Kenya

Big Milestones for Me and All Community Health Workers in Kenya

cbales — Fri, 30 Jun 2023 16:00:49 +0000

Big Milestones for Me and All Community Health Workers in Kenya cbales June 30, 2023

June 30, 2023

Last week USAID’s assistant administrator for Global Health visited and Kenya’s president announced a new commitment.

I was thrilled to receive Dr. Atul Gawande, Assistant Administrator for Global Health at USAID, last week at Mathare North Health Center–my link facility.

I told him about how I, and my fellow community health workers (CHWs) in Kenya, support the Introducing New Tools Project to strengthen tuberculosis (TB) care. I go house to house to educate community members about TB. I screen for TB, and when I identify a person who may have TB, I bring the patient to this facility for further testing and treatment, which can now be done using new technologies.

CHWs have made significant strides in ensuring early detection of TB. I’m a link between my community and the facility, and I connect them to essential health services–not just for TB, but HIV, family planning, maternal health, vaccination services, and more.

CHWs have made significant strides in early detection of TB.

I have gone to extraordinary lengths to become this visible, representing the impact of thousands of CHWs to the largest donor to global health.

My journey began with my own challenges accessing quality and appropriate primary health care services. I became a community health volunteer, or “CHV,” and gained knowledge and understanding of what my community’s health needs are. I continued to work as an unpaid CHV for years and realized I needed to advocate for fair pay for myself and other CHVs. I completed advocacy training and decided to co-create, with my colleague Margaret Odera, the CHW - Champions Network–a national movement for CHWs to advocate as a block for the interests and needs of all CHWs in Kenya, encourage greater leadership opportunities for us, and rally our community behind actions to improve all of our health and wellbeing.

CHWs demonstrate a deep passion for mentoring and guiding residents and fellows in achieving health for all. CHWs willingness to share their knowledge and expertise has undoubtedly shaped the next generation of health care professionals, fostering a culture of innovation and excellence.

Dr. Gawande listens to other health workers at Mathare North Health Center. Photo courtesy Sheringham Elisha.

Dr. Gawande’s visit was a remarkable recognition and testament to all frontline health workers’ exceptional contributions and groundbreaking work in the community. During his visit, different kinds of health workers at the health center discussed the gaps in TB and HIV response. We focused on promoting innovation and access to quality, safe, and affordable health care services for community members.

Dr. Gawande’s visit was a remarkable recognition.

Dr. Gawande said his visit to Kenya and specifically Mathare North Health Center was influenced by the positive outcomes for the fight against TB and HIV/AIDs. “Your accomplishments are a source of inspiration and motivation to the entire community health effort,” he said. “Your work should be replicated in other parts of the country and even in the world at large. I do not doubt that your future endeavors will continue to contribute immensely to the field of community health, improving the lives of countless individuals."

The same week Kenya’s President Ruto committed to hiring 103,000 CHWs, and said community health volunteers will now be known as community health promoters, will be equipped with modern equipment and deployed in communities across Kenya, and that USAID will help train them. I’m impressed by this bold step, and I am looking for our stipends to be changed to fair salaries.

I’ll continue to advocate for funders to invest in me and other CHWs.

Sheringham Elisha is a long-time advocacy partner of the Frontline Health Workers Coalition and has participated in several of the coalition's campaigns, including the recent "Invest in Me" campaign.

While the global community has pledged to end AIDS and TB by 2030, there is still urgent work to be done, including by CHWs and for supporting CHWs. With new approaches and technologies for detecting and treating TB we can make faster progress to end this disease, and new TB vaccines on the horizon could be a major boost to TB prevention. But to reach everyone in need, policy-makers must invest in the health workforce and follow through on funding commitments. That’s why I’ll continue to advocate for USAID and other funders, including national governments, to invest in me and other CHWs.

I am also asking the drafters of the UN Declaration on TB now being negotiated to not forget me and the role we CHWs play in the fight to end TB and to be sure to include strong commitments for our professionalization and remuneration.

