The Crisis in Kenyan Nursing: A Growing Exodus from the Profession
As thousands of Kenyans prepare to embark on their nursing education this year, a startling trend is emerging within the healthcare sector. A recent survey has revealed that a significant portion of employed nurses are considering leaving the profession entirely. This revelation highlights a deepening crisis in Kenya’s nursing workforce, despite the high demand for nursing as a career choice.
High Demand for Nursing Education
Nursing remains one of the most popular courses in Kenya, with students eagerly applying to tertiary institutions. According to the Kenya Universities and Colleges Central Placement Service (KUCCPS), nursing was among the top four most applied-for courses this year. The Kenya Medical Training College (KMTC) also saw a surge in applications, with over 27,000 students vying for just 3,000 available slots at certificate and diploma levels. While KMTC offers more than 120 other medical programs, the overwhelming interest in nursing underscores its appeal.
However, this enthusiasm does not translate into job satisfaction for many nurses once they enter the profession.
A Profound Sense of Discontent
A study conducted by Dr. Evans Kiptulon and his colleagues at KMTC found that 81.4% of nurses in Kenya’s major referral hospitals intend to leave their jobs, while 31.4% plan to exit the nursing profession altogether. The research, published in the BMC Nursing journal, examined over 400 nurses across 14 hospitals and highlighted a severe crisis in the sector.
The findings show that government-owned facilities are hit the hardest, with 86.6% of nurses in national referral hospitals expressing a desire to leave. County referral hospitals also reported high numbers, with 81.2% of nurses considering departure. Private referral hospitals had lower but still concerning rates, at 76.3%.
Despite these alarming figures, 68.5% of nurses expressed a desire to remain in the profession, indicating that while some are dissatisfied, others find value in their work.
Factors Driving Nurses Away
What is causing such a large number of nurses to consider leaving? According to the study, job dissatisfaction is a key factor. Only 56% of nurses reported being happy with their work, citing poor salaries, heavy workloads, lack of respect, and an unsupportive workplace culture as major concerns.
Dr. Kiptulon and his team emphasized that higher job satisfaction correlates with a lower likelihood of leaving both the job and the profession. They called for improved working conditions, better pay, and more support for nurses.
Miklós Zrínyi and Adrienn Ujváriné, co-authors of the report, noted that self-reported data may introduce biases, but the findings align with the experiences of nurses on the ground.
Calls for Change and Better Support
The National Nurses Association of Kenya (NNAK) supports the study’s conclusions, with NNAK President Collins Otieno Ajwang stating that the issue lies not with the profession itself, but with the current employment terms and working environment.
Ajwang pointed out that nurses prefer permanent and pensionable positions, along with fair remuneration. However, many counties only offer temporary contracts, making it difficult for nurses to commit long-term. He urged the implementation of the Career Progression Guidelines for Nursing Personnel 2025, which aim to improve training, grading, and deployment.
The Public Service Commission (PSC) has approved these guidelines for national government employees, and Ajwang believes they could significantly improve job satisfaction if adapted for county governments.
Challenges Faced by Nurses
Nurses also face challenges related to workload and resources. Each year, approximately 8,000 nurses graduate, but employment opportunities are limited. High workloads lead to frustration, mental strain, and even health issues. Additionally, many hospitals lack basic supplies and equipment, making it difficult for nurses to provide adequate care.
Ajwang highlighted the need for scholarships and training opportunities, noting that nurses often lack access to further education compared to other health professionals. Without these opportunities, many feel stuck in their careers and eventually decide to leave.
International Context and Migration Trends
Kenya is not alone in facing nurse retention issues. Globally, hospitals are struggling with burnout, early retirements, and resignations. In the UK, a 2024 report by the Royal College of Nursing warned of a severe shortage of nurses, forcing the government to rely on overseas recruits. Similarly, in Canada, poor working conditions have pushed many nurses to seek better-paying agency roles.
According to the 2024 TruMerit Nurse Migration Report, around 800 Kenyan nurses migrate abroad each year. Many of those surveyed in the Kiptulon study indicated that leaving the country is a serious consideration within the next five years.
Demographic Insights
The study included a diverse group of nurses, with the following characteristics:
- Gender: 58.3% female, 41.7% male
- Marital Status: 66.4% married, 31.0% single, 2.6% widowed
- Age Group: 41.7% aged 21–30, 38.7% aged 31–40, 19.6% over 40
- Work Experience: 81.1% with 1–15 years of experience, 18.9% with over 16 years
- Education Level: 1.6% with a certificate, 33.3% with a diploma, 53.4% with a degree, 11.0% with a master’s, 0.7% with a PhD
- Employment Type: 59.2% in permanent and pensionable roles, 40.8% in fixed-term contracts
- Position: 73.4% general staff, 26.6% in leadership roles
Conclusion
The crisis in Kenya’s nursing sector reflects broader global challenges in retaining healthcare professionals. Without meaningful improvements in working conditions, remuneration, and support systems, the cycle of high enrollment and low retention will continue. Nurses deserve better opportunities, recognition, and a sustainable career path that allows them to thrive rather than simply survive.
