Audit: Staff shortages hit major referral hospitals

The MTRH in Eldoret City for instance is facing an acute shortage of at least 1,032 health workers, approximately 1,000 of them being nurses, according to the latest report by Auditor-General Nancy Gathungu, covering the year ending June 2025.

Staff records show that the hospital has five general surgeons instead of 11, six oncologists instead of 14, medical officers are 73 instead of 83, medics overseeing child health and paediatrics are 15  instead of the required 18, and nine radiologists instead of 14.

The hospital which is supposed to have 1400 nurses, has less than 1000.

"The shortage has severely impacted healthcare services delivery at the second largest referral hospital in Kenya," reads part of the report by Ms Gathungu as it urged the National Treasury to prioritise funding the top facility to fill the staffing gaps.

The Nation learnt that the crisis is partly driven by a "brain drain" of between 60-100 experienced nurses and medics, who resign annually for roles in Europe, the United States of America and the Middle East. 

It is also coupled with hiring budgetary constraints from the National Treasury.

The Hospital Chief Executive Officer Philip Kirwa is on record saying that between 60 and 100 nurses resign annually from the facility, for greener pastures abroad.

On Tuesday (April 14) health workers at the facility issued a one -week strike ultimatum to the government, citing worsening working conditions, severe underfunding and non-remittance of statutory deductions. 

"Staff have been working under difficult conditions because of shortages. he hospital is grappling with acute understaffing. Failure to replace staff exiting through retirement, attrition and those leaving for greener pastures has left remaining staff overstretched. The hospital is in a crisis and requires urgent government intervention," Kenya Medical Practitioners and Dentists Union(KMPDU) branch Secretary Edwin Rono revealed. 

"The hospital is struggling due to reduced funding from the National Treasury. Workers are demoralised especially those nearing retirement without assurance of their benefits. The hospital requires additional funding of about Sh5 billion," he added. 

Records by the audit report show MTRH has accrued unpaid statutory deductions of Sh1.8 billion, as of June 2025,which has negatively affected staff morale.

The hospital has been grappling with a Sh1.2 billion deficit in the 2024/2025 financial year. 

Nakuru County Teaching and Referral Hospital, the largest facility in the South Rift Region is also facing both severe staff shortages and congestion.

The hospital serves Nakuru and more than six neighbouring counties of Baringo, Kericho, Narok, Nyandarua, Laikipia among others.When the Senate Health Committee visited the facility on Tuesday, they came face to face with the reality, learning that two doctors were forced to attend to at least 1,000 patients in a day.

"The staff shortage is undermining service delivery. We have witnessed the impact of the shortage, with two nurses serving thousands of patients, two doctors also serving thousands of patients. This is unacceptable. The county should use funds generated from Facility Improvement Financing to hire additional staff to bridge the gaps," stated Mr Jackson Mandago, the Senate Health Committee Chairman. 

"There is a need for an increase in human resource; more than 60 percent of county budgets are on salaries, they should be directed to healthcare personnel as well. The facility makes revenue of about Sh23 million and receives Sh60million in reimbursements from the Social Health Authority. The county health authorities should use this to hire more personnel. Employ health workers as interns or as permanent and pensionable staff," added Mandago.

Interestingly, on Tuesday, the two doctors who were supposed to be attending to the patients were not in the facility, with only four clinicians available.

According to residents, the recent closure of Mediheal Hospital and Nakuru War Memorial Hospital has left the Nakuru County Teaching and Referral Hospital grappling with congestion.

"The continued closure of the Nakuru War Memorial Hospital and the recent closure of Mediheal Hospital, which used to decongest Nakuru Level Five, have left the referral facility reeling under the burden of the ever increasing number of patients.It was expected," said a resident James Kariuki.

Mediheal Hospital, owned by former Kesses MP, Dr Swarup Mishra, that was situated near Free Area ,along the busy Nakuru-Nairobi highway was last year closed down, over financial woes.

According to the Nakuru Level Five Hospital nursing officer-in-charge Alpharxard Kemboi the facility handles between 1,500 and 2,000 patients daily.

"The average number of patients remains the same. We have been handling between 1,500 and 2,000 patients daily, but l don't think the closure of the two hospitals hasn't affected us much," said Kemboi 

Recently, the KMPDU South Rift Secretary Stephen Omondi revealed that due to the growing number of patients, the Nakuru Level Five Hospital generally was grappling with a shortage of nurses, doctors and other medics, as well as essential equipment.

"Generally the hospital needs at least 300 additional nurses. The paediatric ward ,the Margaret Kenyatta Mother and Baby Unit and other areas need adequate staff. The strained workforce has contributed to the rising complaints of negligence from patients at the hospital," he stated.

At least 50 medics leave the facility for greener pastures abroad every year, according to records.

Kenyatta National Hospital, the country's largest referral hospital is also affected by staff shortage and congestion.

Auditor-General's latest audit revealed the facility had been grappling with bed occupancy constraints.

"Review of the inpatient statistics revealed that the hospital recorded an average yearly bed occupancy rate of 126 percent and several wards in medicine, General Surgery, Pediatrics and Specialised Medicine exceeded 140 percent occupancy," reads part of the report for the year ending June 2025.

The report further reveals that underfunding has affected the hospital's mandate and service delivery.

During the period (2024/2025) the hospital recorded an underfunding of Sh4.9 billion, with a budget of Sh22.5 billion.

Frequent strikes 

Long-standing grievances such as staff shortages and poor working conditions, were part of the issues that prompted a health workers strike that was called off on Tuesday after parties agreed on a return to work formula.

Healthcare workers have been complaining about heavy workloads.

The pressure has in the past months been compounded by frequent strikes in hospitals across neighbouring counties, pushing more patients to seek care at the national referral facility.

"We are usually overwhelmed. The workload is too much compared to our numbers. Currently, we are about 2,300, yet we are supposed to be around 2,800," revealed a nurse at the facility who sought anonymity due to fear of reprisals. 

The Nation established that a nurse at the facility is required to attend to up to 40 patients in a ward.

"In the ICU, one nurse may be assigned four patients, yet the standard should be one nurse per patient," the nurse further revealed.

Nurses also pointed to congestion at the facility, noting that patients with minor illnesses often seem care at the referral hospital, delaying treatment for more serious cases.

However, in a statement, Chief Executive Officer Richard Lesiyampe said management was addressing the concerns and called for patience. 

"I call for patience as the hospital management and relevant government agencies work closely to resolve the issues raised. As the country's largest referral facility we remain committed to the uninterrupted provision of specialised healthcare services to the public," read part of the statement.

He however, did not admit or deny that the country's largest referral facility was grappling with staff shortages.

Follow our WhatsApp channel for breaking news updates and more stories like this.