By Sheringham Elisha

Community health worker and advocate

HIV & AIDS Tuberculosis Policy & Advocacy Community Health Workers Kenya

Is In The Media

Sheringham Elisha discusses his work to end tuberculosis with Dr. Atul Gawande outside of Mathare North Health Center. Photo courtesy Sheringham Elisha.

Vital Thumbnail Image

/sites/default/files/article-thumbnail-images/sheringham-and-atul-gawande-thumb-vig.png

Sheringham Elisha

cbales — Fri, 30 Jun 2023 15:56:37 +0000

Sheringham Elisha Community health worker and advocate cbales June 30, 2023

Sheringham Elisha is a community health worker and advocate in Kenya with over ten years experience in community-based care.

Kenya

Weight

In Queue

Off

The Best Way to Pay Tribute to Health Workers? Invest in Them.

ihadmin2 — Mon, 10 Apr 2023 14:16:49 +0000

The Best Way to Pay Tribute to Health Workers? Invest in Them. ihadmin2 April 10, 2023

April 04, 2023

Janet Muriuki outlines three areas to invest in for a fit-for-purpose health workforce.

Globally, health workers remain the unsung heroes of our society. They work tirelessly, often putting their own lives at risk, to ensure that we stay healthy and safe.

I began my career as a health worker. As a physician, I practiced in some of Kenya’s public and private health facilities, including an HIV clinic and later a hospital that focused on women’s and children’s health. So I know the long hours, the hard work, and the sacrifices it takes for them to do this.

In recognition of their efforts, we celebrate World Health Worker Week every year as an opportunity to thank and appreciate the dedication and commitment of health and care workers.

I know the long hours, the hard work, and the sacrifices it takes.

In Kenya, like many parts of the world during the past three years, health workers have played a vital role in fighting the COVID-19 pandemic. They have been on the front lines caring for those affected by the virus. They have worked long hours, often without breaks, and have faced unimaginable stress and emotional trauma. In many instances, they served without adequate personal protective equipment, amid high volumes of patients, risking becoming infected.

Despite these challenges, they have continued to serve their communities with selflessness and courage. At IntraHealth International, this is just one reason for our commitment to strengthen health systems and better serve health workers with decent pay, benefits, and working conditions, and stronger workforce management and education.

To invest in health workers and achieve a fit-for-purpose health workforce that is resilient, responsive, and able to deliver equitable access to high-quality, person-centered care, we must invest in these three areas:

1. Timely, accurate data to drive decision-making and investment.

For years now we’ve advocated for governments and policymakers to use health workforce budgeting tools to lobby for resources at national and subnational levels; training needs assessments to inform workforce production based on population needs; the Workload Indicators of Staffing Need (‎WISN) tool‎ to rationalize health facility staffing based on workload; and National Health Workforce Accounts to generate data for evidence-based planning linked to investments.

The gains from these efforts continue to emerge—in Kenya, for example, the Ministry of Health and county governments are systematically using data as part of standardized processes to progressively support better health worker management.

2. Coordination.

In Kenya, we’ve worked with the Ministry of Health, county governments, civil society, and other local partners to create a conducive human resources for health (HRH) coordination platform to drive the HRH agenda. Kenya has benefited from this structure through HRH policy and strategy formulation involving both levels of government to harmonize priority areas for implementation.

3. Leadership, management, and governance skills in navigating dynamic health and disease ecosystems.

IntraHealth supports skills-building for health managers and policymakers to create more awareness of and dialogue on the issues that affect health workers. The establishment of work councils in Kenya, for example, has facilitated dialogue with health union leaders and helped to avert health worker unrest in the country. We champion and prioritize fair compensation and the mental and physical health of our health providers.

World Health Worker Week is an important time to appreciate and recognize the dedication of health and care workers. By taking steps to support their well-being and reduce the burden on them, we can make a difference in their lives and help them continue to provide critical care to our communities. When we invest in health workers, our return on investment is healthier, more productive lives for all of us.

Also watch:

[pl

By Janet Muriuki

Senior director of health workforce development (interim)

Health workforce development Policy & Advocacy World Health Worker Week Kenya

Is In The Media

Janet Muriuki. Photo courtesy of IntraHealth International.

