Abstract:
Objective: To examine the availability of paediatricians in Kenya and plans for their
development.
Design: Review of policies and data from multiple sources combined with local expert
insight.
Setting: Kenya with a focus on the public, non-tertiary care sector as an example of a lowincome and middle-income country aiming to improve the survival and long-term health
of newborns, children and adolescents.
Results: There are 305 practising paediatricians, 1.33 per 100 000 individuals of the
population aged <19 years which in total numbers approximately 25 million. Only 94 are
in public sector, non-tertiary county hospitals. There is either no paediatrician at all or
only one paediatrician in 21/47 Kenyan counties that are home to over a quarter of a
million under 19 years of age. Government policy is to achieve employment of 1416
paediatricians in the public sector by 2030, however this remains aspirational as there is
no comprehensive training or financing plan to reach this target and health workforce
recruitment, financing and management is now devolved to 47 counties. The vast majority
of paediatric care is therefore provided by non-specialist healthcare workers.
Discussion: The scale of the paediatric workforce challenge seriously undermines the
ability of the Kenyan health system to deliver on the emerging survive, thrive and
transform agenda that encompasses more complex health needs. Addressing this challenge
may require innovative workforce solutions such as task-sharing, these may in turn
require the role of paediatricians to be redefined. Professional paediatric communities in
countries like Kenya could play a leadership role in developing such solutions.