دورية أكاديمية
Management of human resources for health: implications for health systems efficiency in Kenya.
| العنوان: | Management of human resources for health: implications for health systems efficiency in Kenya. |
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| المؤلفون: | Nyawira L; Health Economics Research Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya., Tsofa B; Health Systems and Research Ethics Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya., Musiega A; Health Economics Research Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya., Munywoki J; Health Economics Research Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya., Njuguna RG; Health Economics Research Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya., Hanson K; Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK., Mulwa A; Directorate of Medical Services, preventive and promotive health, Ministry of Health, Nairobi, Kenya., Molyneux S; Health Systems and Research Ethics Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK., Maina I; Health Financing Department, Ministry of Health, Nairobi, Kenya., Normand C; Centre for Health Policy and Management, Trinity College, the University of Dublin, Dublin, Ireland., Jemutai J; Health Systems and Research Ethics Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya., Barasa E; Health Economics Research Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya. ebarasa@kemri-wellcome.org.; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK. ebarasa@kemri-wellcome.org.; Institute of Healthcare Management, Strathmore Business School, Strathmore University, Nairobi, Kenya. ebarasa@kemri-wellcome.org. |
| المصدر: | BMC health services research [BMC Health Serv Res] 2022 Aug 16; Vol. 22 (1), pp. 1046. Date of Electronic Publication: 2022 Aug 16. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: BioMed Central Country of Publication: England NLM ID: 101088677 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6963 (Electronic) Linking ISSN: 14726963 NLM ISO Abbreviation: BMC Health Serv Res Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: London : BioMed Central, [2001- |
| مواضيع طبية MeSH: | Government Programs* , Local Government*, Humans ; Kenya ; Medical Assistance ; Workforce |
| مستخلص: | Background: Human resources for health consume a substantial share of healthcare resources and determine the efficiency and overall performance of health systems. Under Kenya's devolved governance, human resources for health are managed by county governments. The aim of this study was to examine how the management of human resources for health influences the efficiency of county health systems in Kenya. Methods: We conducted a case study using a mixed methods approach in two purposively selected counties in Kenya. We collected data through in-depth interviews (n = 46) with national and county level HRH stakeholders, and document and secondary data reviews. We analyzed qualitative data using a thematic approach, and quantitative data using descriptive analysis. Results: Human resources for health in the selected counties was inadequately financed and there were an insufficient number of health workers, which compromised the input mix of the health system. The scarcity of medical specialists led to inappropriate task shifting where nonspecialized staff took on the roles of specialists with potential undesired impacts on quality of care and health outcomes. The maldistribution of staff in favor of higher-level facilities led to unnecessary referrals to higher level (referral) hospitals and compromised quality of primary healthcare. Delayed salaries, non-harmonized contractual terms and incentives reduced the motivation of health workers. All of these effects are likely to have negative effects on health system efficiency. Conclusions: Human resources for health management in counties in Kenya could be reformed with likely positive implications for county health system efficiency by increasing the level of funding, resolving funding flow challenges to address the delay of salaries, addressing skill mix challenges, prioritizing the allocation of health workers to lower-level facilities, harmonizing the contractual terms and incentives of health workers, and strengthening monitoring and supervision. (© 2022. The Author(s).) |
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| معلومات مُعتمدة: | United Kingdom WT_ Wellcome Trust; MR/R01373X/1 United Kingdom MRC_ Medical Research Council; MR/R01373X/1 MRC/FCDO/ ESRC/Wellcome Trust Health Systems Research |
| فهرسة مساهمة: | Keywords: Efficiency; Human resources for Health; Kenya; Performance |
| تواريخ الأحداث: | Date Created: 20220816 Date Completed: 20220818 Latest Revision: 20240902 |
| رمز التحديث: | 20240902 |
| مُعرف محوري في PubMed: | PMC9382760 |
| DOI: | 10.1186/s12913-022-08432-1 |
| PMID: | 35974324 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 1472-6963 |
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| DOI: | 10.1186/s12913-022-08432-1 |