Vital Thumbnail Image

/sites/default/files/article-thumbnail-images/commonthumbnailchildhealth_0.png

IQVIA Africa Health Summit

ihadmin2 — Thu, 12 Jan 2023 20:27:54 +0000

IQVIA Africa Health Summit ihadmin2 January 12, 2023

November 16, 2022 - November 17, 2022

The IQVIA Africa Health Summit is a complimentary in-person event which brings together inspiring clinical research and public health experts to share knowledge and exchange ideas about how together we can advance Africa's health through data, technology and innovative research.

IQVIA

https://www.events.iqvia.com/event/e074e714-f672-4ed7-b2a5-239032b5f6a5/regProc…

Learn more

Our Participation

Panel Discussions

African Lessons for Future Pandemic Preparedness

Date(s):	November 16, 2022 02:00pm - 02:45pm EAT (06:00am - 06:45am EST)
More Information:	Global thought leaders from the public and private sectors will discuss what can be learned from African countries’ responses to the pandemic and key priorities for addressing remaining vulnerabilities and strengthening health systems going forward.

Participants

Janet Muriuki

Senior Director Health Workforce Development (interim) and Country Director – Kenya

Kenya Digital Health Measurement & Analytics Health Workforce & Systems

Hide "Add to Calendar" button

Proactive Partnership: Nurse Leaders and Community Health Volunteers Work Together to Increase Family Planning Use in Kenya

kseaton — Tue, 07 Jun 2022 18:03:50 +0000

Proactive Partnership: Nurse Leaders and Community Health Volunteers Work Together to Increase Family Planning Use in Kenya kseaton June 07, 2022

June 07, 2022

IntraHealth sought to find out what happens to women’s access to family planning when you partner nurse leaders with community health workers.

What happens to women’s access to family planning when you partner nurse leaders with community health workers (CHWs)?

That’s what IntraHealth International’s USAID-funded Human Resources for Health (HRH) Kenya Mechanism sought to find out. One year into the COVID-19 pandemic, the United Nations Population Fund estimated that the disruption in contraceptive services led to 1.4 million unintended pregnancies worldwide. And in Kenya, even before COVID-19, about 1 in 10 women wanted to delay or stop having children but were not using contraception. Differences in contraceptive use among Kenyan women living in cities compared to rural areas made the need to tailor services even more pressing. Only 40% of urban women reported use of a modern method, such as an oral contraceptive pill, implant, or injectable, compared to the Kenyan national average of 58%. Fewer urban facilities in Kenya offer family planning services (73%) compared to rural (91%). These disparities are likely due to a large proportion of urban residents living in slum conditions, with limited infrastructure and where women have trouble accessing high-quality health care and other services.

In Kenya, 76% of nurses, 63% of community health assistants (CHAs) and 73% of community health volunteers (CHVs) are female. This type of “woman-to-woman” platform is considered a high-impact practice for increasing access to and use of family planning. As an FP2030 Commitment Maker, the Kenyan government is committed to expanding access to modern family planning methods in both rural and urban facilities. Long-acting reversible contraception (LARC) such as intrauterine devices (IUDs) and implants reduce how often women must visit a health facility or pharmacy for a refill and they are more effective at preventing pregnancy than oral contraceptive pills, injections, or condoms. Increasing the number of LARC users could relieve some of the pressure on Kenya’s overtaxed health system because these patients would not need recurring appointments or prescriptions. Additionally, women using LARC can maintain control of their reproductive health despite disruptions caused by extenuating circumstances such as the current pandemic.

Urban and rural reach

To reach women in both urban and rural areas, trained nurse leaders partnered with Kenya’s growing community health assistant and volunteer cadres. Since 2016, the HRH Kenya Mechanism has worked with the government of Kenya to build stronger human resource systems, data-use methods, and training programs. It has helped institutionalize in-service training in counties to align with national universal health coverage requirements and service delivery guidelines for reproductive health and family planning, among other priority health services. The HRH Kenya Mechanism also facilitated in-service training on LARCs to over 850 health workers from 17 counties, expanding access to these birth control methods through facilities in some of Kenya’s most populous counties, like Nakuru’s Rhonda Dispensary and Maternity health facility. To ensure sustainability, the mechanism helped 13 counties develop and implement health workforce training policies and guidelines.

