The Impact of Out-Migration on the Nursing Workforce in Kenya


  • Address correspondence to Jessica Gross, A.N.P.-B.C., M.P.H.; e-mail: Martha Rogers, M.D., Ilya Teplinskiy, M.D., M.P.H., and Melinda Higgins, Ph.D., are with Emory University, Department of Family and Community Nursing, 1520 Clifton Road, NE, Atlanta, GA 30322. Elizabeth Oywer, B.Sc.N., D.A.N., and David Wambua, R.N., D.A.N., are with Nurses Council of Kenya, Nairobi, Kenya. Andrew Kamenju, B.A., P.G.D.C.S., Rose Kiriinya, M.Sc., and Agnes Waudo, B.Sc.N., are with Kenya Health Workforce Project, Nairobi, Kenya. John Arudo, M.Sc., M.P.H., is with Aga Khan University, Nairobi, Kenya. Patricia L. Riley, C.N.M., M.P.H., F.A.C.N.M., is with the Division of Global HIV/AIDS, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA. Chris Rakuom, B.Sc.N., is with the Kenyan Ministry of Medical Services, Nairobi, Kenya.


Objective. To examine the impact of out-migration on Kenya's nursing workforce.

Study Setting. This study analyzed deidentified nursing data from the Kenya Health Workforce Informatics System, collected by the Nursing Council of Kenya and the Department of Nursing in the Ministry of Medical Services.

Study Design. We analyzed trends in Kenya's nursing workforce from 1999 to 2007, including supply, deployment, and intent to out-migrate, measured by requests for verification of credentials from destination countries.

Principle Findings. From 1999 to 2007, 6 percent of Kenya's nursing workforce of 41,367 nurses applied to out-migrate. Eighty-five percent of applicants were registered or B.Sc.N. prepared nurses, 49 percent applied within 10 years of their initial registration as a nurse, and 82 percent of first-time applications were for the United States or United Kingdom. For every 4.5 nurses that Kenya adds to its nursing workforce through training, 1 nurse from the workforce applies to out-migrate, potentially reducing by 22 percent Kenya's ability to increase its nursing workforce through training.

Conclusions. Nurse out-migration depletes Kenya's nursing workforce of its most highly educated nurses, reduces the percentage of younger nurses in an aging nursing stock, decreases Kenya's ability to increase its nursing workforce through training, and represents a substantial economic loss to the country.