Evidence shows that human resources represent a pillar that Background: 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.A cross-sectional survey research design with a quantitative Methods: 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.

Introduction The contribution of the health workforce for better health care service provision is undoubtedly of great merit to any health system. However, the public district hospitals in Rwanda have been faced with the challenges of retaining the health personnel. This study looks into the management approach to address this challenge by investigating into the effect of employee involvement in the hospital decision-making processes on the retention of professional health workers. Methods A cross-sectional design with quantitative approach was used. With a population of 469 health workers from 3 hospitals, a sample of 252 respondents was considered. Data collection was done by use of survey questionnaire. For data analysis, we used descriptive statistics to report perceived levels of involvement of health workers and intents to stay, and multiple logistic regression at 95% of confidence intervals to assess the effect of health workers? involvement in the hospital decision-making processes on the retention. Results The findings revealed that health workers who perceived a high level of involvement in the hospital decision-making processes through the determination of teams for quality improvement in the health care service delivery were more likely to stay in the hospital (OR=100.111; P=0.001; CI=5.984-16.747) than those who perceived this function as low. It was also found that while an average level of involvement of health workers in the establishment of systems for suggestion in the hospital was associated with 6 odds of staying (OR=6.005; P=0.010; CI=1.529-23.571), health workers who perceived a high level of involvement were nearly 11 times more likely to stay (OR=10.952; P=0.001; CI=7.730-15.519) than their counterparts with low levels of perceptions. Conclusion Although there are positive associations between involvement of health workers in the hospitals decision-making processes and the intentions to stay, the existing level of staff involvement may have a negative effect on retention capacity in the public district hospitals.

Background: Human resources for health are the major component of the health system. Hence health workers are key to better health care service delivery. However, retention of the health workers is one of the major challenges facing the health system in Rwanda, especially in public district hospitals that serve as a major unit of health care service delivery in the country. The study investigated the effect of implementation of performance management function on the retention of professional health workers in public hospitals in Rwanda.Methods: The study used convergent parallel mixed-methods design. A sample of 252 health workers was selected from a population of 402 doctors, nurses, midwives, pharmacists and dentists. Data collection was conducted by use of questionnaire, interviews and focus group discussions. Quantitative data analysis used descriptive statistics and logistic regression models. Qualitative data were analysed by doing thematic analysis, by identifying themes in textual data. Triangulation used qualitative data to expound quantitative data. Data analysis was supported by Stata 13.1 and NVivo 10 softwares.Results: The findings from both quantitative and qualitative data show that health workers generally feel that there exists performance management function in hospitals with slight differences across its major indicators. The study also shows that while performance management planning and evaluation were found to be associated with health workers’ intentions to stay, there was no significant association between performance rewarding and intentions to stay. In fact, health workers who felt that performance management planning was at average and high level were 14.2 and 60 times more likely to stay (OR=14.2; P=0.000 and OR=60.13; P=0.000, respectively). Similarly, while health workers who rated performance evaluation exercise as average were more likely to stay (OR=1.472; P=0.029), perceiving a high level of implementation of performance evaluation in the hospital was associated with 2.215 odds of staying (OR=2.215; P=0.048). Conclusion: Generally, there are divergent levels perceptions on performance management indicators across respondents, and high levels of intentions to leave are noticed among health workers. Although performance planning and rewarding are associated with health workers’ intentions to stay, the existing level of implementation performance management function may have adversely affect retention of health workers.

Background: Evidence shows that human resources are one of the major pillars of the healthcare system. As a result, retaining the health workforce has been  associated with provision of the quality 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 associations with professional health workers’ intentions to stay. Methods: A cross-sectional survey research design with a quantitative approach was used.  With a population of 469 health workers from four district hospitals, the study considered a sample of 252 individuals. The study measured the perceived levels of availability and provision of non-financial incentives in terms of working conditions, training and development, career development, and intentions to stay. Logistic regression was used to assess the associations between predictors and the outcome variable with 95% confidence intervals and 5% of confidence level, and results were reported using odds ratios. Results: The findings of the study show that perceiving an average and high level of working conditions was  associated with professional health workers’ intentions to stay (OR: 9.70, P<0.001 and OR: 5.77, P=0.001, respectively). Similarly, an average and high perceived level of  availability of career development programs predicted health workers’ intention to stay (OR: 13.98, P<0.001 and OR: 12.26, P=0.038, respectively). In the same way, health workers who rater availability of training and development programs as high had more odds of staying  (OR 1.025; P=0.014) than their counterparts who rated such programs as low. Conclusion: There is a need for health care institutions and health planners at higher level to strategically boost health workers’ intentions to stay through non-financial packages including efficient and equitable training of health workers, manageable workload and initiate strong career development programs.

No abstract