Inside the hard-fought birth of three health sciences degrees in Kenya

A new reflective study published in Discover Education offers a rare insider’s account of how one Kenyan university built three innovative health sciences programs from scratch, and what it reveals about the hidden machinery of curriculum reform in low- and middle-income countries. The paper, authored by Ermias Mergia Terefe of United States International University-Africa in Nairobi, reconstructs the concurrent development of a Bachelor of Science in Nursing, a Master of Science in Clinical Pharmacology and Therapeutics, and a Master of Science in Clinical Pharmacognosy and Complementary Medicine. All three programs were designed, taken through internal governance, and carried to accreditation within the university’s School of Pharmacy and Health Sciences, and the analysis draws directly on the author’s role as curriculum lead for each of them.

Methodologically, the study is a scholarly reflective analysis rather than an empirical evaluation. Terefe applied Schön’s theory of reflection-on-action, in which practitioners retrospectively examine their own decisions to surface the tacit assumptions embedded in professional practice, and organized the account around Kern’s Six-Step Approach to curriculum development, a framework that moves from problem identification and general needs assessment through targeted needs assessment, goals and objectives, educational strategies, and implementation, to evaluation and feedback. The reflection proceeded in three stages: a chronological reconstruction of the programs’ development, the identification of critical incidents in which decisions had to be made under evident tension, and the interpretation of those incidents through the combined theoretical lens. Because patterns that recurred across more than one program were judged more likely to reflect structural features of the institutional environment than idiosyncrasies of a single program, the cross-program comparison became the analytical core of the work.

The evidence base combined the author’s professional experience with an extensive documentary record. Curriculum and program proposal documents submitted to the Nursing Council of Kenya and the Commission for University Education, correspondence and feedback from the WASC Senior College and University Commission, internal program-costing and budget documentation, minutes of curriculum committee meetings and stakeholder consultations, and the author’s contemporaneous notes were all used to triangulate recollection against verifiable material. The author explicitly acknowledges the risk of a self-justifying narrative inherent in being both the developer of the curricula and the analyst of that development, and addressed it by checking specific claims against the documentary record and by deliberately foregrounding unresolved tensions and only partially successful strategies rather than presenting a uniformly positive account. No human participants or patient data were involved, so formal ethics review was not required.

The curricular innovations themselves form the most striking part of the account. The nursing degree embedded a global health orientation as a core component, exposing students to diverse healthcare systems, cross-cultural competencies, and international health challenges, complemented by global study tours offering experiential learning in healthcare environments beyond students’ immediate settings. The clinical pharmacology master’s program integrated computational pharmacology and toxicology, introducing in silico modeling and data-driven approaches to drug development and safety evaluation, alongside pharmacogenomics, which addresses genetic variability in drug response and is a cornerstone of precision medicine, and pharmacometrics, which equips students with quantitative tools for optimizing drug dosing. A structured clinical attachment bridged pharmacological theory and patient care in a discipline traditionally taught as laboratory science.

Perhaps the most transformative reorientation described is in the pharmacognosy and complementary medicine program, which shifted from a laboratory-based, product-focused discipline to a clinically integrated, patient-centered framework. Students gained competencies in health assessment and clinical services, undertook hospital attachments providing direct exposure to patient care, and studied evidence-based complementary and alternative medicine within therapeutic decision-making. The author notes that this reorientation can be read as anticipating the direction of the WHO Global Traditional Medicine Strategy 2025-2034, which encourages member states to develop evidence-based regulatory pathways for integrating traditional and complementary medicine into mainstream health systems rather than regulating them as an entirely separate domain.

Stakeholder engagement emerged as central to the programs’ legitimacy. The curriculum team convened dedicated consultative workshops with distinct groups for each program: practising clinicians and nurse leaders for nursing, hospital-based pharmacists and clinical pharmacologists for clinical pharmacology, and traditional and complementary medicine practitioners together with hospital pharmacognosy units for the pharmacognosy program. These sessions validated proposed competency domains against workforce expectations and surfaced gaps invisible from a purely academic vantage point. Regulatory engagement took the form of iterative, informal pre-submission consultation with the Nursing Council of Kenya and the Commission for University Education, allowing concerns to be resolved before they became formal conditions of accreditation. Feedback was incorporated iteratively: competency lists were revised after clinician workshops, clinical attachment structures adjusted to hospital partner capacity, and course sequencing corrected where academic reviewers identified prerequisite gaps.

