Elijah Nyangena, James Mwenda, Miriam Wagoro


Introduction: Training nurses at degree level globally started upon realization that employment of highly trained nurses had a direct relationship with quality of care, improved patient health outcomes and decreased patient mortality rate at reduced health care delivery costs.

Purpose: The purpose of this treatise is to provide a background of the BScN program in Kenya, justify the need for employment of BScN graduates upon completion of the internship and appeal for national action.

Context and Justification: Despite the recommendations by the International Council of Nurses and WHO to governments to ensure employment of highly trained nurses, majority of BScN nurses are not employed in Kenya. Even at this time of COVID-19 pandemic when the need of quality nursing care is dire, the employment of BScNs compared to other cadres of nursing is at a negligible < 1 %. Employment of graduate nurses is justified to improve nurse-patient ratios, add value to patient outcomes, make economic sense, mitigate the shortage of nursing faculty and support universal health coverage.

Conclusion and Petition: The revised scheme of service for nursing personnel (2014) provides for employment of nursing officers with degree qualification. However, six years since then, there is lack of clarity on implementation of the scheme in regard to the Nursing Officers’ positions beyond internship position, and no policy has been enacted to provide for continuous offer of employment to a significant number of nurses with degree qualification. The Ministry of Health should therefore anchor continuous employment of degree level nursing graduates in health human resource policy that provides for inclusion of graduate nurses in advertised nursing vacancies at all levels of health care delivery system, in line with 2014 revised scheme of service of nursing personnel.



Bachelor of Science Bachelor of Science Nursing; Employment; Nursing care; Outcomes; Quality care, Kenya

Full Text:



Abdullahi, K. O., Ghiyasvandian, S., Shahsavari, H., & Imanipour, M. (2019). A critical evaluation of Nursing education

Aiken et al., (2011). Effects of nurse staffing and nurse education on patient deaths in hospitals with different nurse work environments. Medical Care. Vol. 49(12):1047-1053

Aiken et al., (2014).Nurse staffing and education and hospital mortality in nine European Countries: A retrospective study. The Lancet, Vol. 383 (9931), 1824-1830

Aiken, L. H., Clarke, S. P. Cheung, R. B., Sloane, D.M. & Silber, J. H. (2003). Educational Levels of Hospital Nurses and Surgical Patient Mortality. JAMA. 290(12): 1617–1623.

Blegen M.A., Goode, C.J., Park, S.H. Vaughn, T. & Spet, J. (2013). Baccalaureate education in Nursing and patient outcomes. Journal of Nursing Administration. Vol. 43(20, pp 89-94

Bradbury-Jones, C., & Clark, M. (2017). Globalisation and global health: issues for nursing. Nursing Standard, 31(39).

Bvumbwe, T. M. & Mtshali, N. G.F. (2018). A middle-range model for improving quality of nursing education in Malawi. Curationis, 41(1)

Cho, E. et al., (2015). Effects of nurse staffing, work environments and patient mortality: An observational study. International Journal of Nursing studies. Vol. 52(2): 535-542.

Coster, S., Watkins, M. & Norman, I. (2017). What is the impact of professional nursing on patients' outcomes globally? An overview of research evidence. International journal of nursing studies. DOI:10.1016/j.ijnurstu.2017.10.009

Edwards, D. S. (2013). Patient safety and the Institute of Medicine (IOM) report recommendation for an 80% BSN workforce by 2020. Ohio Nurses Rev, 88, 26-27.

