Please use this identifier to cite or link to this item: http://bura.brunel.ac.uk/handle/2438/30510
Title: Examining the absorption of post-internship medical officers into the public sector at county-level in devolved Kenya: a qualitative case study
Authors: Zhao, Y
Mbuthia, D
Munywoki, J
Gathara, D
Nicodemo, C
Nzinga, J
English, M
Keywords: human resources for health;labour market;recruitment
Issue Date: 19-Aug-2023
Publisher: BioMed Central (part of Springer Nature)
Citation: Zhao, Y. et al. (2023) 'Examining the absorption of post-internship medical officers into the public sector at county-level in devolved Kenya: a qualitative case study', BMC Health Services Research, 23 (1), 875, pp. 1 - 11. doi: 10.1186/s12913-023-09928-0.
Abstract: Background: After Kenya’s decentralization and constitutional changes in 2013, 47 devolved county governments are responsible for workforce planning and recruitment including for doctors/medical officers (MO). Data from the Ministry of Health suggested that less than half of these MOs are being absorbed by the public sector between 2015 and 2018. We aimed to examine how post-internship MOs are absorbed into the public sector at the county-level, as part of a broader project focusing on Kenya’s human resources for health. Methods: We employed a qualitative case study design informed by a simplified health labour market framework. Data included interviews with 30 MOs who finished their internship after 2018, 10 consultants who have supervised MOs, and 51 county/sub-county-level managers who are involved in MOs’ planning and recruitment. A thematic analysis approach was used to examine recruitment processes, outcomes as well as perceived demand and supply. Results: We found that Kenya has a large mismatch between supply and demand for MOs. An increasing number of medical schools are offering training in medicine while the demand for MOs in the county-level public sector has not been increasing at the same pace due to fiscal resource constraints and preference for other workforce cadres. The local Department of Health put in requests and participate in interviews but do not lead the recruitment process and respondents suggested that it can be subject to political interference and corruption. The imbalance of supply and demand is leading to unemployment, underemployment and migration of post-internship MOs with further impacts on MOs’ wages and contract conditions, especially in the private sector. Conclusion: The mismatched supply and demand of MO accompanied by problematic recruitment processes led to many MOs not being absorbed by the public sector and subsequent unemployment and underemployment. Although Kenya has ambitious workforce norms, it may need to take a more pragmatic approach and initiate constructive policy dialogue with stakeholders spanning the education, public and private health sectors to better align MO training, recruitment and management.
Description: Availability of data and materials: All data relevant to the study are included in the article.
A Correction to this article was published on 05 September 2023. This article has been updated. Change history: 05 September 2023A. Correction to this paper has been published: https://doi.org/10.1186/s12913-023-09992-6: Following publication of the original article [1], the authors identified errors in the affiliation assignment, caused by a typesetting mistake: affiliation 3 (instead of affiliation 2) was incorrectly assigned to Mike English as a second affiliation. This error is corrected in the affiliations list of this Correction article and the original article [1] has been updated.
URI: https://bura.brunel.ac.uk/handle/2438/30510
DOI: https://doi.org/10.1186/s12913-023-09928-0
Other Identifiers: ORCiD: Catia Nicodemo https://orcid.org/0000-0001-5490-9576
875
Appears in Collections:Brunel Business School Research Papers

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