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The paediatrician workforce and its role in addressing neonatal, child and adolescent healthcare in Kenya
  1. Mike English1,2,
  2. Brigid Strachan3,
  3. Fabian Esamai4,
  4. Thomas Ngwiri5,
  5. Osman Warfa6,
  6. Patrick Mburugu7,
  7. Grace Nalwa8,
  8. Jesse Gitaka9,
  9. John Ngugi10,
  10. Yingxi Zhao2,
  11. Paul Ouma1,
  12. Fred Were11
  1. 1KEMRI-Wellcome Trust Research Programme Nairobi, Nairobi, Kenya
  2. 2Oxford Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, Oxfordshire, UK
  3. 3Independent Consultant, Oxford, UK
  4. 4Department of Paediatrics and Child Health, College of Health Sciences, Moi University, Kenya, Eldoret, Kenya
  5. 5Kenya Paediatric Association, Nairobi, Kenya
  6. 6Ministry of Health, Nairobi, Kenya
  7. 7Department of Paediatrics and Child Health, School of Medicine, Jomo Kenyatta University of Africulture and Technology, Nairobi, Kenya
  8. 8Department of Paediatrics and Child Health, Maseno University, Maseno, Nyanza, Kenya
  9. 9Directorate of Research and Innovation, School of Medicine, Mount Kenya University, Thika, Kenya
  10. 10Department of Paediatrics and Child Health, Kenyatta University, Nairobi, Kenya
  11. 11Department of Paediatrics and Child Health, University of Nairobi, Nairobi, Kenya
  1. Correspondence to Professor Mike English, KEMRI-Wellcome Trust Research Programme Nairobi, Nairobi 00100, Kenya; menglish{at}kemri-wellcome.org

Abstract

Objective To examine the availability of paediatricians in Kenya and plans for their development.

Design Review of policies and data from multiple sources combined with local expert insight.

Setting Kenya with a focus on the public, non-tertiary care sector as an example of a low-income and middle-income country aiming to improve the survival and long-term health of newborns, children and adolescents.

Results There are 305 practising paediatricians, 1.33 per 100 000 individuals of the population aged <19 years which in total numbers approximately 25 million. Only 94 are in public sector, non-tertiary county hospitals. There is either no paediatrician at all or only one paediatrician in 21/47 Kenyan counties that are home to over a quarter of a million under 19 years of age. Government policy is to achieve employment of 1416 paediatricians in the public sector by 2030, however this remains aspirational as there is no comprehensive training or financing plan to reach this target and health workforce recruitment, financing and management is now devolved to 47 counties. The vast majority of paediatric care is therefore provided by non-specialist healthcare workers.

Discussion The scale of the paediatric workforce challenge seriously undermines the ability of the Kenyan health system to deliver on the emerging survive, thrive and transform agenda that encompasses more complex health needs. Addressing this challenge may require innovative workforce solutions such as task-sharing, these may in turn require the role of paediatricians to be redefined. Professional paediatric communities in countries like Kenya could play a leadership role in developing such solutions.

  • general paediatrics
  • health services research
  • medical education
  • paediatric practice
  • tropical paediatrics
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Footnotes

  • Correction notice This paper has been corrected since it was published online. In the author list, the 6th author is listed as Peter Mburugu but his first name is Patrick and not Peter. We have updated the paper with the correct first name.

  • Contributors ME, BS and FW led the development of a report to which all authors contributed on the paediatric workforce that this manuscript is derived from. All authors helped locate the information in this manuscript or checked it for accuracy where possible and then reviewed the manuscript prior to submission.

  • Funding Funds from The Wellcome Trust (#207522) awarded to ME as a Senior Fellowship supported this work. PO is funded under the IDeAL’s Project (107769), DELTAS Africa Initiative [DEL-15-003]. The DELTAS Africa Initiative is an independent funding scheme of the African Academy of Sciences (AAS)'s Alliance for Accelerating Excellence in Science in Africa (AESA) and supported by the New Partnership for Africa's Development Planning and Coordinating Agency (NEPAD Agency) with funding from the Wellcome Trust [number 107769/Z/10/Z] and the UK government

  • Disclaimer The authors have written this report in their personal capacities and any opinions expressed are their own and not indicative of the views of the institutions with which they are affiliated. The funders had no role in drafting or submitting this manuscript.

  • Competing interests All authors with the exception of BS, YZ and PO are themselves paediatricians and involved in some form in the education of paediatricians, or the paediatric professional association or contributing to policy in the areas of neonatal, child and adolescent health in Kenya. The Kenya Paediatric Association is leading the development of the East, Central and Southern African, College of Paediatrics and Child Health in Kenya and receives support from ELMA Philanthropies for this purpose.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; externally peer reviewed.

  • Data availability statement Data are available upon request

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