Human resource retention strategies: Analysis of the factors affecting retention in Uganda's Private-Not-For-Profit hospitals
Shumba, C. (2016) Human resource retention strategies: Analysis of the factors affecting retention in Uganda's Private-Not-For-Profit hospitals, no. 305.
Retention of health workers is an area of sustained focus as health care organizations realize the impact of poor retention on cost, quality and continuity of care. An in-depth understanding of the experiences of health workers (HWs) and factors which cause them to leave their jobs is the fundamental basis of forming effective retention strategies. The lack of evidence on these experiences poses a challenge to health managers within the Private-Not-For-Profit (PNFP) sub-sector in Uganda on how to develop effective retention strategies. This research examined HWs experiences of working in PNFP hospitals and how these influence retention decisions. This mixed methods study included a quantitative survey (n=118) examining length of stay in the hospitals and the determinants. Experiences of 32 HWs including managers were explored through semi-structured interviews using a life cycle lens that took into account motivation for joining the profession, experiences of working in the hospitals and current retention strategies and their perceived effectiveness in influencing retention. God's calling, role models in the medical field, death of close relatives and hopes for immediate employment influenced decisions to join the profession and there was a link between some of these reasons and retention. Median duration working in a PNFP facility was 3.8 years. The only individual factors statistically associated with retention were age and cadre. Three perceptions of organizational characteristics namely: having good interpersonal relationships, well-defined reporting lines, and good career growth potential were independently associated with a 75%, 51% and 35% respectively higher working length at a hospital. Interviews with HWs showed that PNFP organizational culture was predominantly bureaucratic with non-participative management styles and emphasized control and efficiency. Hospitals were implementing some limited retention strategies with weak evidence for their effectiveness. Systematic planning of retention strategies and transformation in organizational culture are necessary to improve retention of HWs.