Mark celebrated his graduation from the University of Eldoret in April 2022, proudly earning a Second Class Honours Upper Division in Public Health. Confident in his qualifications, he expected to secure employment within six months. However, as he began applying to various governmental and non-governmental organizations, he quickly realized that progress would be impossible without obtaining a government license.
Initially thinking it would be a minor hurdle, Mark researched the licensing process, only to be disheartened by the significant effort, time, and cost involved. According to the Public Health Officers and Technicians Council, the body responsible for issuing licenses, he needed to pay Ksh. 7000 ($54) for an index number, and wait over six months to register for a board exam at a cost of Ksh. 23,000 ($177), then wait for the results. After passing the exam, he would have to complete a year-long unpaid internship, which would be assessed by the council for close to six months before he could apply for and finally obtain his license.
Mark’s story is the story of thousands of fresh graduates across Kenya whose economic rights are systematically infringed upon by the very institutions meant to facilitate their professional entry. The licensing process, which should serve as a quality control measure, instead becomes an almost insurmountable barrier, blocking young professionals from contributing to society and securing their livelihoods.
The Employment Act in the Kenyan Constitution mandates that employers promote equal opportunity in employment and strive to eliminate discrimination in any employment policy or practice. However, the Ministry of Health in Kenya, the largest employer of Public Health Officers, has consistently failed to uphold this law, despite years of outcry from Public Health graduates across the country.
As one such graduate, I experienced this firsthand. After paying for my indexing number, I was automatically added to a WhatsApp group titled ‘PHOTC DECEMBER 2023 PROFESSIONAL EXAMINATION.’ As the exam date approached, I received an anonymous call from an unidentified person who asked, “Have you paid for the board exam?” I replied that I had not, as I lacked the financial means at the time, and the caller promptly hung up.
Those who managed to pay for the exam took it, received their results in February, and were scheduled to commence their internships soon after. However, five months later, they are still in limbo, repeatedly querying PHOTC officials in the WhatsApp group without receiving any responses.
Employment discrimination typically conjures images of biases based on race, gender, or other protected characteristics, but economic barriers can be just as exclusionary. When the cost of obtaining a professional license is prohibitively high, it effectively excludes qualified individuals who lack the financial means. This exclusion is not based on the individual’s ability to perform the job but rather on their economic status, perpetuating a cycle of inequality.
The requirement for extended unpaid internships further exacerbates this discrimination. Graduates who need immediate income to support themselves or their families are forced to choose between gaining necessary professional experience and meeting their basic financial needs. This creates a divide where only those who can afford to work without pay for an extended period can advance in their careers, while others are left behind.
In my case, I have had to seek internships and volunteer opportunities from non-governmental organizations. The situation is made even more challenging as most of these opportunities have been from outside the country. This international search for internships highlights the severe lack of accessible opportunities within Kenya for recent Public Health graduates. The irony is not lost on us: while we are well-qualified and eager to contribute to our nation’s health sector, we are forced to look abroad due to the restrictive licensing process and limited local opportunities.
This frustration is compounded by the ruling class’s apparent lack of concern. They express perturbation when the youth take to the streets to protest against bad governance, yet fail to address the systemic issues that drive these protests. Young graduates, who should be the backbone of our nation’s development, find themselves marginalized and voiceless. The struggle to secure meaningful employment despite having invested time, effort, and resources into our education is disheartening and demoralizing.
The government’s neglect in creating a conducive environment for young professionals not only stifles individual aspirations but also hampers national growth. Public Health graduates are trained to address critical health issues, and their underutilization represents a significant loss to the country.
If this situation continues to worsen, the ruling class can only expect more uprisings. The youth are increasingly frustrated with the status quo and the systemic barriers that hinder their economic stability. Protests and demonstrations are symptoms of deeper societal issues that need urgent attention.
Addressing this issue requires recognizing the licensing process as a significant barrier to fair employment opportunities in the Kenyan health sector. To create a more equitable and accessible pathway to professional practice, comprehensive reforms are essential.
First, reducing the costs associated with obtaining a Public Health license is crucial. The high fees for indexing, board exams, and other related expenses place an undue financial burden on graduates, many of whom are already struggling with student debt and limited financial resources.
Second, providing financial support or stipends for interns will alleviate the economic strain of unpaid internships. Many graduates cannot afford to work without pay for extended periods, which forces them to seek alternative employment unrelated to their field of study. Stipends would enable them to gain the required professional experience without sacrificing their financial stability.
Finally, expediting the licensing timeline is essential. The current prolonged process delays graduates’ entry into the workforce, hindering their professional growth and economic progress.
Policymakers and industry leaders must work together to create a system that upholds the principles of equal opportunity and fairness. This is the only way for us to dismantle the hidden barriers that discriminate against economically disadvantaged graduates and pave the way for a more inclusive and just workforce.
About the Author …
Esther Murunga is a public health graduate and a program manager based in Kenya. Currently, she volunteers her program management skills at the Pan African Women Empowerment Network, where she empowers young girls and women to achieve economic independence. Her work with the network underscores her commitment to gender equality and economic empowerment.
Esther has also written insightful articles for prestigious organizations such as the Kenya Medical Association, Global Health Unfiltered, and Kenya Malaria Youth Corps. These contributions showcase her dedication to raising awareness and fostering dialogue on critical health issues.
