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A joint opinion piece by UNFPA Kenya Representative Anders Thomsen and Dr. Eunice Ndirangu-Mugo, Chair, Nursing Council of Kenya and Associate Professor and Dean at the Aga Khan University School of Nursing and Midwifery.

This article first appeared in Capital News on May 5th, 2022.

Today, the world marks the International Day of Midwives, which celebrates the contributions and achievements of the midwifery workforce in saving lives and improving health. With proper investments, a strong midwifery workforce has the potential to save an estimated 4.3 million lives globally, by providing essential services that help prevent maternal and neonatal deaths. In Kenya, celebrations to mark the Day of Midwives this year will include the launch of the National Nursing and Midwifery Policy. This is a key instrument that sets out to build an enabling environment for nurses and midwives to perform their services and grow through the profession. The policy outlines guidelines for enhancing regulation and education frameworks, workforce planning and management, increasing nurses’ and midwives’ participation in decision-making, and sustainable financing for nursing and midwifery services.

Nurses and midwives make up 80% of the health workforce in Kenya and are often the first, and sometimes, the only health professionals that patients encounter when seeking care. They are a trusted part of communities as they understand the cultural and social dynamics, and can therefore better provide services to meet the needs of the local population. Their critical role in ensuring access to comprehensive, quality, and affordable healthcare is central to the achievement of Universal Health Coverage, as envisioned in President Uhuru Kenyatta’s Big Four Agenda. 

Despite their important role in the community, systemic challenges continue to stifle the profession, threatening the delivery of quality health care services across all levels of the health system in Kenya.  Some incidences such as industrial strikes that have highlighted their dissatisfaction with work conditions and remuneration. The quality of nurse and midwifery education and training also remains a major concern due to the limited number of adequately equipped training institutions, and facilities such as skills labs. The workforce is also facing a challenge of demand and supply, with Kenya among countries in the East, Central, and Southern Africa region reporting a high needs-based shortage of nurses and midwives. This is expected to worsen by 2030, in the absence of mitigating measures. 

There is progress in strengthening the nursing and midwifery profession. The launch of the Nurse and Midwife Alliance in August 2021 was a pivotal moment that established a platform that facilitates the professional growth of the healthcare practice. Since its inception, the alliance has served as a powerful convener of nurses, midwives, stakeholders in the health sector, donors, and other partners who are working together to improve education, professional development, standards, regulation, and terms of service for nurses and midwives.

The new nursing and midwifery policy presents a great opportunity for Kenya to build a formidable healthcare workforce with adequate capacity and skills to deliver quality primary health services for all. Its full implementation will ensure that nurses and midwives benefit from continuous professional development and a work environment that is satisfying and rewarding.  Building an enabling environment for nurses and midwives will increase recruitment, deployment, retention, and motivation, which is critical to enhancing access to quality of health services across the country particularly in marginalized and hard to reach areas of the country, including the Arid and Semi-Arid Counties.

Additionally, as part of the launch, the Advanced Practice Nursing and Advanced Practice Midwifery scopes of practice, and the ongoing development of the Scheme of service will define the operational frameworks for the profession.  Nurses and midwives will be set in defining their crucial roles towards primary healthcare and its overall contribution to universal health coverage in Kenya.

The Covid-19 pandemic served to stress on the urgent need to strengthen the health workforce. It also presented a striking reminder of the unique role that nurses and midwives play as frontline health workers. Ensuring adequate support to this cadre of health professionals must therefore remain a top priority, now and in the future.