Factors Influencing Retention of Health Workers in the Public Health Sector in Kenya: A Case Study of Kenyatta National Hospital

Abstract

Universal health coverage depends on having the necessary human resources to deliver health care services. Kenya is among the African countries currently experiencing a crisis in the area of Human Resources for Health (HRH). The major causes of the crisis include inadequate and inequitable distribution of health workers; high staff turnover; weak development, planning and management of the health workforce; deficient information systems; high migration and high vacancy rates; insufficient education capacity to supply the desired levels of health workers needed by the market; inadequate wages and working conditions to attract and retain people into health work, particularly in public sector. This shortage affects most of the available health worker categories. The importance of retention of health workers has been captured in the Sustainable Development Goals which is one of the targets. The aim of the research was to determine whether leadership style, remuneration, promotion, training and work environment influence retention of health workers in the public sector. A cross sectional survey of the health workers was conducted in Kenyatta National Hospital. A total of 400 questionnaires were distributed to the respondents. Stratified sampling was used in the first stage to ensure all categories of health workers are represented. Simple random sampling was used in the second stage. Participants from the Focus Group Discussion were drawn from the five distinct categories of health workers as classified by World Health Organization. Key informant interviews were conducted for each head of division (Deputy Director) to get in depth information on retention but one declined to be interviewed. Data collected was analyzed using descriptive statistics and presented in form of graphs. Inferential statistics were correlation and regression. The research findings indicated remuneration and leadership remained key determining health workers retention. The findings also indicated that promotion, training and work environment influenced health workers. Non clinical staff felt that hospital favors clinical staff on remuneration while among nonclinical staff feels specialists are favored when it comes to remuneration. The study recommends improvement in remuneration compensation factors and encouraged participatory approach in leadership from the departmental heads to senior management. The Management should proactive, to avail suitable working conditions, adhere to best practices in corporate governance to promote fairness in allocation of promotion and training opportunities and competitive remuneration . KNH management is called upon to draw lessons from other health institutions within and outside the country and come up with proactive pragmatic approaches that would ensure the hospital is an employer of choice so that it can succeed in attracting and retaining staff. Workload need be managed and supervision should be done in ways that make staff appreciate its benefits.