DETERMINANTS OF NURSES PERFORMANCE IN TIER THREE HEALTH FACILITIES: A CASE STUDY OF KAJIADO COUNTY, KENYA

Abstract

Purpose: Human Resources for Health (HRH) is critical for improved productivity and efficient delivery of health services. However, insufficient health personnel in terms of numbers and level of performance are a major constraint in disease control and maintenance of a health population. A study was carried out to determine the relationship between jobrelated factors, the work environment, organizational factors and policy practices that affect the performance of nurses in tier three health facilities in Kajiado County. Method:A cross sectional, descriptive study design was utilized, adopting qualitative and quantitative data collection approaches. Four tier three health facilities were included and one hundred and thirty (130) respondents were involved in the study. Purposive sampling was used Nurses working in the various departments in the respective facilities were issued with questionnaires to fill in and return. The heads of the different departments were interviewed using an interview guide. Inferential statistics was used to analyze the data. Quantitative data was analysed using SPSS version 23.0 and qualitative data was analysed through thematic content analysis. Results:Results on organizational-relation aspects revealed lack of necessary support provision for incompetent nurses. It also revealed a substantial lack of an appraisal and reviewsystem. The findings on job related factors showed that most of the nurses were diploma holders hence the need for opportunities for further training and enhancement in education levels to advance their knowledge. Findings on organizational factors showedthat inadequate staff levels led to increased workload on available staff which in turn affected the performance of nurses. Unique Contribution to Theory, Practice and Policy:The study recommends thatthere should add more refresher and training courses for the nurses, recruitment of more nursing staff and improvement of resources available.