Non-financial incentives and professional health workers’ intentions to stay in public district hospitals in Rwanda: A cross-sectional study

Abstract

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.