Introducing Kelly Muraya: Exploring leadership in health systems in Kenya with a gender lens

I work at the KEMRI-Wellcome Trust Research Programme (KWTRP) as a post-doctoral researcher. My most recent work has been on household gender relations and the implementation and use of community-based child nutrition interventions in rural areas of the Kenyan Coast.

I have always been interested in gender issues. I come from a family where male and female children were treated equally but I realised pretty early on that society as a whole was not like that. I remember when I was young I saw a TV programme about a woman who had experienced domestic violence and I was touched by the injustice of it. I wanted to learn and do more. So whilst studying for my undergraduate degree in Adelaide, Australia, I did volunteer work in domestic violence centres and women’s referral services. Later, as part of my Honours Degree I undertook a research project that focused on the experiences of domestic violence amongst African refugee women who had resettled in Australia. Undertaking this project sparked my interest in research and I was keen on doing research closer to home. I was therefore thrilled when I was offered an advertised PhD studentship with KWTRP in Kilifi, Kenya; and used that opportunity to learn and explore more on gender issues but focusing on a different topic area. Importantly, the specific topic area was geared towards better understanding the delivery and use of public health nutrition interventions (from the perspective of intervention beneficiaries), which can hopefully contribute to informing future practice. It was an enriching and great learning experience working within a community in Kenya that was different to my own.

I have just started a project on gender and leadership in the health care system together with Sassy Molyneux and Benjamin Tsofa, as part of the RESYST Consortium. This provides a fantastic opportunity to still focus on the topic that I am most passionate about – gender – but exploring this in a very different area of the health system compared to my PhD topic (and now focusing on the providers of health services). The project is a multi-country study working with colleagues in South Africa and Nigeria. A multi-country design will enable mutual learning across the three sites as well as cross-country comparisons. In Kenya specifically, we will focus on senior health managers at the county level. Kenya has recently moved to a devolved system of governance and as such many functions have passed to the county level. In this context of devolution, we are interested in better understanding the role, if any, of gender in healthcare leadership. Furthermore, literature from high-income settings suggests that despite a significant proportion of health care workers being female, they tend to be under-represented in leadership positions. We would like to explore whether similar dynamics exist in Kenya, and understand factors that shape the leadership experiences of both male and female senior healthcare staff including: career trajectories; management of roles and responsibilities; and views on healthcare leadership. This work will employ an intersectional lens to gender, recognising that gender intersects with various other social factors such as ethnicity, social and economic status, and age to create specific positionings for individuals. The work will utilise a qualitative case study approach, interviewing male and female senior healthcare staff using life histories, and plotting critical incidents that shaped the way that they manage their responsibilities and view their leadership positions.

We hope that the findings of this work will contribute to shaping and informing policy and practice issues such as; supportive supervision, training and career development, mentorship, and contribute to the country’s commitment to gender equity as stated in our constitution.