Yingxi Zhao: Medical workforce research in Kenya

I'm Yingxi Zhao, I'm a postdoctoral research scientist based in the HSC, Health System Collaborative in the Nuffield Department of Medicine, Centre for Global Health Research.

Most of my research focus on human resources for health. Globally there's a massive shortage of health workforce, this is most acute and most severe in low- and middle-income country, especially in African countries. Those countries also suffer from other challenges, for example health workers are more likely to concentrate in more urban cities, as opposed to rural areas. And also, more health workers are likely to work in a high-income country after migration. Those countries also face other challenges of health workforce, which lead to them being demotivated and also very likely to be burnt out, which directly harms the quality of care they deliver.

Some of my previous and ongoing work focus on the Kenya's medical workforce. This is directly in collaboration with the medical schools, the medical regulator and the professional association in Kenya. We looked at the internship training of medical doctors in Kenya and the labour market transition. We found out that the training experience of medical interns in Kenya is relatively poor. They don't have good supervision at all times, especially for those interning in smaller hospitals. For example, there are some interns who have to learn how to do a caesarean section on a YouTube video because there's no consultant available in that hospital. But also, the limited helps and financing means that many of those doctors, after their training couldn't work in public hospital, even though many wanted to. This is despite public hospitals have a shortage of medical doctors. This creates a massive challenge.

The challenge with health workforce shortage is a global problem, it's in every country and there's no easy solution. Some of the areas of interest for us include how do we develop new roles and also develop new responsibilities and tasks for existing workforce, as well as how do we ensure the ethical recruitment of workforce from low and middle-income country into high-income countries like the UK. The other problem, I think, really importantly we need to consider, is how do we ensure the own personal well-being and experience of health workforce. Health workers are all individuals, are humans, they often suffer from burnout and well-being problem as we've seen from COVID, so how do we ensure themselves are being taken care of.

It makes a difference for patients, for one all of those health workers are usually at the front line of patient engagement. Their own well-being and their own motivation will ensure the patient service they deliver is of good quality and safe, this directly benefits patients. And second, because health workforce education and training usually are publicly subsidized, each individual training of medical doctor in Kenya cost about £30,000, this often generated from public financing. Ensuring health workforce planning is being done well, we ensure there's no resource waste from public financing and from individual population as taxpayers.

It matters because every health system requires human resources for health to function. Think about all the new medical innovation we develop, whether this is a new drug or a new diagnostic or a new way of doing surgery, it will require health worker to either do it or to supervise a robot to do it. Improving the planning of health workforce is the single most important factor to improve the performance of a health system, so that's why this is really important.

This interview was recorded in July 2024.