Together, nurses and CHVs are making the facility a favored destination for women seeking family planning.

Health workers participating in the LARC in-service training, like Alice Boit, the nurse-in-charge of the Rhonda Dispensary and Maternity health facility, brought what they learned back to their posts and spearheaded a continuous training and mentorship program. In Alice’s facility, where she supervises 40 staff members, she taught other nurses what she had learned during her training, including insertion and removal of IUDs. In turn, she and her team worked with CHAs and CHVs linked to the facility to do household outreach visits, provide relevant information about LARC methods, dispel myths and misconceptions, and assist with referrals and links to services. Together, these trained nurses and CHVs are reaching a population of more than 27,000 people in Nakuru county, making the facility a favored destination for women seeking family planning while increasing the number of clients choosing LARCs.

A partnership that works

The power of this partnership between nurses and CHWs is real. A two-year post-training follow-up of 274 health workers (32% of the total 850 trained) showed that the quality and quantity of LARC and other family planning services improved in the counties where trainings had occurred. From 2017 to 2019, insertions of IUDs (1,188 to 1,914) and implants (6,234 to 7,077) increased, the number of IUD removals (402 to 292) decreased, and implant removals by a local skilled provider (1,116 to 3,019) increased. Furthermore, 84% of supervisors observed positive changes in the quality of services delivered by health workers trained in LARC.

Training nurses alone isn’t enough. Integrating trained, equipped, and supported CHWs into the health system, as done in this model, is a high-impact practice which increases access to and use of family planning, especially among women constrained by social or geographic barriers. With this partnership model in place, the number of people reached with an expanded set of contraceptive options through nurses and CHVs should only continue to grow. Nationwide, there are already over 89,000 CHVs and 3,250 CHAs in action. By 2030, these cadres are expected to expand to 100,000 and 10,000 respectively to help the government of Kenya reach its goal of 1 CHA and 10 CHVs per 5,000 Kenyans, per the country’s Community Health Policy 2020-2030 and Community Health Strategy 2020-2025. In a crucial step toward this goal, the Ministry of Health in Kenya launched Community Health Volunteers Training and Certification Guidelines in February 2022, which include a module dedicated to family planning that prepares CHVs to counsel women on all family planning methods and make appropriate referrals. In some counties, CHWs like Margaret Odera are being recognized for their important role in the health system.

“I have seen changes taking place, in our community and even in the facility," says Margaret Odera. "A CHW right now has been recognized by the government. And this is a [county-level] law that was passed in October that a CHW has to be recognized and get a monthly stipend. And this is a plus for me and for CHWs.”

To improve family planning services, #CountCHWs

CHWs are key to reducing inequities in family planning access and increasing contraceptive use among women with an unmet need or barriers to use. Yet in most countries, including in Kenya, governments do not have robust data on CHW numbers, location, skills, or performance. This reality limits CHW integration into the health system where they are needed most to meet family planning and other health care goals. How can governments (and other partners) get the data on CHW they need to efficiently train, equip, and support these workers if date collection tools are inadequate?

CHWs are key to reducing inequities in family planning access and increasing contraceptive use.

CHW master lists and registries are integral to maximizing the engagement of CHWs in delivering family planning and other essential health services. Acting as a single source of data on CHWs, such lists and registries can confirm whether workers meet minimum job criteria, that fair pay and supervision are in place, and that CHWs are recruited and deployed to facilities and communities most in need. Open-source information systems such as iHRIS can support the creation of CHW master lists and registries, as iHRIS meets all of the criteria outlined in the recently released Implementation Support Guide from CHAI, CHIC, Health GeoLab, Living Goods, the Global Fund, and UNICEF. iHRIS has been used successfully to support creation of health workforce master lists and registries, including for CHWs, with data collection and use shared among government and partners. As a digital global good, its use can enable future integration with other HRIS and health information systems for a broader view of the human resources for health and for tracking progress toward service delivery goals.

