Vacancies in the health system vary according to cadre, and are mainly noticeable in the public health sector (Chankova, Muchiri, & Kombe, 2009). A report in 2010 indicated that the Ministry of Health had the highest vacancy rate for clinical officers at 35.5%, followed by medical officers at 34.2% then nursing officers at 23.2% with 6.8% unfilled positions for Medical laboratory technologists and technicians (Kiambati, Kiio, & Toweett, 2013). This is relatively high and poses a threat to the efficient delivery of health services (Ministry of Medical Services, 2009). These high vacancy rates have been worsened by  poor infrastructure, insecurity and harsh climatic conditions (MoH, 2013).

Extremely remote rural regions struggle the most with retention and recruitment of personnel. A study conducted in Northern Kenya counties representing 6% of Kenya’s population showed that the counties had access to only 3% of all health workers, while 9% of all health workers were located in Kenya’s capital, Nairobi (representing 8% of the population)  (Ministry of Health, 2015b).  Therefore, careful consideration in terms of better pay and/or hardship allowances needs to be given for health workers deployed in resource-constrained areas in order to increase retention since with better pay, health care workers state that they can work in the harshest areas (MoH, 2013).

Staff turnover rates have been relatively high with more than 50% of physicians and 81% of enrolled community nurses leaving the health workforce between 2005 and 2009. Furthermore, a turnover of 49% was reported among laboratory technologists and technicians during the same period (Kiambati et al., 2013). Some of the common factors resulting in staff turn-over rates in the public health system include retirement, voluntary resignation, death, better pay in private health sector or abroad  (Chankova et al., 2009).

Other factors that have contributed to compromised availability of the health care workers and play a role in turnover rate include lack of employment (not absorbed by the ministry) of trained workers, limited career development opportunities, huge workloads, high prevalence of HIV/AIDS, increased risk of occupational exposure, political violence and social instability (Gross et al.,  2011).

References:

Chankova, S., Muchiri, S., & Kombe, G. (2009). Health workforce attrition in the public sector in Kenya: a look at the reasons. Human Resources for Health, 7(1). http://doi.org/10.1186/1478-4491-7-58

Gross, J. M., Rogers, M. F., Teplinskiy, I., Oywer, E., Wambua, D., Kamenju, A., … Waudo, A. (2011). The impact of out-migration on the nursing workforce in Kenya. Health Services Research, 46(4), 1300–1318. https://doi.org/10.1111/j.1475-6773.2011.01251.x

Kiambati, H., Kiio, C., & Toweett, J. (2013). Understanding the labour of human resources for health in kenya. Working Paper, (November), 29. https://www.who.int/hrh/tools/Kenya_final.pdf?ua=1

Ministry of Health. (2015b). Kenya Health Workforce Report. https://taskforce.org/wp-content/uploads/2019/09/KHWF_2017Report_Fullreport_042317-MR-comments.pdf

Ministry of Medical Services. (2009). National Human Resources for Health: Strategic Plan 2009-2012. Nairobi, Kenya. http://guidelines.health.go.ke:8000/media/hrh-strategic-plan-revised.pdf

MoH. (2013). Human Resources for Health ( HRH ) Assessment report for Northern Kenya: Overview of Health Workforce Distribution across 10 Counties May 2013. https://www.health.go.ke/wp-content/uploads/2015/09/Final%20merged%20NK%20HRH%20Report.pdf