Five years ago, Esther Omagwa was one of only two nurses at the Railways Health Centre in Kisumu County, western Kenya. The immense workload often exhausted her, forcing her to turn away clients.

Today, the scene at the community health centre is remarkably different. With the nursing staff now expanded to a team of four, Omagwa and her colleagues are better equipped to deal with the load.

The health centre’s overall staff has tripled to 30 and this includes specialists for services such as maternal and child health, cardiology, orthopaedics and mental health. “Since we have been able to incorporate more specialized services in each department, we haven’t had to refer as many patients to larger facilities,” says Violet Ouma, a laboratory officer at the health centre.

Kisumu is one of Kenya’s six model counties for human resources for health, having successfully piloted the primary health care networks initiative in Kenya and reflects a broader transformation that is taking place in the country’s health service delivery. According to Kenya’s 2023 Health Labour Market Analysis, the country has doubled its health workforce in the last 10 years to almost 190 000 active health workers across 13 major health occupations, including nurses, midwives, doctors, surgeons and other specialists. Currently, the country produces approximately 8200 health care workers annually and by 2031, the number of health workers is projected to climb to over 270 000.

Efforts to increase digitalization at facility level is producing timely and accurate data collection, which helps health authorities identify staffing needs and gaps, facilitate targeted training programmes and distribute medical professionals equitably across the country.

“In the past we’ve been using the manual way of collecting data and currently all our services are being digitalized,” says Flavia Naudi, Health Records Information Officer at Railways Health Centre. “We are part of the new generation that is actually using technology to improve healthcare service delivery on staffing and specialization.”

In 2019, World Health Organization (WHO) introduced Kenya’s Ministry of Health to the National Health Workforce Accounts, a system designed by the Organization to help countries collect, analyse and use data related to their health workforce. So far, the country has conducted three cycles, helping to better identify staffing needs and investment areas and aligning with the Kenya Human Resources for Health Strategy 2019–2023.

The implementation of National Health Workforce Accounts provided a foundation for a Health Labour Market Analysis, conducted between 2021 and 2023 and supported by WHO. The analysis provided evidence for the mismatch between supply and demand of health workers and the feasibility and impact of different policy options.

“Health workers are the backbone of the health system. The steps that the country is taking to improve the quality and quantity of the health workforce will help universal health coverage become a reality,” says Dr Abdourahmane Diallo, WHO Representative to Kenya.

Data shows that despite significant improvements, as of 2020, the density of health workers was 13.8 per 10 000 people, highlighting a significant gap in health care provision. For Kenya to meet population health needs and achieve universal health coverage by 2030, an estimated 7‒11% increase of current investment is required.

According to Professor Francis Wafula, the board chair of the Kenya Health Human Resource Advisory Council a critical issue is inequitable distribution of health care workers, not only across Kenya’s 47 counties but also between urban and rural areas, even in the six model counties. “We have a problem of poor distribution of health work force across the country. We need to strike a balance between what is acceptable in the context that we have and what inefficient use of the health workforce,” he says.

Despite these challenges, Kenya has several opportunities to further strengthen its health workforce. Recently President Williams Ruto inaugurated a presidential taskforce to lead human resources for health reforms in Kenya. This high-level commitment aims to attract more investments in health workforce to improve training, employment and retention. Additionally, the momentum from multi-stakeholder national dialogues, facilitated by WHO, offer a strategic advantage. The 2023 Kericho Declaration, emerging from one such dialogue, outlines a roadmap with clear action points for enhancing health workforce management and development.

For Violet Odongo, a client of Railways Health Centre, the improvements are making a difference. “The nurses and the doctors helped us so much and we are so relieved,” she says.

Distributed by APO Group on behalf of World Health Organization – Kenya.

The Economic Community of West African States (ECOWAS) engaged Member States and diverse group of maritime sector stakeholders to assess the financial, economic, and implementation options of the Praia-Dakar maritime transport project. This consultation is a key milestone towards the completion of the technical studies for the project which is aimed at advancing the larger Praia-Dakar-Abidjan-Lagos Corridor Transport Project, which strives to improve regional connectivity and promote economic integration within West Africa.

The engagement meeting, which took place in Praia, brought together experts and stakeholders who considered alternatives for the establishment of maritime services, either as a Container liner or a RoPax (Passenger and some Goods). The experts recommended a third alternative which will combine container and Ropax services considering the high level objective of enhancing the free movement of persons and boosting intraregional trade.

