Rural healthcare under threat as nurses eye jobs abroad

Stakeholders in the public health sector have raised concerns that rural communities will be adversely affected by the increased migration of Kenyan nurses to foreign countries.

The massive migration of nurses abroad in search of greener pastures has got backing from the national government in recent months with many travelling to Europe, the US, and the Middle East.

According to the Kilifi County Nurses and Midwives Alliance, the trend used to be common among doctors and nurses in urban areas, but of late, even those at health facilities in rural areas are moving out of the country.

“After the nurses’ strike in 2017, many nurses were demoralised and we started to look at how we could survive and from that time, many experienced nurses started to migrate abroad in search of greener pastures…”

“Initially it used to be that doctors and nurses in Nairobi would move abroad, but as we speak now, many of our colleagues in the facilities are in the process of migrating, while many have already gone,” Kilifi County Reproductive Health Coordinator, Kenneth Miriti, said.

Despite this migration, the health workers claim there has been little effort by the national and county governments to fill the void left in hospitals and health centres.

Instead, they say, what they have been witnessing is a government encouraging more nurses to seek employment opportunities outside the country.

To them, an opportunity to work overseas is appealing because of the better working environment and salaries that they expect from foreign countries as compared to locally. 

However, this comes at a cost to communities, whose first, and most probably only point of accessing healthcare is at a clinic or dispensary mainly manned by nurses.

“We have not been given the right opportunity in the healthcare system. The government has ignored the issue of salaries for nurses which is very crucial. You will find that a clinical officer working with a nurse in a dispensary earns a bigger salary,” he added.

According to Mr Miriti, veteran nurses have sensed the danger looming in the country’s healthcare system.

Kilifi County currently has about 760 nurses, with sources saying that a number of them are in the process of seeking employment outside the country.

Nurses exodus

Kilifi nurses and midwives celebrate outside the Kilifi County Referral Hospital during the marking of the National Nurses and Midwives Week on Monday, May 13, 2024. 

Photo credit: Maureen Ongala|Nation

The Kilifi County Head of the Family Health Services Division, Ms Jesca Deche, says that the nurses’ exodus has severely affected service delivery at the grassroots.​

“We are facing a shortage of nurses in our county. Some retired, others died, others are on transfer while others moved abroad in search of greener pastures because of poor salaries for nurses in Kenya,” she said.

Ms Deche said the County Public Service Board has not employed nurses for over five years despite the gaps left.

“A majority of the nurses who have been there within that period have gone abroad, severely affecting service delivery from dispensaries and forcing us to hire nurses on contract for the referral hospitals,” she said.

She expressed concerns over the quality of service by newly employed nurses, who she said had no one to mentor them, especially those in maternal health care.

She said the fact that nurses took charge of the health facilities during the doctor’s strike should be a wake-up call for stakeholders to take seriously the need to retain them in the country.

“It is a serious problem and it’s a ticking time bomb if our county government does not intervene to address the gap,” she said.

Kenya National Union of Nurses (KNUN) Kilifi County Chairperson, Ms Juliana Nyevu, said over 450 nurses were awaiting promotion by the County Service Public Board.

Ms Nyevu said the nurses had presented their letters to the board. 

Kilifi County Director for Health, Dr Hassan Leli, said the department was working to address nurses’ grievances.

“At the end of it all you deserve rewards for what you give and as a department. We are working tirelessly to make sure all those who are due for promotion get them and also capacity building,” he said.


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