Nairobi: A severe shortage of nurses in Kenyan hospitals' newborn units (NBUs) is leaving sick and premature babies with only a fraction of the care they need, despite significant investments in modern medical technology, a new study has revealed.
According to Kenya News Agency, the HIGH-Q study, conducted by the Kenya Medical Research Institute (KEMRI)-Wellcome Trust in collaboration with the Kenya Paediatric Research Consortium (KEPRECON) and the University of Oxford, found that in some facilities, nurses care for more than 25 newborns during a single 12-hour shift, with each baby receiving an average of just 30 minutes of attention-far below international standards.
The World Health Organisation (WHO) and UNICEF recommend that critically ill newborns receive continuous monitoring with nurse-to-baby ratios of 1:1 or 1:2, while even stable newborns require frequent observation. Researchers warn that the staffing crisis undermines the benefits of new equipment and threatens Kenya's ability to meet its Sustainable Development Goal (SDG) target of reducing neonatal deaths to below 12 per 1,000 live births by 2030. Currently, the national average stands at 22 per 1,000 live births.
In his speech during the HIGH-Q Media Breakfast and Stakeholder Dissemination meeting in Nairobi, KEMRI Director General Prof. Elijah Songok described the findings as a wake-up call that is already prompting action. He emphasized the need for workforce development to build a resilient health system and ensure every newborn receives the quality care they deserve. Songok noted that the government, through the Ministry of Health, is taking decisive steps using the solutions identified by this research.
The study also highlighted the emotional toll on mothers, many of whom reported stress, stigma, and confusion due to poor communication and lack of support from overwhelmed nurses. Staff burnout, overcrowded wards, and poorly designed facilities were also found to compromise hygiene, safety, and patient dignity.
Dr. Dorothy Oluoch, Social Science Research Fellow at KEMRI Wellcome Trust, emphasized the critical role nurses play in neonatal care, noting that severe nurse shortages and high patient loads adversely affect care delivery. Prof. Mike English, Principal Investigator of the study, stressed the need to improve nurse staffing and the design of newborn wards to advance quality care.
The Ministry of Health, in collaboration with county governments, KEMRI, KEPRECON, and international partners, is already implementing evidence-based solutions identified in the HIGH-Q study. Prof. Fred Were, Professor of Paediatrics and Child Health, highlighted that these solutions, including increasing nurse staffing and redesigning newborn units, will improve care for babies and support nurses effectively.
The HIGH-Q project piloted three interventions: hiring extra nurses, introducing ward assistants, and providing communication skills training, all of which improved teamwork, hygiene, emotional support for mothers, and nurse-parent interactions. Researchers recommend scaling up these interventions alongside major investments in recruitment and infrastructure.
The study covered eight county hospitals within the Clinical Information Network where the Newborn Essential Solutions and Technologies (NEST 360°) programme has been rolled out and was funded by the UK's National Institute for Health and Care Research (NIHR). With these findings now in the hands of policymakers, health leaders hope the combined efforts of government, partners, and frontline health workers will transform neonatal care and give every newborn in Kenya the best possible start in life.