Human resource management practices and retention of professional health workers in public district hospitals in Kigali, Rwanda

Abstract

Retaining the health workforce has been considered as an important pillar to the health system. However, the challenge of human resources for health in terms of turnover of health workers in Rwanda has been more pronounced in the recent years. The purpose of this study therefore, was to investigate the influence human resource management practices on the retention of professional health workers in public district hospitals in Kigali. The study objectives were: to establish the effect of performance management function on the retention of professional health workers, to determine the effect of financial incentives on the retention of professional health workers, to establish the effect of non-financial incentives on the retention of professional health workers, and to determine the effect of participation and involvement in the decision-making on the retention of professional health workers. The study was devised in the social exchange theory and the equity theory as its underpinning theoretical framework . Grounded in the philosophical paradigm of pragmatism, the study used a cross-sectional research design with a mixed-methods approach. With a population of 402 individuals, the study considered a sample of 252 respondents including doctors, nurses, midwives, pharmacists and dentists from 3 district hospitals. The study instruments entailed a questionnaire as quantitative data collection tool, and interviews and focus group discussions as qualitative data gathering tools. To analyse quantitative data, descriptive statistics were used to assess the perceived status of human resource management practices and the magnitude of intentions to stay, and inferential statistics used to show the effect of predictors on the outcome variable by plotting a multiple linear regression. Qualitative data were analyzed in themes and reported in narrative and verbatim quotes, and were used to complement descriptive findings for better understanding of the magnitude of the study variables. The findings of this study showed a significant and positive effect of performance management function (β=0.183; P=0.004), financial incentives (β=0.189; P=0.003), non-financial incentives (β=0.108; P=0.007) and participation and involvement in decision-making (β=0.425; P=0.000) on retention of health workers. This study is expected to be a major contributor for the improvement of the health system in the country and other similar settings as it has provided the insights for strategic orientation in the area of human resources for health, especially for enhanced retention strategies in relation with integrated human resource management approach.