Tough Questions
Nov 15th, 2007 by Suzy Jed
We spent yesterday at the Health Rights Advocacy Forum Conference. The agenda was phenomenal, including well-known Kenyan speakers and a range of topics including: basic health rights, advocacy for health care workers, the impact of development partners on health worker policies and health sector reforms. The sessions were informative, yet overwhelming. It was all I could do to try to soak it all in and attempt basic processing of the information.
One of the topics touched on throughout the day was the issue of brain drain, the loss of trained health care workers from developing nations to wealthier nations. Health care worker shortage in Kenya is a complex issue. Kenya actually has a surplus of trained nurses but a shortage of funding to provide positions for all of them.
[Suzy Jed, MSN, APRN-BC and the American and Kenyan teams in the Kenyatta National Hospital HIV Comprehensive Care Clinic Laboratory]
Before the conference, we had the privilege of visiting two different health care facilities that provide care to HIV-infected individuals. Both facilities have comprehensive HIV care clinics, funded primarily by foreign donors, and are considered centers of excellence. One of the care facilities was a primarily public facility, while the other was semi-private and receives significantly more government funding. Both clinics provide phenomenal services. However, as a result of funding, there was a drastic difference in the condition and size of the facilities, number of health care workers to provide services and availability of labs.
As Lissy mentioned, one of the healthcare facilities may be faced with a severe health worker shortage in early 2008. While funding is the underlying issue, it is not clear how to arrive at a sustainable solution. For one thing, foreign donors are unable to provide indefinite funding. Many donors provide funding for long periods of time but then pull out. Such problems raise more questions. Should countries that employ foreign healthcare workers pay the healthcare worker’s home country the cost of education and training? Is it beneficial for governments to train healthcare workers as an export? There are many tough questions like these and no simple or straightforward solutions.
[Suzy Jed, MSN, APRN-BC, Sarah Kalloch, Andrew Suleh, MD and the nurse leadership at Mbagathi Hospital.]