NAIROBI, Kenya – Kenya’s public and private health facilities are grappling with critical staffing gaps, drug shortages and inadequate infrastructure, according to a new national assessment that raises fresh concerns over the country’s progress toward Universal Health Coverage (UHC).
The Kenya Health Facility Assessment 2024 – Quality of Care and Human Resources for Health Report, released in Nairobi, examined 3,605 hospitals and clinics across all 47 counties.
It identifies widespread weaknesses in the health system, with many facilities unable to meet even the most basic standards for safe and reliable care.
The Ministry of Health-backed review shows that while access to healthcare has expanded in recent years, quality and safety remain major challenges.
“Some facilities are misclassified or offering services beyond their capacity,” the report cautions, urging improved oversight and reclassification of health centres.
Facilities Doing Surgeries Beyond Their Level
The assessment found that some Level 2 and 3 centres, especially privately run ones, were conducting major surgeries, including Caesarean sections—procedures meant for higher-tier hospitals with surgical, blood transfusion and emergency support capacity.
This practice, the report notes, places patients at risk and highlights weak enforcement of national service delivery guidelines.
Maternal Care Still Among Weakest Areas
Maternal and newborn health—long a pressure point in Kenya’s care system—lags behind key benchmarks.
Out of more than 6,000 facilities offering delivery services, only 37% had all essential emergency obstetric and newborn functions required to respond to complications.
Even among Level 4 and 5 hospitals, fewer than half met the standards expected for full emergency maternal care.
Drug Shortages and Poor Diagnostic Capacity
Laboratory and pharmacy services were also flagged as fragile. Only 57% of higher-level hospitals could perform a basic hemogram blood test, and 39% reported interruptions in lab services.
Stockouts of essential medicines were widespread. All 23 tracer drugs monitored in the assessment—including oxytocin, magnesium sulphate and benzyl penicillin—experienced shortages during the review period.
Health Workforce Below Global Standards
Kenya has an average of 14.3 core health workers per 10,000 people—far below the World Health Organisation’s recommended minimum of 23. Only Nairobi, Mombasa, Kisumu and Nyeri meet this threshold.
The report also noted:
- Less than half of staff are on permanent and pensionable contracts.
- Only 65% of public facility staff are medical professionals, below the 70% benchmark.
- Absenteeism, though reduced from 2018 levels, remains high at 30%.
Workplace risks were also prominent: 17% of healthcare workers reported verbal or physical assault, while nearly a third were exposed to hazardous materials.
Treatment Quality and Documentation Still Poor
Clinical audits revealed inconsistent adherence to care guidelines. Correct diagnosis and treatment were achieved in:
- 40% of severe diarrhoea cases in children
- 39% of non-severe pneumonia cases
- 47% of hypertension cases in adults
While malaria care scored better, documentation for tuberculosis and postpartum care was incomplete in most cases.
Yet family planning services received high satisfaction ratings, with 97% of clients reporting positive experiences, although 16% felt pressured toward certain contraceptive choices.
Government Pledges Reforms
The Ministry of Health said the findings would guide ongoing reforms under UHC, including staffing redistribution, infrastructure investment, stronger supervision and continuous medical training.
The report recommends improving workplace safety, ensuring steady drug supplies, and enforcing service level standards to protect patient safety.
