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.