Frings, M., Lakes, T., Müller, D., Khan, M. M. H., Epprecht, M., Kipruto, S., Galea, S. & Gruebner, O. (2018). Modeling and mapping the burden of disease in Kenya. SCIENTIFIC REPORTS | (2018) 8:9826 | DOI:10.1038/s41598-018-28266-4 Accessed from: www.nature.com/scientificreports

Hardicre, J. (2003) Meeting the requirements for becoming a nurse lecturer. Nursing Times; 99: 31, 32–35

in Nigeria: A literature review. International Journal of Scientific & Engineering Research Volume 10, Issue 1,

Institute of Medicine (2011).The future of nursing: Leading change, Advancing Health. Washington, DC. The National Academy Press

Institute of Medicine. (2001). Crossing the Quality Chasm: A New Health System for the 21st Century. Washington (DC): National Academies Press

Kendall-Gallagher, D., Aiken, L., Sloane, D.M. & Cimiotti, J.P. (2011). Nurse specialty certification, inpatient mortality, and failure to rescue. Journal of Nursing Scholarship, 43(2), 188-194

Kutney-Lee, A., Wu, E. S. Sloane,D. M., Aiken,L. H. & Fagin, C. M. (2013). Changes in Hospital Nurse Work Environments and Nurse Job Outcomes: An Analysis of Panel Data. International Journal of Nursing Studies, 50(2): 195–201.

Ministry of Devolution and planning (2014). Revised scheme of service for nursing personnel. Nairobi, Author.

Ministry of Devolution and Planning. (2014). Revised Scheme of Service for Nursing Personnel. Nairobi, Kenya. Author

Ministry of health (2012). Kenya Health Sector Strategic plan and Investment plan (KHSSPI) 2013-2017. Nairobi, Kenya. Author

Ministry of Health (2015). Kenya Nursing workforce Report: The status of Nursing in Kenya, 2012. Nairobi, Kenya. Author.

Ministry of Health (2017). Kenya Health Workforce Report: The Status of Healthcare Professionals in Kenya, 2015. Nairobi, Kenya. Author

Ministry of Health. (2014). Human resource strategy 2014-2018. Nairobi, Kenya. Author

Miseda, M. H., Were, S. O., Murianki, C. A., Mutuku, M. P., & Mutwiwa, S. N. (2017). The implication of the shortage of health workforce specialist on universal health coverage in Kenya. Human resources for health, 15(1), 80.

Mosadeghrad, A.M. (2014). Factors influencing healthcare service quality. International Journal of health policy management. Vol. 3(2): 77-89

Mwenda, V., Githuku, J., Gathecha, G., Wambugu, B. M., Roka, Z. G. & Ong'or, W. O. (2019). Prevalence and factors associated with chronic kidney disease among medical inpatients at the Kenyatta National Hospital, Kenya, 2018: a cross-sectional study. Pan Africa Medical Journal, 33: 321.

Tourangeau, A. E. et al., (2007). Impact of hospital nursing care on 30-day mortality for acute medical patients. (2007). Journal of advanced Nursing. Vil. 57(1): 32-44

Wakaba, M., Mbindyo, P., Ochieng, J., Kiriinya, R., Todd, J., Waudo, A., ... & English, M. (2014). The public sector nursing workforce in Kenya: a county-level analysis. Human resources for health, 12 (1), 6.

Waudo, A., Todd, J., Kiriinya, R., Ochieng, J., Mbindyo, P., & Wakaba, M. (2014). The public sector nursing workforce in Kenya: a county-level analysis.

WHO Factsheet. (2019). Universal Health Coverage. Geneva, 29 January 2019. Author

WHO. (2016). Global strategy on human resources for health: Workforce 2030. Geneva, Author

WHO. (2016). Global strategy on human resources for health: workforce 2030. Author

WHO. (2020). State of the World’s Nursing 2020: Investing in education, jobs and leadership. Geneva, Author

World Health Organization. (2017). Density of nursing and midwifery personnel (total number per 1000 population, latest available year). The Global Health Observatory

Yakusheva O1, Lindrooth R, & Weiss M., (2014). Economic evaluation of the 80% baccalaureate nurse workforce recommendation: a patient-level analysis. Accesses 8/5/2020: https://www.ncbi.nlm.nih.gov/pubmed/25215646


  • There are currently no refbacks.

Copyright (c) 2022 Elijah Nyangena, James Mwenda, Miriam Wagoro

© Numid Publishers        ISSN:  2518-8631