Michael Scanlon, MPH, MA, PhD(c)
Nominated From: Indiana University
Research Site: Moi University
Research Area: Health Policy and Systems
Primary Mentor: Rachel Vreeman
Labor relations and strikes in the Kenyan public health sector: Opportunities and challenges for Universal Health Coverage
Kenya has been affected by dozens of strikes by health workers at the national and county levels in recent years. After a 100-day nationwide strike by public sector doctors was followed by a 150-day nationwide strike by public sector nurses, the Kenyan Daily Nation declared 2017 to be “the year [that] public healthcare died.” The goal of my research is to describe the environment for labor relations and identify key factors driving industrial conflict in the Kenyan public health sector to inform governance and policy reforms. My research will be guided by an applied political economy analysis framework and a mixed methods approach, including institutional and stakeholder mapping, document analysis, and in-depth interviews with key informants. I situate my interdisciplinary research within the emerging field of health policy and systems research that prioritizes the social and political dimensions of health policy and systems, including both their “hardware” (e.g., technical, financial, and material) and “software” (e.g., ideas and interests, values and norms, and power relations across institutions and actors) elements.
Several scholars identify strikes by health workers as potential barriers to health systems strengthening and universal health coverage. A 2019 review by Giuliano Russo and colleagues in the Bulletin of the World Health Organization found that among 31 low-income countries, on average a health system was affected by a regional or national-level health workers’ strike every third day between 2009 and 2018. While a voluminous literature exists on the “global health workforce crisis,” scholars have remained curiously silent about strikes by health workers, including the factors driving recent industrial action by health workers, the actors and institutions involved in health sector labor relations, and the role that labor relations and strikes play in health systems governance and policy, particularly in sub-Saharan Africa. Using Kenya as a primary case study, my research will provide one of the first in-depth studies of labor relations and strikes in the public health sector in the context of global health governance and policy commitments to universal health coverage.
Advice for Potential Candidates
Apply! I was a bit hesitant that the Fogarty program would be a good fit for me given my interdisciplinary research topic and methodologies. I was thrilled to be accepted and the mentorship I have received from the NPGH program and community has been wonderful.
- Dr. Rachel Vreeman, MD, MS, Professor in the Department of Health Systems Design and Global Health at the Icahn School of Medicine at Mount Sinai in New York, NY, USA
- Dr. Lukoye Atwoli, PhD, MMED, Professor of Medicine at the Moi University School of Medicine in Eldoret Kenya.
- Dr. Courtenay Sprague, PhD, Professor of Global Health at the University of Massachusetts, Boston, MA, USA
- Dr. Adrian Gardner, MD, MPH, Assistant Professor of Clinical Medicine at Indiana University School of Medicine and Field Director for the AMPATH Consortium