services. [from author]

This study was designed to document the role and experience of health professionals with significant responsibility for human resource management (HRM); identify the challenges that these health professionals face; identify additional skills and knowledge needed by these health professionals to address HRM challenges; solicit recommendations for changes in pre-service and in-service HRM training. [from summary]

Anecdotal evidence suggests that there is severe competition for personnel and staff time between various health programmes and between public and private providers. Such competition is reinforced by the vertical nature of various funding mechanisms supported by bilateral donors, international NGOs and global initiatives. The objective of this study was to analyse in what way HRH recruitment, deployment and retention at the district level are influenced by externally funded programmes. [from summary]

The author outlines the results of the Emergency Hiring Plan which was designed to quickly hire and train large numbers of qualified health workers in Kenya and deploy them where they are most needed. [adapted from author]

This document chronicles the evolution of e-learning among nurses in Kenya. It charts the obstacles - a shortage of qualified tutors, the scarcity of clinical placements - and the priorities to overcome them. [adapted from author]

This study analyzed data from a human resources health facility survey conducted in Kenya. The study looked into the status of attrition rates and the proportion of attrition due to retirement, resignation or death among doctors, clinical officers, nurses and laboratory and pharmacy specialists in surveyed facilities. [adapted from abstract]

This paper discusses the role and impact of community health workers in Nyanza Province, Kenya, in response to the growing demands the HIV epidemic has placed on the people and communities in this region. [adapted from abstract]

We wanted to try to account for worker motivation as a key factor that might affect the success of an intervention to improve implementation of health worker practices in eight district hospitals in Kenya. In the absence of available tools, we therefore aimed to develop a tool that could enable a rapid measurement of motivation at baseline and at subsequent points during the 18-month intervention study. [from abstract]

In response to the critical HRH shortages in Africa, the UK Department for International Development (DFID) and Office of the US Global Aids Coordinator (OGAC) have been in discussion with a number of African countries to develop strategies and country level actions. The aim is to demonstrate the maximum flexibility of disease specific programmes to support broad based primary care in line with countries’ health plans. This report presents a summary of the main findings from the country visit to Kenya. [from introduction]

The study used a literature review and field research to obtain data on strategies for the retention of health workers in various institutions in Kenya.

This issue of Voices discusses the impact of the Emergency Hiring Plan developed in combination with the Capacity Project and the Kenyan Ministry of Health to increase the number of qualified professionals working in Kenya’s public health facilities. [adapted from author]

This policy brief explores the major challenges facing Kenya in the implementation of their Integrated Management of Childhood Illness strategy and looks at why it is failing to fulfill its potential to improve health care and reduce child mortality. [adapted from introduction]

This study focused on factors associated with the readiness of Kenyan health facilities to provide quality and appropriate care to family planning clientele; the degree to which health care providers foster informed selection of an appropriate contraceptive method; and the extent to which clients perceive services to be of high quality. [from abstract]

Given the worrying trends in infant and child mortality rates, there is a clear need to assess current practices in the management of childhood illnesses and to identify opportunities for intervention. The 2004 Kenya Service Provision Assessment Survey (KSPA) findings indicate that most health care providers are not taking care of sick children holistically, but rather are treating children only for the presenting illness.

Empirical investigations of health worker training in Kenya have been limited to mappings of health service providers in terms of cadre and distribution and assessments of the training needs for various skills. However, there has not been a comprehensive study of the influence of training on the provision of quality Emergency Obstetric Care (EmOC). We seek to fill this gap by assessing the link between health provider training and practice with regard to the provision of EmOC. [from author]

The study had three objectives: to determine the current competency levels of the workforce attending women during labor, delivery, and the early postpartum period; examine conditions at the workplace to determine environmental and organizational factors that affect workforce productivity and performance; and assess implications for regional training and performance improvement at the workplace. [from author]

