Analytical Review of Kenya’s Health Workforce Policy Strategies, 1994-2024: Implication for Health Workforce Management

<ns3:p>Background Explicit human resource policies and guidance can support the management and governance of the health workforce and is needed to address the challenges of shortages, maldistribution, outmigration, and lack of motivation. Our study aimed to review the historical evolution of HWF policies and strategies in Kenya and analyze their implication on HWF management in the country over time. Methods We carried out a desk review and policy analysis of the national general health sector and HWF-specific policy and strategy documents in Kenya from 1994 to 2023. Guided by the Walt and Gilson’s policy analysis triangle we analyzed the extracted data using the policy triangle domains of content, context, process, and actors and their implication on HWF management in the country. Results We reviewed 6 strategic plan documents and 1 policy document. Most documents reviewed were not explicitly HWF documents but also health systems documents that mention HWF, which shows a gap in the prioritization of HWF policy. The content of most of the reviewed documents focused on increasing HWF numbers and reducing maldistribution with little focus on strategic HWF management like conducive working environment. The formulation and implementation guidance in the documents were related to broader health system contextual factors like the structural adjustment program, disease burden, devolution, and Sustainable Development Goals. Both the content and context within which the strategic plans and policies were formulated and implemented have been driven mainly by development partners, donor organizations, ministry of health and private organizations whose roles and interests constantly change during the different formulation timelines. Conclusion Kenya has made some progress in developing guidance on the HWF through the development of 5-year strategic plan documents. However, the development of a dedicated HWF policy that aligns with Universal Health Coverage goals should be prioritized for strategic governance and management of HWF.</ns3:p>