Health workforce attrition in the public sector in Kenya: a look at the reasons
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BioMed Central
Open Access
Research
Health workforce attrition in the public sector in Kenya: a look at the reasons Slavea Chankova*1, Stephen Muchiri2 and Gilbert Kombe1 Address: 1International Health Division, Abt Associates Inc., Bethesda, Maryland, USA and 2Ministry of State for Planning, National Development and Vision 2030, Nairobi, Kenya Email: Slavea Chankova* - [email protected]; Stephen Muchiri - [email protected]; Gilbert Kombe - [email protected] * Corresponding author
Published: 21 July 2009 Human Resources for Health 2009, 7:58
doi:10.1186/1478-4491-7-58
Received: 16 April 2009 Accepted: 21 July 2009
This article is available from: http://www.human-resources-health.com/content/7/1/58 © 2009 Chankova et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: Kenya, like many other countries in sub-Saharan Africa, has been affected by shortages of health workers in the public sector. Data on the rates and leading reasons for health workers attrition in the public sector are key in developing effective, evidence-based planning and policy on human resources for health. Methods: This study analysed data from a human resources health facility survey conducted in 2005 in 52 health centres and 22 public hospitals (including all provincial hospitals) across all eight provinces in Kenya. The study looked into the status of attrition rates and the proportion of attrition due to retirement, resignation or death among doctors, clinical officers, nurses and laboratory and pharmacy specialists in surveyed facilities. Results: Overall health workers attrition rates from 2004 to 2005 were similar across type of health facility: provincial hospitals lost on average 4% of their health workers, compared to 3% for district hospitals and 5% for health centres. However, there are differences in the patterns of attrition rates by cadre. Attrition among doctors and registered nurses was much higher at the provincial hospitals than at district hospitals or health centres, whereas the opposite pattern was observed for laboratory and pharmacy staff (lost at a higher rate in lower-level facilities). In provincial hospitals, doctors had higher attrition rates than clinical officers, and registered nurses had higher attrition rates than enrolled nurses. In contrast, attrition of enrolled and registered nurses in district hospitals and health centres was similar. The main reason for health worker attrition (all cadres combined) at each level of facility was retirement, followed by resignation and death. However, resignation drives attrition among doctors and clinical officers; retirement accounts for the main share of attrition among nurses and pharmacy staff; and death is the primary reason for attrition among laboratory staff, pa
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