Kenyans will soon enjoy increased care from health workers as a result of the implementation of United States Agency for International Development (USAID) FUNZOKenya project that is assisting to double the training of health workers across the country.
The goal is to uplift the country’s health system to World Health Organisation (WHO) recommendation of a minimum density threshold of 23 skilled health professionals per 10,000 people to provide the most basic health coverage. This move is also in line with one of President Uhuru Kenyatta’s four pillars for his second term, which is to realise universal health coverage for all Kenyans. It also fulfills one of the basic rights as spelt out in Constitution of Kenya 2010 and Vision 2030.
The Ministry of Health (MOH) is also implementing its Human Resources Health Strategic Plan as part of its goal to increase key health indicators. Increasing trained nurses and medical technicians is an important task for MOH, as these professionals are the backbone of medical care in health institutions.
Currently there is a large gap between supply and demand due to shortage of spaces in training colleges. A survey carried out between 2008 and 2012 by USAID FUNZOKenya Project showed that medical colleges were graduating 40 per cent less personnel that Kenyan hospitals need. This means that MOH needs to increase the training of health workers by 50 per cent, by working with partners to double the seats available for students in private and public medical colleges.
The success of the training will realise the required staffing levels as recommended by WHO health worker to patient ratio and provide quality healthcare to Kenyans as per the Constitutional provision. It is why the Government of Kenya has partnered with USAID FUNZOKenya Project, to improve access to quality training and build the health workforce.
Some of its key initiatives include mobilising resources for infrastructure development to expand medical schools and colleges, transportation, and adequate tutors and lecturers. The goal is to increase graduation numbers of health workers to meet the demand of hospitals.
In order to get reliable information the project surveyed 14 training institutions – public, faith based organisations and private – and identified nine areas that needed attention. These were: classrooms, demonstration rooms, libraries, laboratories, computer labs, dormitories, cafeteria, electricity and water. A majority of the institutions scored below the 75 per cent threshold in these nine key areas.
FUNZOKenya project identified four driving initiatives that if implemented, would address the nine key areas. These are: Financing, Public Private Partnership, Technology and Accountability. The project has provided experienced technical assistance to various medical institutions in order to develop its business strategy.
This has resulted in a positive response from some of the local banks who have advanced Sh307 million in development loans to the institutions. Others have raised internal funds for their projects; these include Tenwek, Outspan, Ortum, Kijabe and Technical University of Mombasa.
The institutions were also trained in designing Public Private Partnerships (PPPs) especially for infrastructure development. The government is developing PPPs capacity and these institutions have submitted their documents to the line ministries and the PPPs unit of the National Treasury for approval and funding for development under the PPP framework.
So far five PPP projects proposals, for Kenya Medical Training College (KMTC) and Pwani University, have been approved for development under the PPP framework by the National Treasury and are currently in the feasibility studies phase. The other option for development of medical institutions is Private Equity Funds or Venture Capital.
Kenya has seen a rise of interest in investors in the medical sector. FUNZOKenya has held discussions with a number of them to promote investment in medical training institutions. One of them, the Abraaj Capital Group, is currently in the process of establishing a private middle-level college and a multi-specialty hospital in Kiambu County.
The project is also tapping into bilateral and multilateral funding through the Development Partners in Health Kenya platform to present the need for associates to finance medical training in Kenya. It also has held discussions with IFC World Bank and the African Development Bank (AfDB) to develop financing products, with local banks, for medical training institutions.
USAID is also playing is part by providing Sh5 million in grants under FUNZOKenya to some selected medical training colleges to buy equipment and furniture to improve the quality of training. In addition, staffs were trained on how to develop proposals for grants from donors and agencies.
As the medical training colleges step up their capacity for admissions, the other challenge that will come up is the ability of students to pay fees for their education. This is being addressed through a new program Afya Elimu Fund (AEF) that provides affordable student loans to medical trainees.
The MOH, private and public medical schools, NGOs and other partners should continue their commitment to long term, focused and sustainable medical training models, which prioritize investment in the medical schools and in the students.