The HRH Kenya Mechanism partnered with the Kenya Ministry of Health to #CountCHWs by developing a community health workforce module in its iHRIS version 4.2. It subsequently trained national and county government focal persons to use the system and map 33,935 CHVs and 779 CHAs in 15 counties. Data collected were used to establish a CHW registry that could provide information on the:

Deployment and distribution of CHVs and CHAs per the MOH recommendation
Composition of CHVs and their skill mix at the community level for family planning and other essential health service provision
Number of available CHVs and CHAs for planning and budgeting trainings, stipends and salaries, and other support CHWs need to perform well.

The data showed 95% of CHWs were employed by the government and 5% by non-profits, NGOs, and other partners. Nearly two-thirds of CHVs had at least a primary-level education. Data also revealed that community health services were poorly supervised, with one CHA supervising 10-27 CHVs. Of the six counties that did not meet the recommended 1 to 10 ratio of CHA to CHV, three—Nairobi, Bungoma, and Meru—are among the most populous counties in Kenya according to the 2019 census. This finding underscored the need for more CHAs for more effective supervision of family planning and other health services. The mapping also highlighted that a minority of CHVs are under 30 years old (9%), which may limit efforts to reach adolescents and young adults with family planning services.

There are three key steps to expand high-impact practices for family planning like this partnership model in Kenya:

Train health workers, including CHWs, in LARC and other methods
Use master lists and registries to #CountCHWs for better planning and management
Advocate for CHWs to be recognized for their important role in service provision, with fair pay, equipment and supplies, and supervision to do their jobs well

Together, taking these steps will help us to make even greater progress in LARC and other family planning use in Kenya, with facility- and community-based health workers at the forefront of those efforts.

This blog post was originally published on CHW Central's website on June 1, 2022. Read it here.

By Alex Collins

Former health workforce technical advisor, IntraHealth International

By Janet Muriuki

Senior director of health workforce development (interim)

Human Resources for Health (HRH) Kenya Program Health Workers Community Health Workers Kenya

Community health worker Margaret Odera counsels a client in February 2020. Photo by Patrick Meinhardt for IntraHealth International.

Vital Thumbnail Image

/sites/default/files/resource-thumbnail-images/result-iconhealthworkerblue.png

A New Generation of Health Workers Enters a Stronger Health System in Kenya

kseaton — Wed, 17 Nov 2021 17:06:02 +0000

A New Generation of Health Workers Enters a Stronger Health System in Kenya kseaton November 17, 2021 November 17, 2021

As part of Kenya’s overarching efforts to build and strengthen its health workforce, the country has provided much-needed financial aid to train more than 40,000 aspiring health workers in the past five years. This is just one way the country is addressing its shortage of health workers and using strategic data to address HIV, COVID-19, and other urgent health challenges.

Since 2016, IntraHealth International’s USAID-funded Human Resources for Health (HRH) Kenya Mechanism has partnered with the government of Kenya to build stronger human resource systems, data-use methods, and training programs. Over the past five years, the project:

Provided 40,257 students with $30.6 million in financial aid through the Afya Elimu Fund.
Tracked 69,000 health workers' personnel records through iHRIS, which the Kenya Ministry of Health has now adopted.
Established work councils in 25 counties for regular engagement between trade unions and health leaders to help prevent strikes and improve collaboration.

“You can’t have health care without health workers,” says Janet Muriuki, IntraHealth’s Kenya country director. “We need nurses, midwives, and community health workers ready and deployed, which is why the Kenya HRH project has been so critical recruiting, educating, training, and retaining health workers for better health care in Kenya.”

Training

One of the project’s key approaches to strengthen the country’s health workforce is training. The project has partnered with medical training institutions to improve the quality of preservice and in-service training and to make it accessible to more aspiring health workers.

In 2013, IntraHealth and our partners established the Afya Elimu Fund, which provides low-interest student loans to health care trainees. HRH Kenya gradually transitioned the program to the Higher Education Loans Board, which now continues to administer the funds as an affordable, revolving loan program, putting repayments back into the fund to support new trainees.

