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.
