Jacinta Nzinga, a researcher in health systems at the KEMRI Wellcome Trust Research Programme, works on the health work force, particularly in nursing. She explores the main issues that impact on the quality of nursing care provided to sick newborns in hospitals in Nairobi City County.
The KEMRI-Wellcome Trust Research Programme is a major Wellcome Trust’s overseas programmes. Its work has had a major influence on national and international health policy. Research spans a wide variety of topics and disciplines including research on malaria and bacterial and viral infectious diseases, work to map disease risk and intervention coverage and work on research ethics and health systems strengthening.
I’m Dr Jacinta Nzinga, I work with KEMRI Wellcome Trust in Nairobi. My early training is in the basics of public health, then I went on to do my masters in global health, and my PhD in leadership and management in clinical healthcare settings.
I branched off a bit from doing public health, because looking at how health systems are governed is very important, particularly if you are thinking about how to make sure that interventions are successful and that they are sustainable. It is important to look at what’s happening behind those interventions, not just the technical aspects of it but also the social context and how that influences how things are done.
At the moment I am doing some work on the health work force, that’s where my main interest is. I’m doing work on the nursing health work force in Kenya, part of the health systems that deliver for newborns. We are doing an ethnography of nursing within the neonatal wards to understand how nurses make sense of what to do in such chaotic and very emotive environments, particularly in terms of how to prioritise what care to deliver to children, when they have such huge numbers of babies and such small ratios of nurses.
This work is very important in the sense that historically nurses have been left out in the policy table, their voices not heard. Not just in Kenya but globally, they have been thought of as an assisting profession. We want to give them voice, so that they can show how much they do and therefore how important they are in delivering these interventions.
The ethnographic work in the health services that deliver for newborns is also related to a new grant we won with a colleague of mine that’s going to look at the role of nurses and improving quality of care. We are going to focus on their professional identities to understand how nurses are socialised from training schools and therefore what that means in terms of giving them urgency and agitated for change. So far we’ve already seen a lot of interest in health work force issues in Kenya, particularly post devolution, with a lot of the leadership within the counties wanted to know how to make use of such a limited resource. We are already in discussions with a lot of expert groups within the Kenyan ground, from the council and training schools, and trying to work with them together in developing not just the questions, but feeding back interim as we go on to see how they can improve practice and training itself from the word go.
It does feel like timely work and it does feel like it’s going to make a lot of difference in terms of making sure interventions are sustainable over time.