an Eldis Resource
Incentives for health worker retention in Kenya: an assessment of current practice
Recruiting and retaining health care staff in Kenya
Authors:
D. M. Ndetei; L. Khasakhala; J. O. Omolo; African Mental Health Foundation (AMHF); University of Namibia; University of Limpopo
Publisher:
EQUINET: Network for Equity in Health in Southern Africa, 2008
Kenya's health system faces a variety of human resource problems, primarily an overall lack of personnel in key areas, which is worsened by high numbers of trained personnel leaving the health sector to work overseas. This study undertaken by EQUINET provides a literature review and field research which obtains data on strategies for the retention of health workers in various institutions in Kenya. The authors reviewed existing strategies for recruiting and retaining health workers over time in Kenya. The paper highlights how facilities in Kenya offered a number of financial incentives to their staff, such as paid leave and overtime pay, access to house or car loans at lower negotiated market rates and numerous allowances, such as transport, entertainment, hardship, responsibility, special duty and uniform allowances. Some staff worked in bonding agreements, whereby the institution paid for their studies but they had to work for a specific numbers of years in return.
It is found that private medical institutions, national hospitals and training institutions had implemented non-financial incentives by improving working conditions through renovations, upgrading the facilities and making medical supplies accessible to the communities. However, in public facilities, there were many unfilled positions despite high unemployment rates for health workers in the country. Primary health care facilities were severely understaffed. The paper shows how this imbalance causes health workers in public institutions to migrate from primary health care (PHC) facilities to district hospitals, provincial and then national hospitals. The authors recommend that government put in place national-level policies to retain health workers in rural areas, in lower-income districts and at lower levels of the health system. Financial and non-financial incentives are appreciated by health workers; these include improved working conditions, and training and supervision.
