Notes

(FOREIGN) Assessing the effect of devolution on the number of healthcare workers in hardship areas: a case study of doctors, clinical officers, nurses and specialists in Wajir County:

Kenya has faced a persistent challenge in providing adequate healthcare services since its independence, with a significant shortage of healthcare workers, particularly in rural and hardship areas where the majority of healthcare workers tend to avoid. The Constitution of Kenya 2010 sought to address this challenge by devolving the management of healthcare workers to the 47 counties, with the aim of improving the distribution and access to healthcare services.

In a study published in 2018 by Strathmore University, authored by Kala, Adankhalif Adan, the impact of this devolution on the number and distribution of healthcare workers in Wajir County, a typical hardship area, was examined. The study focused on the number of doctors, nurses, clinical officers, and specialists in the country.

The study analyzed secondary data from the health department's payroll and budget for five years, from 2012 to 2017, to determine the number of healthcare workers in terms of absolute numbers, specialization, and salaries paid. The study also looked at the number of healthcare workers on study leave and the allocation of health budgets during this period.

The findings of the study revealed that Wajir County had experienced a significant improvement in the number of healthcare workers in the past five years, with a substantial increase in the number of healthcare workers who had undergone further training and specialized in different fields of nursing, medicine, and clinical medicine. The study also found that Wajir County had allocated significant funds in its annual budget for health, which had enabled the recruitment of enough healthcare workers.

Furthermore, the study found that Wajir County had recruited its first medical specialist, a surgeon, in 2017, and had given a substantial number of staff paid study leave to improve the number of specialists among doctors, nurses, and clinical officers. The study concluded that there was a positive relationship between devolution and improvement in the number of healthcare workers in Wajir County.

The study provides valuable insights into the impact of devolution on the number and distribution of healthcare workers in hardship areas, specifically Wajir County. The findings highlight the importance of devolution in improving the distribution and access to healthcare services, particularly in rural and hardship areas. The study also underscores the need for adequate budgetary allocation to health to enable the recruitment and training of enough healthcare workers to address the persistent challenge of healthcare worker shortage in Kenya.

The study on the impact of devolution on healthcare workers in Wajir County revealed a significant improvement in healthcare worker numbers over a five-year period. This improvement was attributed to increased specialization and training among healthcare workers, supported by a substantial budget allocation for healthcare in the county. Notably, the recruitment of the first medical specialist in 2017 and the provision of study leave for staff to enhance specialization underscored proactive measures taken to address healthcare worker shortages. The study concluded that devolution had a positive relationship with the increase in healthcare workers, emphasizing the importance of decentralized healthcare management and adequate budgetary allocation for sustaining and improving healthcare services. These findings offer valuable insights for policy-making, highlighting the need to replicate successful strategies from Wajir County to address healthcare challenges in other hardship areas effectively.