Yet the analysis identifies four persistent structural challenges. Regulatory rigidity, particularly prescribed curricular structures from the Nursing Council of Kenya, constrained how far global health content could be embedded without extensive justification. Program costing models penalized specialized postgraduate programs with small initial cohorts, since conventional financial evaluations prioritized short-term enrollment and revenue over scientific or workforce merit, placing the viability of the pharmacology and pharmacognosy master’s programs repeatedly in question. Academic incentive systems undervalued curriculum development relative to research output, contributing to faculty fatigue across three programs developed in close succession. And reconciling divergent stakeholder expectations, notably industry partners favoring earlier clinical exposure against academic reviewers favoring stronger foundational grounding, required repeated renegotiation rather than a single resolution.

The strategies adopted in response met with mixed success. Iterative pre-submission consultation with regulators reduced, though did not eliminate, downstream delay. Resource-intensive components, particularly for the pharmacognosy program, were phased into implementation in stages to manage financial risk, an approach that drew directly on financial risk encountered earlier in developing the clinical pharmacology program. Stakeholder consultation was deliberately sequenced, with academic and clinical reviewers consulted iteratively rather than simultaneously. The misalignment between academic incentives and curriculum development effort was raised internally but not resolved, and the author identifies it as an unresolved structural issue: because curriculum work is collaborative, long-term, and poorly captured by conventional academic metrics, faculty who invest heavily in it often face increased workload without commensurate recognition, which in turn limits institutional capacity for sustained innovation.

The study’s limitations are stated plainly. It draws on a single institution and a single author, so its lessons are analytically generalizable and transferable rather than statistically generalizable. The retrospective, memory-based reconstruction was mitigated but not eliminated by triangulation against documents, and the author’s dual positionality introduces a residual risk that challenges are recalled as more fully resolved than they were. Crucially, no independent outcome data such as student performance, graduate employment, or employer satisfaction are presented to substantiate claims about program impact; the author flags such empirical evaluation as an important direction for future research.

The transferable lessons, the paper argues, lie in process rather than content. Curriculum innovation in this setting is best pursued as a negotiated, iterative process rather than a single design-and-approve event; early, structured regulator engagement reduces delay more reliably than post-submission negotiation; and financial evaluation frameworks require deliberate modification for specialized postgraduate programs, which will otherwise be structurally disadvantaged regardless of their academic or workforce case. The author recommends that comparable institutions embed pre-submission regulatory consultation as standard practice, that national regulators and international bodies consider explicit guidance on flexible regulatory pathways for interdisciplinary and emerging competency areas, and that universities formally recognize curriculum development as scholarly work in their incentive frameworks. Without such recognition, the paper concludes, reflective scholarship on curriculum development is likely to remain rare, precisely because the faculty best placed to produce it are not incentivized to do so, leaving the practical knowledge that determines whether well-designed curricula are actually implementable largely undocumented.

Subject of Research: Reflective analysis of health sciences curriculum development and innovation at a Kenyan university

Article Title: Reflective analysis of health sciences curriculum innovation at a Kenyan University

Article References: Terefe, E. M. (2026). Reflective analysis of health sciences curriculum innovation at a Kenyan University. Discover Education, 5(1), Article 1213. https://doi.org/10.1007/s44217-026-02287-y

Image Credits: AI Generated

DOI: 10.1007/s44217-026-02287-y

Keywords: curriculum development, health sciences education, Kenya, nursing education, clinical pharmacology, pharmacognosy, accreditation, stakeholder engagement, low- and middle-income countries, reflective practice, Kern's Six-Step Approach, regulatory frameworks