Through the U.S. Agency for International Development (USAID)-funded Capacity Kenya Project, Tetra Tech has been working with the Government of Kenya and Kenyan health sector leaders to strengthen health systems and the health workforce in the public, private, and faith-based sectors. 

Kenya, which is close in size to the state of Texas, is an ethnically and geographically diverse country in the middle of the African continent’s east coast. Despite Kenya’s having one of the top economies in Africa, its ratio of doctors, nurses, and other skilled health workers per 1,000 inhabitants is quite low, ranking at 43 percent below the benchmark established by the World Health Organization. In addition, attrition, an excessive concentration of health workers in urban areas, a general inadequacy of facilities and equipment, and being one of the fastest growing populations in Africa have all added to the health care challenges facing the Kenyan people.

The Capacity Kenya Project was designed to improve health care and thus enhance the overall health of the Kenyan population by:

  • Strengthening health workforce policy and planning
  • Increasing the knowledge and skills of health workers
  • Improving health worker productivity and retention, especially in rural and remote areas

The end of project assessment was intended to help USAID and the Kenyan government to better understand the challenges and successes associated with project goals and to identify lessons learned and recommendations. 

We integrated a review of documents, key informant interviews, focus group discussions, direct observations, exit interviews, and an on-line quantitative survey. The team triangulated quantitative and qualitative data to verify data quality and legitimized findings by evaluating alternative explanations, disconfirming evidence, and exploring negative case scenarios. They triangulated recommendations from diverse data sources to the extent possible.

The study provided high-quality evidence on the degree to which the Capacity Kenya Project had accomplished USAID’s objectives. It provided design input for subsequent strengthening of the human resources for health, including recommendations specific to both county-level and national-level concerns. Overall, the assessment underscored the significance of the project’s success, highlighted the need to align desired objectives of follow-on work with reasonable expectations, and advocated for integrating an effective monitoring and evaluation plan into any future work.