Closing the Policy Gap in Standardized Maternity and Postnatal Support for Surgical Trainees in Kenya

Overview

Women are entering medical school and the healthcare workforce at record numbers, yet they remain underrepresented in surgical specialties. While multiple factors contribute to this gap, growing evidence suggests that the absence of clear, supportive, and standardised policies around pregnancy, parenthood, and return to training continues to influence career progression and workforce retention. Despite legal protections and institutional goodwill, maternity and postnatal support for surgical trainees in Kenya remains inconsistent across training institutions. Policies are often unclear, implementation varies between departments, and trainees frequently rely on informal arrangements rather than standardised institutional processes. Recognising this policy gap, the Surgical Work and Equity Lab (SWEL) is leading the development of Kenya's first evidence-informed framework for standardised maternity, postnatal, and return-to-training support within surgical residency programmes.

The Challenge

Building a sustainable surgical workforce requires more than recruiting future surgeons—it requires creating training environments that enable them to remain, progress, and thrive throughout their careers. Consultations with trainees, consultants, and academic leaders consistently highlighted challenges related to parental leave, return-to-training pathways, workplace accommodations, mentorship, and awareness of trainee entitlements. These issues are not simply matters of individual wellbeing; they are workforce and health systems challenges with implications for surgical capacity, workforce retention, and equitable access to care.

Our Approach

The framework has been developed through a structured process of evidence generation, stakeholder engagement, and policy analysis. Key activities include:

• Literature review and international policy benchmarking
• National stakeholder consultations
• Surgical trainee and consultant surveys
• International Women's Week Roundtable 2026
• Policy analysis and framework development
• Validation with professional associations and academic institutions

This collaborative approach ensures that the framework reflects both international best practice and the realities of surgical training in Kenya.

The Framework

The proposed framework provides practical recommendations to support surgical trainees before, during, and after parental leave while maintaining the quality and continuity of specialist training. Key policy areas include:

• Standardised maternity and parental leave guidance
• Structured return-to-training pathways
• Clinical and workplace accommodations
• Mentorship and professional support
• Communication of trainee entitlements
• Monitoring, evaluation, and institutional accountability

Rather than creating additional administrative burden, the framework seeks to provide clear, practical guidance that strengthens workforce sustainability while supporting both trainees and training institutions.

Partners

• Kenya Association of Women Surgeons (KAWS)
• Surgical Society of Kenya (SSK)
• Operation Smile
• Nkafu Policy Institute
• University of Global Health Equity (UGHE)

Looking Ahead

SWEL is working with academic institutions, professional associations, and policymakers to validate, pilot, and refine the framework. The long-term vision is to support the adoption of evidence-informed policies that strengthen surgical training, improve workforce retention, and contribute to more resilient surgical systems in Kenya and across Africa.