The meeting featured an opening address from the Chairman of ENAPOR’s the Board of Directors, of the National Company for Port Administration of Cabo Verde “ENAPOR”, Mr Eduardo Lima, who stated, “The Praia-Dakar-Abidjan corridor is one of the largest integration and infrastructure projects in our region. Its execution will offer citizens of Cabo Verde a significant opportunity to access the 400 million plus market of ECOWAS. This he said, will promote true integration among member states in all aspects. Effective transportation and communication systems are essential to face the challenges of economic globalization, ensuring reliability, quality, integrity, and security.”

ECOWAS’ acting Director Transport, Mr. Chris Appiah, highlighted the importance of the project, stating that the Praia-Dakar shipping line will serve a crucial link on the community transportation network presenting a cheaper means of moving trade which is key to economic growth and connectivity. Through improving transportation connections between key locations, we are laying the groundwork for increased mobility, tourism, and trade across West Africa.

A technical field visit to the Port of Praia offered valuable insights into the infrastructure and logistical facilities, safety and security mechanisms required for the shipping services. The discussions centered around the validation of recommended financial strategies, economic benefits, and logistical execution. The objective is to establish the shipping line to further integrate Cabo Verde into the market of the other ECOWAS Member States. The Shipping line is expected to commence by the end of 2026.

Distributed by APO Group on behalf of Economic Community of West African States (ECOWAS).

As dawn breaks over Wau, Northern Bahr El Ghazal, 17 trucks, line otherwise empty streets around the United Nations Mission in South Sudan’s (UNMISS) field office here. Their destination lies on the other side of some of South Sudan’s most dangerous roads.

However, these drivers, who deliver vital aid and supplies, are not on this journey alone.

They will be accompanied by Blue Helmets from Mongolia as they transport essential fuel across state lines to the UN Peacekeeping mission’s base in Bentiu, the capital of Unity state.

This fuel is crucial to sustain the mission’s efforts to protect civilians and build sustained peace in an area that has been ravaged by climate change and intercommunal conflict.

Providing force protection to such road convoys is part of UNMISS’ mandate to safeguard deliveries that millions depend upon, especially considering recent attacks on drivers and increasing regional instability.

But the presence of peacekeepers goes beyond meeting immediate supply needs. By maintaining open and safe supply routes, they support broader humanitarian efforts, ensuring that food, medical supplies, and other essential aid reach those in areas hard hit by conflict and environmental disasters.

Lado Abdul Rashid, a veteran driver on this route, underscores the necessity of having peacekeepers escort these invaluable deliveries.

“The cargo we carry is precious and the roads are insecure. We have waited two weeks for our turn to travel under UNMISS escort after some of our fellow truckers have been ambushed or lost their lives,” he explains.

The road ahead is primarily dirt, and during South Sudan’s long rainy season, it becomes nearly impassable. Pre-positioning supplies for UNMISS and humanitarian partners ahead of the rains is, therefore, non-negotiable.  

Thus, the convoy presses on, traveling 12 hours daily, leveraging the early light for safety and stopping as night falls at different UNMISS field offices to mitigate risks.

The drivers are accustomed to long hours on the road, but without protection, their journeys could be much longer. “If we travel without UNMISS peacekeepers, it will take us around six days to reach Bentiu because of the dangers that force us to stop frequently. But with peacekeepers by our side, we can be much more time efficient,” said Fuad Abdul Seif, another seasoned driver, during a checkpoint stop in Warrap state.

With peacekeepers, the journey takes only three days.

Lieutenant Colonel Ugganbaatar Khurelbat, who is leading the mission to Bentiu, emphasizes their core objective. “Our primary goal is to protect civilians. Ensuring the safety of these drivers is paramount for the uninterrupted delivery of essential supplies, and keeping those who risk their lives to deliver them safe” he states.

As the fuel trucks reach the depot in Bentiu and unload the liquid that will sustain UNMISS operations for months to come, the mission isn’t over.

Ghanaian peacekeepers stand ready to escort the 17 drivers back to Wau, where the next convoy awaits their turn to travel under the protection of the Blue Helmets.

The success of these missions is a massive logistical effort that requires coordination among the various UNMISS field offices across the country; local and national government partners; national security forces; humanitarian partners, and the private sector.

Distributed by APO Group on behalf of United Nations Mission in South Sudan (UNMISS).