Challenges Facing Health Workers In Psychiatric Units In Level Five Hospitals In Western Kenya Region

Abstract

Introduction: The Burden of mental disorder is greatwith the prevalence felt globally.In Kenya like in many other African countries, mental health services had a humble beginning until after independence that attempts were made to decentralize mental health services to the provincial (regional) level. Health care providers however face numerous challenges in the process of service delivery. Objectives: The main objective of the study was to identify challenges health workers faced in course of duty, factors contributing to the challenges and what strategies were to be put in place to curb them. Methodology: This was a cross- sectional study targeting all health workers in the four psychiatric units under study. Qualitative and quantitative data was collected using self-administered questionnaire as well KIs. Coding was done prior to data collection in which five major themes were identified under which the respondents were to discuss. The respondents were then asked to provide factors contributing to the challenges and to further make recommendations on how to curb them. QRS Nvivo version 10 software was used in the analysis of the data. The software formed the basis for categorization, report generation and visualization of the data. Results: A total of 46 respondents participated. Female respondents were 29. The mean age of respondents was 38, a minimum of 23, maximum of 58 with a standard deviation of 10. Majority (62%) were diploma holder, 19% degree holders, 8% masters and 11% secondary certificate holders. Respondents included 32 nurses, 5 support staff, 4 occupational therapists, 4 social workers and 1 clinical officer. The average salary was Ksh.50, 756 with a standard deviation of 18,918. The average period of employment was 3 years with the lowest being 1 month while the respondent who had been on employment the longest was 30 years. The identified challenges were classified into 5 themes. Challenges related to work environment included; unavailability of drugs, insecurity, limited resources, poor facilities and staff shortage. Administration related challenges include; inadequate resource, poor support and slow response to issues arising as well as poor management systems. Challenges related to patient factors included; poor family support, poverty and relapses. Colleague related challenges included; disagreements amongst staff, lateness and absconding from duty and stigmatization. Finally challenges related to public perception included; stigmatization. Factors contributing to the challenges were identified as limited resources, neglect of the unit as well as poor public perception of the unit. Suggestions to curb the challenges and they included; Increase and improve the number of psychiatric facilities, increase awareness on mental illness to the general public, recruit more health care staff in the unit, availing the necessary drugs to the unit, improve on staff training and motivation as well as improvement on the management systems. Conclusion: Health care workers in psychiatric units indicated that they faced a lot of challenges which could be attributed to environmental factors, patient related factors, challenges related to seniors and those in management among other. Recommendations: The government to increase the resource allocation to the psychiatric units, as well as increase sponsorship to health care workers who want to pursue a career in mental health.Hospital administrations to ensure that there is a proper and conducive workenvironment, renovate existing structures, promote staff empowerment, and recruit more health care staff.Health care workers should embrace staff interactions and team work.