BY VERAH OKEYO
Anastacia Odhiambo, a nurse at the maternity wing of the Jaramogi Oginga Odinga Teaching and Referral Hospital in Kisumu County, knows what it means to be overworked.
Before June 2013, when free maternity was rolled out, about 350 women used to deliver at her unit. The number has since risen by 34 per cent, to about 470.
Ideally, Ms Odhiambo says, the beds in her unit should accommodate 14 patients, but on the day this writer visited the hospital there were 29, more than double the limit.
According to the most recent national nurses’ census which was completed in 2012, Kenya’s nurses are overworked, short-staffed, underpaid, and doing jobs that are poorly matched to their specialised skills.
The lopsided, uneven geographical distribution of nurses also hinders their ability to provide adequate health care. Nurses are an essential part of Kenya’s healthcare system, but public hospitals operate with far fewer than are necessary.
Currently, Kenya has around 46,000 registered nurses and 27,500 enrolled nurses, according to the 2016 Economic Survey.
According to the nurses’ census which was conducted by the Nursing Council of Kenya, the country had about 50 for every 100,000 or 5 for for every 10,000 people, going by WHO units.
The World Health Organisation (WHO) recommends that in order to sufficiently cover the population with essential health services, 23 nurses, doctors and midwives per 10,000 people should be available at a minimum.
Available figures from 2010 show Kenya had 13 of all three kinds of health workers per 10,000 people, meaning the country still needed an increase of 10 doctors, nurses and midwives for every 10,000 people.
Back at the referral hospital in Kisumu, an entry in the department’s visitors’ book on December 16, 2014 by a Dr Jane Wakahe reads partly: “The staff are burnt out… consider having in-house medical officers and anaesthetists because of the many emergencies.”
The referral hospital attends to women from as far as Vihiga, Kakamega, Homa Bay, Busia and Bungoma counties, most of whom have complications such as high blood pressure and early rapturing of the membrane.
Take, for example, the paediatric nurses Caroline and her colleague Abigail Nyatogo, who work at Jaramogi Oginga Odinga Teaching and Referral hospital in Kisumu. They are the only qualified nurses looking after 31 babies with various birth-related medical complications in the unit.
Most of the newborns suffer from birth asphyxia, a medical condition resulting from deprivation of oxygen to a newborn infant that lasts long enough during the birth process to cause physical harm, usually to the brain.
Caroline’s job description reads like a constitution: check the babies’ vitals (respiratory rate and temperature); administer intravenous and intramuscular injections in some beds at certain intervals; ensure that the temperatures at all 12 incubators are at 31 degrees; observe feeding of the children; document every little activity and nursing care given to each baby.
Kisumu County has 73 nurses for every 100,000 patients, ranking it seventh nationally. Turkana, with 12 nurses per 100,000 people, and Wajir, with 20 nurses per 100,000 people, are ranked second and third from the bottom respectively.
Kisii County has 59 nurses per 100,000 people, and Murang’a has 47 nurses per 100,000 people.
Isiolo, the best-nursed county in Kenya, has 128 nurses per 100,00 people. The county has more than 13 times more nurses per 100,000 people than Mandera, which with nine nurses per 100,000 is the lowest ranked county in the country.
Embu is in second place, with 15 nurses per 100,000 people followed by Nyeri with 10.
This feature was first published in the Daily Nation by Verah Okeyo.