Senators alarmed by acute staff shortage at Nakuru County Referral Hospital

The visit by the Senate Standing Committee on health to the Nakuru County Referral and Teaching Hospital (NCRTH) has revealed a critical staffing shortage that could significantly affect service delivery at the busy Level 5 facility.

During a tour of the hospital, the Uasin Gishu Senator Jackson Mandago led Committee raised concerns over the severe personnel gap in key departments, particularly in the casualty section. 

He notes that the current medical worker-to-patient ratio is high and unsustainable posing a risk to both patients and healthcare workers.

The visibly long cue with many patients awaiting services matches the senators’ concerns. 

“Having a section like the casualty department being served by only two doctors and nurses, four clinical officers attending to close to 1,000 patients daily raises serious concerns about the quality and efficiency of care. It also puts immense strain on the staff, making it difficult for them to rest as required,” Mandago says.

Mandago warned that such numbers are insufficient to meet the high patient demand, resulting in overworked staff and compromised healthcare delivery.

He emphasized that quality healthcare cannot be achieved without adequate human resources and called on the Nakuru County Government to take urgent action.

“We cannot efficiently deliver quality healthcare without human resources. We are asking the government of Nakuru to put measures in place to ensure that we increase the number of staff working in this facility, particularly now that SHA and FIF are in place,” he says.

Mandago notes that the hospital has the financial capacity to address some of its staffing challenges through its own-source revenue and reimbursements from the Social Health Authority (SHA). 

Responding to the chairman's inquiry on how much the facility generates in a month, the facilities medical superintendent James Waweru to that," The hospital generates 23 million from its own collection and gets about 60 million in reimbursements from SHA summing up the revenue to approximately 83 million monthly."

The senator pointed out the Facility Improvement Financing (FIF) framework as a key solution to some of the hospital's challenges including staffing.

 Established under the Facilities Improvement Financing Act of 2023, FIF allows public health facilities to retain, manage, and utilize revenue generated at source instead of remitting it to the County Revenue Fund.

He urged the hospital’s management and board to leverage this framework to improve staffing levels.

“Now that we have the FIF Act, the facility has a board and a management team responsible for making decisions on how these funds are utilized. Using their own generated revenue, they can address these issues, including hiring additional staff,” he recommends.

Mandago stressed that the high patient-to-staff ratio must be addressed urgently to improve efficiency and ensure quality care.

The committee’s findings highlight the need for immediate investment in human resources, even as new financing mechanisms like SHA and FIF offer an opportunity for hospitals to strengthen service delivery and respond more effectively to patient needs.

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