More than four in five health workers posted to rural and hard-to-reach areas are considering leaving their jobs, raising fresh concerns about the sustainability of healthcare delivery in Kenya’s counties.
The findings come from a new study by the African Population and Health Research Centre (APHRC), presented at a forum in Voi that brought together county health officials and frontline workers from across the country.
Conducted in nine counties, the research sought to understand why attracting and retaining health personnel in remote areas remains a persistent challenge more than a decade after devolution.
Researchers told participants that decisions to remain in rural postings are driven less by professional commitment and more by everyday realities on the ground. Poor living and working conditions emerged as the strongest factors influencing whether health workers stay or leave.
Key concerns cited include unreliable electricity, limited access to clean water, personal safety risks, and poorly equipped health facilities. These challenges, the study found, significantly undermine morale and job satisfaction.
Presenting the findings, APHRC researcher Jarim Mtumishi Omogi said the problem cuts across counties and reflects a broader national pattern that threatens service delivery in marginalised regions.
“The findings will be shared with the Council of Governors, the National Assembly and the Senate for serious consideration, to inform decisions that can strengthen healthcare systems and services,” Omogi said.
While many respondents acknowledged the relative job security offered by public-sector employment, the study found that low pay, limited opportunities for skills development, and unclear promotion pathways continue to push workers away from rural postings.
These pressures are worsened by chronic understaffing, with health workers reporting heavy workloads in facilities serving vast or geographically challenging areas.
During the forum, frontline workers shared personal experiences of working under sustained strain, noting that many colleagues eventually seek transfers to urban centres or exit public service altogether. Some participants acknowledged incremental improvements in certain facilities, though progress was described as uneven and inconsistent.
Taita Taveta Deputy Governor Christine Kilalo said the study provides critical evidence to guide county-level planning, particularly as devolved units continue to shoulder responsibility for healthcare delivery.
County Chief Officer for Health Services Violet Mkamburi also recognised the concerns raised, emphasising that staff welfare and working conditions remain central to stabilising the health workforce.
The study recommends targeted investment in health infrastructure, stronger emergency and referral systems, improved financing, harmonised employment terms, and a review of hardship allowance classifications. It also calls for clearer career progression frameworks to motivate staff and reduce attrition in rural areas.
Researchers warned that without deliberate and coordinated action, continued staff losses could further restrict access to quality healthcare for communities living in Kenya’s most remote regions.
