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

Wakaba, Mabel; Mbindyo, Patrick; Ochieng, Jacob; Kiriinya, Rose; Todd, Jim; Waudo, Agnes; Noor, Abdisalan M.; Rakuom, Chris; Rogers, Martha F.; English, Mike

doi:10.1186/1478-4491-12-6

Cited by 64 publications

(67 citation statements)

References 20 publications

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“…Globally, facility deliveries are not associated with a subsequent reduction in perinatal mortality due to key quality gaps, including inadequate staffing, widespread use of inexperienced trainees as front line workers and overcrowded facilities (12)(13)(14)(15)(16)(17)(18).…”

Section: Key Notesmentioning

confidence: 99%

Using quality improvement to decrease birth asphyxia rates after ‘Helping Babies Breathe’ training in Kenya

et al. 2017

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Aim: The Helping Babies Breathe (HBB) programme is known to decrease neonatal mortality in low-resource settings but gaps in care still exist. This study describes the use of quality improvement to sustain gains in birth asphyxia-related mortality after HBB.Methods: Tenwek Hospital, a rural referral hospital in Kenya, identified high rates of birth asphyxia (BA). They developed a goal to decrease the suspected hypoxic-ischaemic encephalopathy (SHIE) rate by 50% within six months after HBB. Rapid cycles of change were used to test interventions including training, retention and engagement for staff/ trainees and improved data collection. Run charts followed the rate over time, and chi-square analysis was used.

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Section: Key Notesmentioning

confidence: 99%

Using quality improvement to decrease birth asphyxia rates after ‘Helping Babies Breathe’ training in Kenya

et al. 2017

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“…Whereas recent data suggest that Kenya has more than 50,000 nurses registered to practice, fewer than 17,000 offer care in the public sector that is most relied on by the poor for inpatient care (Wakaba et al . ). Thus, the main factor constraining expansion of the nursing workforce to improve access to services through the public sector in Kenya is absence of adequate finance (NCK ).…”

Section: Introductionmentioning

confidence: 97%

What does the literature tell us about health workers' experiences of task‐shifting projects in sub‐Saharan Africa? A systematic, qualitative review

Mijović

McKnight

English

2016

Journal of Clinical Nursing

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Aims and ObjectivesTo review systematically, qualitative literature covering the implementation of task shifting in sub‐Saharan Africa to address the growing interest in interventions of this kind. This review aims to distil the key practical findings to both guide a specific project aiming to improve the quality of neonatal care in Kenya and to contribute to the broader literature.BackgroundTask‐shifting programmes aim to improve access to healthcare by delegating specific tasks from higher to lower skilled health workers. Evidence suggests that task‐shifting programmes in sub‐Saharan Africa may improve patient outcomes, but they have also been criticised for providing fragmented, unsustainable services. This systematic review of qualitative literature summarises factors affecting implementation of task shifting and how such interventions in sub‐Saharan Africa may have affected health workers' feelings about their own positions and their ability to provide care.DesignFollowing literature search, a modified Critical Appraisal Skills Program (CASP) framework was used to assess quality. Thereafter, analysis adopted a thematic synthesis approach.MethodsA systematic literature search identified qualitative studies examining task ‐shifting interventions in sub‐Saharan Africa. Thematic synthesis was used to identify overarching themes arising from across the studies and infer how task‐shifting interventions may impact on the health workers from whom tasks are being shifted.ResultsFrom the 230 studies screened, 13 met the inclusion criteria. Overarching themes identified showed that task shifting has been associated with jurisdictional debates linked to new cadres working beyond their scope of practice, and tension around compensation and career development for those taking on tasks that were being delegated.ConclusionsBased on the qualitative data available, it appears that task shifting may negatively impact the sense of agency and the ability to perform of health workers' from whom tasks are shifted. The potential implications of task shifting on all health workers should be considered prior to implementing task‐shifting solutions.

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“…For highly dependent populations, the high quality of care needed is labour intensive and requires appropriate and adequate skilled nurse staffing (Murphy, Gathara, et al, ). Unfortunately, there are major nursing workforce deficits in Kenyan facilities and while addressing these can be expensive and challenging (Aiken et al, ; Wakaba et al, ), changes in how care is organized and delivered could reduce avoidable neonatal deaths (Aiken et al, ; Butler et al, ; Kane, Shamliyan, Mueller, Duval, & Wilt, ). Appropriate forms of task sharing offer a possible solution for service improvements in Kenyan hospitals.…”

Section: Introductionmentioning

confidence: 99%

Informal task‐sharing practices in inpatient newborn settings in a low‐income setting—A task analysis approach

et al. 2020

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Aim To describe the complexity and criticality of neonatal nursing tasks and existing task‐sharing practices to identify tasks that might be safely shared in inpatient neonatal settings. Design We conducted a cross‐sectional study in a large geographically dispersed sample using the STROBE guidelines. Methods We used a task analysis approach to describe the complexity/criticality of neonatal nursing tasks and to explore the nature of task sharing using data from structured, self‐administered questionnaires. Data was collected between 26th April and 22nd August 2017. Results Thirty‐two facilities were surveyed between 26th April and 22nd August, 2017. Nearly half (42%, 6/14) of the “moderately critical” and “not critical” (41%, 5/11) tasks were ranked as consuming most of the nurses' time and reported as shared with mothers respectively. Most tasks were reported as shared in the public sector than in the private‐not‐for‐profit facilities. This may largely be a response to inadequate nurse staffing, as such, there may be space for considering the future role of health care assistants.

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

Cited by 64 publications

References 20 publications

Using quality improvement to decrease birth asphyxia rates after ‘Helping Babies Breathe’ training in Kenya

Using quality improvement to decrease birth asphyxia rates after ‘Helping Babies Breathe’ training in Kenya

What does the literature tell us about health workers' experiences of task‐shifting projects in sub‐Saharan Africa? A systematic, qualitative review

Informal task‐sharing practices in inpatient newborn settings in a low‐income setting—A task analysis approach

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