A new paper from Mike English's team finds there is a need to review the roles and training of paediatricians in Kenya.
CITATION: English M, Strachan B, Esamai F, et al. The paediatrician workforce and its role in addressing neonatal, child and adolescent healthcare in Kenya. Archives of Disease in Childhood 2020;105:927-931.
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.
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http://dx.doi.org/10.1136/archdischild-2019-318434
WHAT IS ALREADY KNOWN ON THIS TOPIC?
Kenya and many low and middle income countries face critical shortages and maldistribution of all health workers which undermines access to and quality of care.
Countries like Kenya aspire to deliver on a universal health coverage agenda and address broader neonatal, child and adolescent health needs. Meeting all these needs will require an appropriately skilled workforce.
There are few reports that focus on the development of the paediatric workforce.
WHAT THIS STUDY ADDS?
We provide a careful description and analysis of the paediatric workforce and its distribution in Kenya.
Data suggest large parts of the country have none or only one paediatrician in the public sector, that there are few other cadres with specific training in neonatal, child or adolescent health and that the current production of doctors in general and paediatricians in particular remains very limited.
To meet future needs of new borns, children and adolescents, the roles and training of paediatricians should be reviewed alongside other workforce innovations to enable equitable access to quality care.
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Best wishes, Neil
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CHIFA profile: Neil Pakenham-Walsh is the coordinator of the HIFA campaign (Healthcare Information For All) and assistant moderator of the CHIFA forum. Twitter: @hifa_org FB: facebook.com/HIFAdotORG neil@hifa.org
