Abstract
Background: Evidence shows that human resources represent a pillar that supports the healthcare system. As a result, retaining the health workforce has been considered to be a way of significantly improving of the quality of healthcare services. However, the challenge of retaining the health workforce has been an issue of concern in Rwanda. The purpose of this study was to assess the level of availability and provision of non-financial incentives, and their association with professional health workers’ intentions to stay in public district hospitals. Methods: A cross-sectional survey research design with a quantitative approach was used. With a population of 469 health workers from four district hospitals in Kigali, Rwanda, the study used a sample of 252 individuals. The study measured the perceived levels of variability and provision of working conditions, training and development, career development opportunities, and intentions to stay. Logistic regression was used to show associations between predictors and the outcome variable with 95% confidence intervals. Results: The findings of the study show significant associations between predictors and the outcome variable. In fact, average and high perceptions on working conditions are associated with professional health workers’ likelihood of staying in the hospital (OR: 9.70, P<0.001 and OR: 5.77, P=0.001, respectively). Similarly, an average and high level of perception on the availability of career development opportunities is a predictor of intention to stay (OR: 13.98, P<0.001 and OR: 12.26, P=0.038, respectively). In the same view point, there is a likelihood that health workers who perceive high level of training will stay (OR 1.025; P=0.014). Conclusion: There is evidence of significant associations between predictors and the outcome variable. However, the current status of non-financial incentives may adversely affect health workers’ intentions to stay.
Highlights
The health system in Rwanda has undergone major changes, ranging from traditional healing system to modern practices, including current technological innovations in the health sector[1]
With different types of health services offered to people in the capital city of the country, Kigali attracts different types of professional health workers who are employed in the four public district hospitals available in the city
The present study found that working conditions, training and development, and opportunities for career development are positively associated with health workers’ intentions to stay, confirming findings by other researchers who studied the issue of non-financial incentives and intentions to stay in health workers
Summary
The health system in Rwanda has undergone major changes, ranging from traditional healing system to modern practices, including current technological innovations in the health sector[1]. In addition to the existing teaching institutions that train the health personnel, there has been an attempt to develop partnerships with foreign healthcare organizations to provide staff with the necessary expertise and engage experts with their Rwandan counterparts for a better healthcare service practical activities This involves foreign medical and surgical residencies, nursing programs, health professional trainings and support in hospital administration[4]. The Rwandan Economic Development and Poverty Reduction Strategy had in its main goals components relating to providing the health system with adequate personnel[5] As result of these interventions, the number of professional health workers, including doctors and nurses, increased to such an extent that by 2012 there was one doctor and one nurse to a population of 16,001 and 1,291, respectively[6]. The current status of non-financial incentives may adversely affect health workers’ intentions to stay
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