Doctors oppose push by clinical officers to be allowed to conduct CS surgeries
They noted that the scope of practice for various medical cadres in Kenya is clearly defined in law and reinforced through professional regulatory bodies
The Kenya Medical Association (KMA) and the Kenya Obstetrical and Gynaecological Society (KOGS) have expressed opposition to any move to allow clinical officers to conduct surgeries, particularly obstetric and gynaecologic surgery over safety concerns.
In a joint statement, KMA Secretary General Dr Diana Marion and KOGS President Dr Kireki Omanwa said expanding the scope of practice for health workers without training and regulation will put the safety of patients in peril.
They cited recent demands by clinical officers and other allied health care providers to be allowed to independently conduct surgical procedures, including Caesarean sections.
“While we recognise the critical role that all healthcare providers play in delivering services to our population, we must unequivocally state that surgery, particularly obstetric and gynaecologic surgery, requires highly specialised training, rigorous and continuous competency assessments, and strict adherence to globally accepted medical and surgical safety standards,” the statement said.
Dr Marion and Dr Omanwa warned that independent performance of such procedures by cadres without the requisite surgical training, accreditation, and oversight directly endangers the lives of mothers and newborns.
“Maternal mortality and morbidity remain a national concern, and inappropriate delegation of surgical responsibilities risks worsening this crisis further.”
They noted that the scope of practice for various medical cadres in Kenya is clearly defined in law and reinforced through professional regulatory bodies.
“Any expansion of these roles must be guided by robust evidence, structured training, and regulatory frameworks—not political lobbying or workforce shortages. The principle of “Primum non nocere” (First, do no harm) must guide all policy decisions in healthcare.”
Clinical officers are currently on strike over their sidelining from the Universal Health Coverage programming, demanding that they be given approval status by the Social Health Authority (SHA).
Currently, patients seeking treatment under the Social Health Insurance Fund (SHIF) cannot access services at health centres and dispensaries, which are manned by cliniical officers, nurses and other health workers since SHA allowed the Kenya Medical Practitioners and Dentists Council (KMPDU) to be the sole accreditor.
The clinical officers argue that this has put the lives of patients seeking emergence care such as women who have suffered miscarriage in danger as they have pay out of the pocket to be attended to or in the alternative seek help in bigger hospitals.
Despite their demands, Marion and Omanwa, however, asked the ministry of Health, Parliament and all relevant stakeholders ensure that any modifications to healthcare practice are backed by scientific evidence and rigorous competency-based training, rather than political negotiations.
They also said there is need to maintain a structured, team-based approach where all professionals work within their regulated scope of practice to enhance patient outcomes rather than compromise them.
Further, the two want the government to invest in training more medical specialists and medical officers to meet the growing demand for surgical services while ensuring patient safety is not compromised and ensure that all surgical procedures are conducted by professionals legally recognised and adequately trained to perform them including the facilitation of medical training via formal medical schools for clinical officers who wish to pursue this path.
“Any proposed changes in medical practice must involve substantive engagement with professional bodies, medical regulatory authorities, and the wider healthcare community,” they added.
“Kenya has made significant strides in reducing maternal and neonatal mortality and improving general well being of women, but much remains to be done. Compromising surgical safety through unregulated practices will only erode the gains we have made. KMA and KOGS will continue advocating for evidence-based policies that protect patients, uphold professional integrity, and strengthen Kenya’s health system,” they added.
“We urge the ministry of Health and policymakers to remain steadfast in upholding the principles of safe, high-quality, and patient-centered care for all Kenyans,”
