Factors Influencing Staff Performance in Public Level Two and Three Health Facilities in Githunguri Sub-County, Kiambu County, Kenya

Abstract

Staff performance is a crucial element in the realization of the goals and objectives of any organization. Staff training is one of the techniques for assisting employees to become experts at their own trade. Most of the countries which do not meet the minimum threshold in various health parameters are from Sub-Saharan Africa and this lead to an increase in the rate of global disease burden. The main objective of this study was to examine the factors influencing staff performance in public level 2 and 3 health facilities in Githunguri Subcounty, Kiambu County, Kenya. Specifically, the study determined the influence of training, availability of job descriptions,

deployment practices and supervision on staff performance. The design was descriptive cross- sectional study with quantitative data collection. The research study was conducted at all public

level 2 and 3 health facilities in Githunguri Subcounty, in Kiambu County. The study target population comprised of the 262 Health Care Workers (HCWs) from 13 healthcare facilities. The study sample was 159 HCWs and data was collected using self-administered questionnaires. The results showed that majority of the technical staff were fully trained and close to 42(27.2%) were partially trained. A third, 47(30.5%) reported that they had not attended any Continuous Medical Education (CMEs) sessions while 45(29.2%) had attended at least two CMEs and 25(16.2%) had attended only one CME in the past half year prior to the study. Half, 56(36.4%) had not attended any workshop/seminar, while 49(31.8%) had attended more than three on-job trainings. Half, 90(58.4%) were aware of the deployment policies in the organization, 81(52.6%) ascertained that they felt their roles were aligned to their training and expectations, 93(60.4%) were aware of the supervision policy. Their attitude towards whether their roles were aligned to their training and expectations had a non-significant effect on the staff performance. the training extent had a positive influence on the performance of the HCWs as those fully trained had OR of 5.1 compared to those partially trained who had OR 3.4, (p<0.05) while the number of CMEs attended by the respondents, had a positive impact on the staff performance as those who attended one CME had OR=2.7, (p<0.05) while two CMEs attended had OR=6.7, (p<0.05). that job description had a positive effect on the job performance as on the statement that if they felt roles were aligned to their training, those that agreed had OR of 3.22 (p<0.05) compared to those who disagreed while assessing their level of satisfaction with current job, those that were very satisfied had OR of 5.01 (p<0.05) compared to those satisfied (OR=5.4, p<0.05). On deployment, awareness of the deployment policies had a positive effect on job performance as those indicated yes had OR=2.49 (p<0.05) while number of transfers had negative impacts on job performance as those that none transfers had OR of 0.5, p>0.05) compared to those with one and two transfers (OR=2.8, p<0.05) and OR=12.6, p>0.05) respectively. The structures for reporting complaints and compliments had negative influence on the staff performance. The study recommends that the County Government of Kiambu should increase the number of on-job trainings, seminars and workshops to motivate, increase skills and competence among HCWs. The Health Management Teams of the health facilities should conduct staff sensitization on the deployment policies and reduce the number of transfers given to the staff. The County health offices should maintain a clear and well-defined structures of promotion and motivation strategies.