HRH Kenya helped develop training and accreditation standards and standardized the core curricula for key cadres of health workers, such as nurses, laboratory technicians, and clinical officers, in collaboration with health regulatory boards and councils, the Commission for University Education, the Technical and Vocational Education and Training Authority, and training institutions.

And when COVID-19 spread around the world, HRH Kenya quickly trained 1,000 new health workers on disease surveillance, infection prevention, triage, and COVID-19 case management.

Government partnership

HRH Kenya works with Kenyan counties to prioritize human resources management, including providing technical assistance, mentorship, coaching, and HRH budgeting tools. This has helped county health management teams and health facilities communicate better with national and county governments and allowed them attract, recruit, and deploy health workers.

As part of this county dialogue, we established work councils in 25 counties in Kenya and provided training on leadership, management, and governance for 96 national and county health sector union leaders. The result is stronger employer-worker and employer-union relations. This avoids, mitigates, and resolves health worker strikes and ensures continuity in health care, especially for HIV, family planning, and reproductive, maternal, newborn, and child health.

Through the work councils, issues affecting health workers—such as delayed salary payments, poor working conditions, and stalled career progression—have been resolved diplomatically, resulting in well placed, skilled health workers who remain available and ready to deliver health services without disruption. The work councils have created new and better channels of communication, allowing greater discussion about the challenges health workers face and joint resolutions to address them.

Now, all parties work together to improve health services in counties and there are channels to help identify and address emerging challenges in a timely manner, thereby averting industrial unrest and strikes.

Data

The HRH Kenya project integrated iHRIS—IntraHealth’s health workforce information system that enables the Ministry of Health and counties to design and manage a comprehensive human resources strategy—in 37 counties and established technical working groups in 19 counties to help institutionalize the system.

The project developed guidelines on how to implement and use iHRIS and trained trainers and mentors to collect, analyze, manage, and use data for decision-making. iHRIS now helps the Ministry of Health track, manage, deploy, and map the health workforce, a crucial need during COVID-19.

The Human Resources for Health (HRH) Kenya Mechanism is a five-year project funded by the US Agency for International Development (USAID) to strengthen health professional training programs and health workforce management systems throughout Kenya to help the country improve the health of its citizens.

Kenya Digital Health Health workforce development Leadership and Governance Health Workforce & SystemsPhoto by Edwin Joe for IntraHealth International.

Anne Malubi

kseaton — Thu, 28 Oct 2021 13:43:39 +0000

Anne Malubi Human resources for health coordinator kseaton October 28, 2021

Anne is a human resources for health coordinator for the HRH Kenya project.

Kenya

Weight

160

In Queue

Queue Weight

160

Health Workers in Kenya Use New Negotiation Skills to Improve Their Working Conditions

kseaton — Wed, 27 Oct 2021 16:37:31 +0000

Health Workers in Kenya Use New Negotiation Skills to Improve Their Working Conditions kseaton October 27, 2021

October 27, 2021

The partnership between health worker unions, government leaders, and others prevents strikes and keeps health services available.

It was a common situation for both Mary and Alice—they tried to visit the hospital, but couldn’t receive the care they needed. The health workers were on strike again.

Mary had traveled 4 kilometers and was pondering what to do with her sick child because no health workers were available at the hospital. Alice did not have the money to visit a private hospital and she wondered why she and Mary’s child were suffering—after all, they had nothing to do with the disagreement between health workers and the government.

Over the years, the health sector in Kenya has been characterized by persistent health worker unrest, which negatively affects health services. Between 2010 and 2020 there were eight nationwide strikes and many more county strikes. And in 2017 alone, there were over 250 days in which the health system was dysfunctional, with far-reaching impacts on access to and quality of essential services.

Between 2010 and 2020 there were eight nationwide strikes in Kenya.

The reason for all these strikes? The government failed to implement collective bargaining agreements and return-to-work formulas. Health workers worked in poor conditions and experienced medical supply, equipment, and staff shortages. Promotions, salaries, and career progressions were delayed. There was a lack of training opportunities and comprehensive medical coverage.

During a pandemic, the impacts of health worker strikes are even greater and frontline health workers fear for their safety .

