The public sector nursing workforce in Kenya: a county-level analysis

Area of Science:

• Public Health
• Health Workforce Analysis
• Nursing Studies

Background:

• Kenya faces a documented shortage of healthcare professionals.
• Health service delivery is being devolved to 47 new county administrations.
• This study characterizes the public sector nursing workforce for county-level inheritance.

Purpose of the Study:

• To describe the public sector nursing workforce in Kenya.
• To examine the relationship between nursing workforce density and key health indicators across counties.
• To inform strategies for equitable healthcare delivery post-devolution.

Main Methods:

• Utilized national nursing deployment and supply data.
• Analyzed data using statistical and geographical software.
• Excluded nurses from national referral and non-public sector facilities.
• Examined nursing densities against county remoteness and correlated with health indicators.

Main Results:

• The public non-tertiary nursing workforce (16,371 nurses) is predominantly female (76%) and registered nurses (53%), with a significant proportion aged 40-49 (35%).
• Nursing densities varied widely across counties (0.08 to 1.2 per 1,000 population).
• Higher nursing density correlated with increased health spending per capita (P=0.0028) and immunization rates (P=0.0018).
• County remoteness was associated with a lower female-to-male nurse ratio (P<0.0001).

Conclusions:

• Kenya's public sector faces a significant nursing shortage complicated by mal-distribution and varied workforce demographics across counties.
• Improvements in human resources information systems are crucial.
• Addressing personnel shortages and mal-distribution is essential for achieving equitable, quality county-level healthcare.