What motivated you to pursue higher education, and what obstacles did you encounter on your journey?
Growing up in rural western Kenya, I had very few opportunities. My primary school didn’t have classrooms—we learned under a tree. There was no library. Our headmistress, whose family owned a bookshop in the nearby market, believed in us and brought us books from their shop. I made it through primary school only because there were no hefty fees. My class was only the second cohort to sit for the national exams (Kenya Certificate of Primary Education, KCPE) in our young school. We were just six students—two girls and four boys. Many villagers, who preferred a more established school a few kilometres away, were curious to see how far we’d go.
When we excelled in the KCPE and outperformed more established schools, the challenge of joining high school began. My parents had no money. Various relatives—uncles, grandparents—sold their only animals (often a cow) to contribute. Looking back, it truly took a village to get me through high school. I vividly remember walking 10 km to a cattle auction to sell a cow after I had been sent home for fees. Unlike primary school, high school required significant fees—the better the school, the higher the cost.
Between relatives selling livestock and my teachers lobbying for me to get government bursaries (partial scholarships), I was able to stay in school. It was during this difficult period that I decided to work hard and pursue the highest degree possible—if I could just finish high school. At the time, university education in Kenya was heavily subsidised, and I held onto that hope. I needed a goal to keep me from giving up and becoming another dropout statistic. At one point, after all the animals had been sold, my father suggested switching to a local day school. But my mother, a woman of faith, insisted that a miracle would happen—and it did. I completed high school. By my final year (Form Four), I was considered too bright to be excluded from sitting the Kenya Certificate of Secondary Education (KCSE), despite having accumulated a large fee balance.
In short, I decided to pursue a PhD while still in high school, long before I knew what profession I would end up in. Coming to Lancaster was, in many ways, my older self keeping a promise to my younger self.
Why did you choose Lancaster for your PhD?
After completing my MPH in 2017, I searched for a suitable PhD program, preferably funded, but without success. I applied to a university in South Africa and explored options in the U.S. and Europe. Most programs required me to quit my full-time job, which wasn’t feasible. I needed something flexible, as I had grown used to studying while working during my MPH. I also needed the income to support my family.
In 2020, when the COVID-19 pandemic hit, I decided it was time to act. Around the same time, a colleague shared their published article and mentioned they had just graduated with a PhD. I reached out to them and learned they had studied at Lancaster. They gave glowing feedback about the blended PhD in Public Health and strongly recommended it. I immediately visited the website, read as much as I could, and expressed interest. By May 2020, I had my admissions interview.
Can you tell us about your research in Kenya and the impact you hope it will have?
My research focused on how hospital teams in Kenya are working to improve the quality of primary health care (PHC). I was driven by the many quality lapses I had witnessed—some of which had led to preventable loss of life.
As part of my job, I support government teams in using data to enhance PHC delivery. My research aligned with this work and was designed to add value to everyday practice. I also wanted to understand why efforts to improve publicly delivered PHC have not been widely successful, despite the availability of evidence-based guidelines and various health system investments.
To investigate this, I conducted a focused ethnography. I spent time with PHC teams in Kenyan hospitals, observing their work, conducting interviews, and collecting documents. My analysis revealed many barriers to quality improvement. The most significant was weak governance - both political and within the health system. This undermines health worker motivation and retention, weakens accountability for quality, and results in misaligned investments. I hope my findings will guide policymakers and lead to reforms in how PHC and quality improvement are planned and implemented in Kenya, particularly as we work toward achieving the 2030 Sustainable Development Goal targets related to health.
What have been the highlights of your time at Lancaster?
I truly enjoyed my time at Lancaster. I had insightful interactions with faculty and classmates. The electronic library gave me access to a vast range of resources that fuelled my love for learning. I formed friendships and hope to continue collaborating with some of my peers. Lancaster also introduced me to various research groups and virtual platforms that helped deepen my academic interests, including realist theory, rapid reviews, and ethnography.
How has your PhD experience shaped your academic and professional journey?
Through the PhD, I’ve developed strong skills in analysing and critiquing public health evidence, conducting independent research, and writing for publication. My study on PHC quality improvement in Kenya has already been shared with policymakers and contributed to revisions of the national quality model. I've also helped highlight the important role QI (Quality Improvement) teams play in PHC—not just in improving health outcomes but also in enhancing patient experiences and satisfaction.
What advice would you give to prospective students considering Lancaster?
Lancaster is an excellent place to study. If you’re considering it, don’t hesitate to reach out to the Admissions team. My admissions process—from interview to enrolment—was smooth. You’ll study alongside a diverse cohort and be taught by world-class faculty. You’ll also receive the support and guidance you need to succeed. I completed my PhD in four years, largely thanks to the encouragement and flexibility of my supervisors.
If you choose the blended learning option, you’ll benefit from a flexible structure that allows you to balance work and study. The Academies were a great opportunity to set expectations and connect with colleagues. Most importantly, enjoy the PhD journey. It’s a lot of work, but it becomes manageable if you genuinely engage with your research. My favourite modules were Research Philosophy and Advanced Data Analysis.
What’s next for you after completing your PhD?
In the short term, I plan to take a break from studying. I realised I’ve been in school for 27 out of my 40 years! I’d like to enjoy things I’ve missed: travelling, reading non-academic books, watching football (which I stopped following in 2020!), and reconnecting with friends. In the medium term, I may consider a one or two-year research or travel fellowship to step away from my current job and gain fresh perspectives. Long term, I’d like to explore teaching.
But first, I want to apply what I’ve learned to improve Kenya’s health system, especially by using evidence to advocate for high-quality primary healthcare. Kenyans deserve better.