And while the health workers were fighting for their own rights, clients weren’t able to access the care they needed. The strikes caused decreases in women attending their fourth antenatal care visits, pregnant women starting antiretroviral treatment, viral load testing, short- and long-acting family planning method uptake, facility deliveries.

So, in 2018, IntraHealth International’s USAID-funded Human Resources for Health program supported the Council of Governors to convene a stakeholders’ meeting, bringing together key county leaders, national institutions, faith-based organizations, health worker trade union representatives, private-sector partners, and other relevant stakeholders.

The meeting focused on the causes of the health worker strikes and identified strategies to improve employee/employer relations to avoid service disruptions. One of the main causes of the strikes was a lack of effective communication between employers and health worker trade unions. So, the group established national and county work councils for county leaders and health trade union leaders to proactively discuss and amicably seek solutions to health worker grievances.

Read: Averting Public Health Sector Industrial Unrest in Kenya: Establishing Stakeholder Work Councils to Foster Harmonious Labor Relations

To train the health management teams and trade union leaders on negotiation skills, labor dispute resolutions, and other relevant skills, IntraHealth brought together 96 health worker union leaders from four registered worker unions, 60 county health management teams, and 57 county human resources officers and trained them on leadership management and governance with a focus on human resources for health. The training provided experiential learning and focused on how to manage trade unions within International Labour Organization (ILO) conventions, and local labor laws as provided by the Labour Relations Act.

Many counties involve union leaders when they develop new policies, guidelines, and strategies.

Now, many counties involve union leaders when they develop new policies, guidelines, and strategies and union leaders use their training to participate. In Muranga County, union representatives were involved in developing health worker cadres. In Meru, Busia, Makueni, and Nyandarua counties, union representatives were involved in developing plans for human resources for health and the Ministry of Health’s Human Resources for Health Strategic Plan for 2019 to 2023.

Twenty-five counties have work councils who meet every quarter and as needed to discuss key issues affecting health workers, share progress made in implementing their action plans to improve employer/employee relations for effective management of the health workforce, and engage with health worker unions to address looming health worker grievances.

For instance, Turkana County health worker trade unions issued a joint strike notice to the county leadership on October 23, 2020, over delayed promotions and redesignation of health workers, notifying them that a strike would go into effect on November 12, 2020. The county convened a work council meeting on November 11, 2020, in which the County Public Service Board committed to promoting all health workers who were due for promotion by November 30, 2020. As a result, the union resolved to call off the strike as the county worked on redesignating 841 health workers.

“The engagement diffused a lot of suspicion between the county and the union and cultivated some trust,” says Dr. Gilchrist Lokoel, a county director of health in Turkana County. “We all realized that we care about health workers and needed to harness our energies for the general good rather than tear each other apart in supremacy battles.”

Migori, Samburu, Kirinyaga, Nyeri, Laikipia, Bomet, and Marsabit counties also negotiated with union leaders and agreed on an action plan, which prevented medical officers, nurses, and clinical officers from striking. Health workers in other counties eventually called off their strikes as a result of negotiations with the unions through the work councils.

On top of that, 3,303 health workers were recruited in six counties to address the health worker shortage and the work councils helped resolve issues around health worker promotions, provision of protective equipment, prompt salary payments, and designated COVID-19 isolation centers for affected health workers.

The work councils have helped limit the occurrence and length of the health workers strikes and are proving to be effective in not only averting health workers strikes but contributing to improved workplace environments and speedy resolution of labor disputes, which improves the availability and quality of health services for people like Mary and Alice, who need it the most.

The Human Resources for Health (HRH) Kenya Program is a five-year project funded by the US Agency for International Development (USAID) to strengthen health professional training programs and health workforce management systems throughout Kenya to help the country improve the health of its citizens.

By Anne Malubi

Human resources for health coordinator

By Janet Muriuki

Senior director of health workforce development (interim)

By Mathew Thuku

Assistant director, national HRH strengthening, IntraHealth International

By Wycliffe Omanya

Former knowledge management and communications manager, IntraHealth International

Human Resources for Health (HRH) Kenya Program Community Health Leadership and Governance 2021 Year of the Health and Care Worker Health Workforce & Systems Health Workers Kenya

Is In The Media

A public health officer counsels clients at Tudor Subcounty Hospital in Kenya. Photo by Edwin Joe for IntraHealth International.