Increasing access to safe delivery and family planning services within rural communities increases the opportunities for women to have positive outcomes for their pregnancies as well as to plan and achieve their desired family size. This paper examines the scaling up of a community-based model in Kenya that enabled women to give birth safely at home or to be referred to a hospital when attended by a self-employed skilled midwife living in the community. [adapted from summary]

Through an analysis of focus group discussion data, we examine Kenyan traditional birth attendants’ accounts of the persistence of homebirths and the key challenges they present. [from abstract]

In health facilities across Kenya, many workers are struggling to do their jobs in less-than-ideal conditions. Work climate issues such as poor working environments, unfriendly colleagues, disorganized facility functions and ineffective supervision have been hindering workers’ performance and productivity and contributing to low retention. [from author]

This document summarizes a project to design, implement and compare two models of integrating CT for HIV within FP services in 23 health facilities in Kenya in terms of their feasibility, acceptability, cost and effect on the voluntary use of CT, as well as the quality of FP services. [adapted from summary]

JHPIEGO has been focused on improving the quality and availability of reproductive health and family planning services for slum residents, both by targeting the facility-based health care providers and the community members who access these services. This document outlines several lessons that have been learned from this experience. [adapted from author]

This Voices discusses the experiences of nurse hired through the Emergency Hiring Plan in Kenya in providing family planning services, and the importance of confidentiality in the successful provision of these services.

Despite a pool of unemployed health staff available in Kenya, staffing levels at most facilities were only 50%, and maldistribution of staff left many people without access to antiretroviral therapy. Because in the current system it takes one to two years to fill vacant positions, even when funding is available, an emergency approach was needed to fast-track the hiring and deployment process. A stakeholder group was formed to bring together leaders from several sectors to design and implement a fast-track hiring and deployment model that would mobilize 830 additional health workers.

Prior to implementing male circumcision as a public health measure against the spread of HIV, the feasibility, safety and costs of the procedure within target countries should be evaluated to understand what measures need to be taken to ensure access to safe, affordable voluntary circumcision services. The aims of this study were to assess variation and safety of male circumcision practices, as well as resource and training needs related to the procedure, in a community that has been practicing circumcision traditionally for many generations. [from introduction]

This case study evaluates a project in Kenya that concentrates on HIV and AIDS care and prevention through support and training of community volunteers to provide PLHA with HBC, widespread and diverse efforts to promote behavior change and raise awareness about HIV and AIDS, improving access to VCT, as well as capacity building efforts and direct material assistance for OVC and PLHA. [adapted from introduction]

This mid-term evaluation report focuses on Capacity Project support to the Government of Kenya’s Emergency Hiring Plan. It assesses the main achievements, challenges and impact on service delivery and health systems improvement, from the plan’s inception through the November 2007 mid-point. The report outlines all aspects of the approach used, providing clear recommendations on how the Ministry of Health may strengthen its existing human resource systems on the basis of lessons learned, and provides additional insights to the process, which may be useful for informing similar country contexts.

This study was conducted to identify determinants, benchmarks and indicators of the costs and benefits and distributional impact of the migration of human resources for health on health services in Kenya and to make policy proposals for intervention. [from abstract]

This brief describes the successful process of working within the government to achieve results in HIV planning. [adapted from author]

The emphasis of the COPHIA program is the provision of home-based care and support services by multi-purpose community-based health workers to vulnerable households in the geographic focus areas that are coping with the burden of caring for seriously ill family members or caring for orphans and vulnerable children. The COPHIA community-based health workers, with the support of clinical and non-clinical supervisors, provide the direct physical and emotional care and support services to PLWHA and orphans and vulnerable children in the project catchment area with the support of trained primary caregivers.

During the 1990s in Kenya, nurse midwives, a new group of private-sector service providers, were licensed to operate private clinics close to communities. The private nurse midwives operate private clinics, nursing and maternity homes primarily in densely populated peri-urban areas, rural trading centers and towns. The networks described in this report emerged out of the need for a sustainable supervision system and a continuing education program for the private nurse midwives. [from introduction]