Effect of devolution of healthcare services on the motivation and retention of medical personnel in Bungoma County

Abstract

Background: In struggle to achieve sustainable development goal (SDGS) number three ‘good health and well-being,’ populace is at liberty to be treated by a trained, motivated and valued medical workers. Nevertheless, the challenge of medical workers’ motivation and retention persist in Bungoma County, Kenya, Africa and universally. In a devolved healthcare system implementation, medical workers ‘motivation and retention is vital, but it has grown a predicament of devolution of healthcare. Transition of power from national to county governments has however created turbulence in enthusiasm and retention of medical workers at Bungoma County marked within consistency, poor understanding of health system, management issues and lack of coordination between the two levels of government.Methods: A cluster sample design was used to select 299 health care providers to participate in the study. Data was collected using structured questionnaires and a Focus Group discussion guides.Results: In view of retention: 50.9% (152) of the respondents affirmed their zeal to remain working for Bungoma county while 49.1% (147) would walk out of which 26.9% (40) would prefer NGO, 11.7% (18) out of the country, 6.3% (10) in FBOs and 4.2% (7) in private institutions. Inadequate staff, transport, inadequate supportive supervision, essentials (gloves) contribute to dissatisfaction of medical workers.Conclusions: Senior medical professionals in specialized services are leaving Bungoma County for better working condition and the morale of staff is low due to remunerations.