The Kenya Health Workforce Project Dr. Martha Rogers Project Principal Investigator Emory University
Situation in Sub-Saharan Africa Many countries are facing a shortage of healthcare manpower. The demand for health workers is increasing While supply is decreasing
Problem for Health Managers Need to manage workers efficiently Which requires data for planning and making decisions BUT Lack informatics systems to generate data
Project Objectives: Establish an electronic health workforce informatics system that could be used to analyze workforce capacity at MOH and regulatory agencies Assist Kenyan leaders in HRH management, research and policy development
Why was the project needed? Kenya healthcare workforce data existed in paper forms only MOH lacked accurate data on the number of health workers by position, cadre/ qualification, region or rate of attrition Checking reliability of data was labor and time consuming Kenyan training institutions lacked data on the training and staffing needs of health professionals
Situation in Kenya Many different qualifications exist for nurses + Many nurses have multiple qualifications Difficulty tracking nurses
Workforce Dynamics Supply: the available number of healthcare workers (e.g., nurses) Those in training Those trained outside Kenya migrating in Those lost through attrition (death, retirement) Those migrating out of the country Demand: deployment, worksite requirements for HRH, provider:population
Who has this information? Supply: Data kept by regulatory agencies (e.g., Nursing Council of Kenya) Indexing, licensure, registration, and retention Application to work in Kenya or to verify license to work outside Kenya Demand: Staff returns from MOH facilities and private and mission healthcare sector
The Process First Step: form a steering committee with representatives of key stakeholders for input Inform stakeholders of the need Gather input, needs, and ideas Use as ongoing network for dissemination Day-to-day decisions made by smaller groups Policy sub committee Technical subcommittee
The Process Hardware needs were assessed Computer workstations including computer, printer, power back-ups were installed Satellite dish was placed on the roof for sending signals through the Internet Data user needs assessed for development of software program
The Process Software program was developed with the following database system features: Flexible to expansion and revision Information can be used to produce a wide variety of reports Can be decentralized in different regions/countries Different people can use the system simultaneously
Phase I: Supply Side Convert hard copy data at the regulatory agency (e.g., NCK) to electronic data
Phase II: Link with MOH Network MOH to the regulatory agency via satellite equipment NCK CNO NCK=Nursing Council of Kenya CNO=Chief Nursing Office, MOH
Phase III: Deployment Side Design system for capturing data from health facilities Assessment of hardware and data user needs Development of software program for data capture and analysis Roll-out to provincial level Sensitization of health managers necessary Training of data entry staff Workshop for district-level managers emphasizing role in data collection
Roll-Out to Provinces Western Coast Rift Valley Central CNO NCK Nyanza North Eastern Nairobi Eastern
Kenyan Nurses Age <55 by Cadre 1% 35% 64% Enrolled RN BSN
Newly Trained Nurses: 2005-2007 5% 5% Enrolled RN BSN 90%
Ratio of RNs to Population Province Nairobi Central Coast Eastern N Eastern Nyanza Rift Valley Western No. People per RN 2097 1441 4054 2394 7754 2783 2891 3287 No. People per Any Nurse 975 521 1458 717 2993 918 1116 977
Use of Provincial Data for Planning of HIV Care Nyanza Province has the highest prevalence of HIV (15%) and lowest prevalence of circumcision (46%). Population age 15-49 2.6 million Estimated no. needing HIV Rx 35,000+ No. needing circumcision 600,000 Task shifting is being proposed to allow for more HIV+ people to received ARVs. Male RNs could be trained to do circs.
RNs in Health Facilities Nyanza Province 855 RNs in Nyanza Province 63 hospitals 74% 141 health centers 11% 332 dispensaries 4% 193 (23%) RNs are male 3000+ uncircumcised men per male RN
US Federal Funding Agency Organizational Structure US University Provides Oversight of the Project Kenya Ministry of Health Kenya Professional Regulatory Agencies Dr. Martha Rogers, PI In-Country Coordinator Ms. Agnes Waudo Programmer Mr. Andrew Kamenju Hardware-IT Mr. Japheth Ngoya Program Analyst Mr. John Arudo Provincial Health Offices District Health Offices Health Facilities
Future Plans Create informatics systems for other health cadres Build capacity for healthcare managers to be able to fully utilize the data to better manage their human resources Publish annual reports for all cadres that can be widely distributed Disseminate to other countries
Kenya Project Team Agnes Waudo Japheth Ngoya In-Country Director Project Networker Eunice Masamo Andrew Kamenju MOH Coordinator Project Programmer John Arudo Program Analyst CDC Technical Advisors Rebecca Bunnell, Director Tom Oluoch CDC-GAP-Kenya CDC-GAP-Kenya Patricia Riley CDC-GAP-Atlanta
Thanks! Asante Sana!