Vital Thumbnail Image

/sites/default/files/news-article-thumbnail-images/resource-thumb-kenya.png

Technical & Policy Briefs: Human Resources for Health (HRH) Kenya Program

kmelton — Tue, 26 Oct 2021 20:40:31 +0000

Technical & Policy Briefs: Human Resources for Health (HRH) Kenya Program 2021 kmelton October 26, 2021

Our USAID-funded Human Resources for Health (HRH) Kenya Program has partnered with the government of Kenya to build an even more resilient health workforce, with stronger human resource systems, processes, data use, and community health systems. Learn more about our results in the briefs below:

Technical Briefs

Policy Briefs

Countries Kenya

Projects Human Resources for Health (HRH) Kenya Program

By Janet Muriuki, Peter Milo, Tervil Okoko, Esther Wanjiru Kariuki, Wycliffe Omanya, Mathew Thuku

Averting Public Health Sector Industrial Unrest in Kenya: Establishing Stakeholder Work Councils to Foster Harmonious Labor Relations

kmelton — Wed, 15 Sep 2021 20:14:14 +0000

Averting Public Health Sector Industrial Unrest in Kenya: Establishing Stakeholder Work Councils to Foster Harmonious Labor Relations 2021 kmelton September 15, 2021

Health worker-related industrial unrest has serious negative effects on health service delivery especially on rural poor. Kenya’s health worker strike lasted over 300 days, with the doctors’ strike lasting 100 days—the longest ever experienced in Kenya. IntraHealth innovated the Work Council as a formal consultative and dialogue platforms between the county departments of health and health sector union leaders to find space where issues affecting health workers can be discussed and actioned to avert strikes. This brief provides policy recommendations on structure and institutionalization of work council to permanently avert health worker strikes.

Download

Technical & Policy Briefs: Human Resources for Health (HRH) Kenya Program

Improving the Quality and Accessibility of Medical Training to Increase Health Workforce Numbers to Meet Universal Health Coverage Needs

By Mathew Thuku, Janet Muriuki, Esther Wanjiru Kariuki, Wycliffe Omanya

Kenya

Big Milestones for Me and All Community Health Workers in Kenya

Sheringham Elisha

The Best Way to Pay Tribute to Health Workers? Invest in Them.

1. Timely, accurate data to drive decision-making and investment.

2. Coordination.

3. Leadership, management, and governance skills in navigating dynamic health and disease ecosystems.

Also watch:

IQVIA Africa Health Summit

Our Participation

Panel Discussions

African Lessons for Future Pandemic Preparedness

Participants

Janet Muriuki

Proactive Partnership: Nurse Leaders and Community Health Volunteers Work Together to Increase Family Planning Use in Kenya

Urban and rural reach

A partnership that works

To improve family planning services, #CountCHWs

A New Generation of Health Workers Enters a Stronger Health System in Kenya

Training

Government partnership

Data

Anne Malubi

Health Workers in Kenya Use New Negotiation Skills to Improve Their Working Conditions

Technical & Policy Briefs: Human Resources for Health (HRH) Kenya Program

Averting Public Health Sector Industrial Unrest in Kenya: Establishing Stakeholder Work Councils to Foster Harmonious Labor Relations

Technical & Policy Briefs: Human Resources for Health (HRH) Kenya Program

Improving the Quality and Accessibility of Medical Training to Increase Health Workforce Numbers to Meet Universal Health Coverage Needs

Improving Leadership, Management, and Governance of the Health Workforce in Kenya’s Devolved System

Optimizing Data Use for Effective Decision-Making in Managing Kenya’s Health Workforce

Building a Sustainable Financial Resource Base to Support Health Workforce Training Toward Universal Health Coverage

Establishing Human Resources for Health Units to Strengthen Health Workforce Management in Kenya’s Counties

Promoting County Training Needs Assessments for Effective Human Resources for Health Capacity Development in Kenya

Strengthening Data for Decision-Making in Human Resources for Health Management Through Systems Interoperability