Role of Remuneration in Retention of Health Workforce in a Rural District Setting in Uganda
[1]
Tom Mwende Kajungu, District Health Office, Ibanda District Local Government, Ibanda, Uganda.
[2]
John Francis Mugisha, Faculty of Health Sciences, Uganda Martyrs University, Kampala, Uganda.
Context: Although employee remuneration has been said to be pivotal in employee management, instituting suitable remuneration packages to retain functional human resources has remained an intriguing issue (Manila, 2011). This study examined the relationship between remuneration and retention of health workers in a rural district setting in Uganda. Ibanda district was selected to represent this setting. Objectives: The study sought to contribute to the improvement of health of the rural communities in Ibanda district by establishing the relationship between preferential remuneration and health workers’ retention in the rural areas, results of which would inform policy makers on how remuneration could be used to achieve retention of health professionals in the health sector. The specific objectives were: to examine the relationship between pay levels and health workers’ retention; to establish the relationship between performance related pay and health workers’ retention and to assess the relationship between monetary allowances and health workers’ retention. Methodology: This was a descriptive-cross sectional design that utilised mixed methods. Key informant interviews were conducted with district political and administrative leadership while a survey questionnaire was administered to health workers in nine public health centers in the district. Data were collected from 115 respondents, 103 of whom were health workers and 12 from the district political and administrative leadership. The collected data were analyzed using SPSS verson16.0. Study findings: The study showed that there is a significant relationship between remuneration and retention of health workers in rural health centers in Ibanda district. All remuneration factors such as pay level, allowances and merit pay showed a significant relationship with retention of health workers tested using Pearson product moment correlation at 0.01level of significance. Conclusions: The study concludes that increasing pay levels, merit pay and allowances that are comparable in the labor market have a critical role in health workers’ retention. Adequate pay makes the health workers more stable on job while inadequate pay keeps them on look-out for better jobs. Recommendations: The study recommends pay policy reforms and structures that can greatly minimize health workers’ turnover. This is achievable by conducting labor market pay surveys. The study further recommends redesigning of allowances to make them more inclusive of various cadres of health workers and timely promotion of the employees that are due since this increases their opportunities for promotion where they can earn increased salaries and stay longer in service.
Retention, Remuneration, Pay Level, Merit Pay, Allowances
[1]
Akan, O., Allen, R. S. and White, C. S. 2009. Equity sensitivity and organizational citizenship behavior, Small Group Research. v. 40(1): 94-112.
[2]
Armstrong M, Brown D, Reilly P (2010). Evidence-Based Reward Management: Creating measurable business impact from your pay and reward practices. Kogan Page
[3]
Baxamusa, B. N. (2012). Equity theory of motivation. Retrieved from http://www.buzzle.com/articles/equity-theory-of-motivation.html
[4]
Breaugh, JA., and Starke, M. "Research on Employee Recruitment: So Many Studies, So Many Remaining Questions." Journal of Management (2000): 305-434.
[5]
Chiang, F.T., &BirchT.A.(2006).An empirical examination of reward preferences within and across national settings. Management International Review, 46(5), 573-596
[6]
Dambisya, Y.M. (2007a) ‘A review of non-financial incentives for health worker retention in east and southern Africa’, EQUINET Discussion Paper 44: University of Limpopo and Equinet: Harare.
[7]
Dambisya, Y.M. (2007b). ‘Human resource for health protocols, strategies and approaches: A desk review’, Unpublished paper. ECSA-HC: Tanzania.
[8]
Grobler, P. A., Wärnich, S., Carrell, M. R., Elbert, N. F. & Hatfield, R. D. 2011. Human Resource Management in South Africa (4th ed.), Andover: Cengage
[9]
Hughes, R.L., GinneT, R.C. and Curph,Y G.J.(2009) Leadership: Enhancing the lessons of experience. 6. Boston: McGraw-Hill/Irwin; 2009.
[10]
Iipinge, S. Hofnie, K., Van der Westhuizen, L. and Pendukeni M. (2006) ‘Perceptions of health workers about conditions of service: A Namibian case study,’ EQUINET Discussion Paper 35. EQUINET: Harare
[11]
Jamison, D. T., J. Breman, A. R. Measham, G. Alleyne, M. Claeson, D. Evans, P. Jha, A. Mills and P. Musgrove, Eds. April 2006. Disease Control Priorities in Developing Countries, 2nd edition. Oxford and New York: Oxford University Press.
[12]
Kabene SM, Orachard C, Howard JM, Soriano MA, Leduc R. 2006. The Importance of Human Resources Management in Health Care: A Global Context. HRH 4:20
[13]
Kaplan, R.M. and Saccuzz,o D.P. 1993. Psychological testing principles, applications and issues. Brooks/Cole: Belmont.
[14]
Leonard, K.L. and Masatu, M.C. (2010). Professionalism and the know-do gap: Exploring intrinsic motivation among health workers in Tanzania. Health Economics. 2010;19(12):1461–1477. doi: 10.1002/hec.1564
[15]
Meyers, J., & Degges-White, S. (2007). Aging well in an upscale retirement community: The relationships among perceived stress, mattering, and wellness. Adultspan Journal, 6, 96-110.
[16]
MOH, (2010a) Human Resource for Health biannual report Vol. (1) Kampala. Ministry of Health.
[17]
MOH, (2010b). Annual health sector Performance Report. Kampala. Ministry of Health.
[18]
MOH. (2006). Human Resource Policy Uganda. Kampala. Ministry of Health.
[19]
Munga, M.A. and Mbilinyi, D.R. (2008) ‘Non-financial incentives and retention of health workers in Tanzania: Combined evidence from literature review and a focused cross-sectional study,’ EQUINET Discussion Paper 61. NIMRI Tanzania, EQUINET, ECSA-HC: Harare.
[20]
Padarath A, Chamberlain C, McCoy D, Ntuli A, Rowson M, Loewenson R. Health Personnel in Southern Africa: Confronting Maldistribution and Brain Drain” 2003. Equinet Discussion Paper Number 3. EQUINET Health Systems Trust (South Africa) and MEDACT (UK)
[21]
Phillips, J. M., & Gully, S. M. (2012). Organizational Behavior: Tools for Success (1st ed.). Mason, OH: South - Western/Cengage Learning.
[22]
Prasetya, A. and Masanori K. (2011) The Effect of Financial and Non Financial Compensation to the Employee Performance Graduate School of Asia Pacific Studies, Ritsumeikan Asia Pacific University Beppu-shi, Oita-ken, Japan
[23]
Spector, P.E. (2008). Industrial and Organizational Behavior (5th ed.). Wiley: Hoboken, NJ.
[24]
Swanepoel, B.J., Erasmus, B.J., & Schenk, H.W. (2008). South African human resource management: Theory and practice. (4th edn.). Cape Town: Juta.
[25]
Vujicic, M; Ohiri, K; Sparkes, S. 2009. Working in Health: Financing and Managing the Public Sector Health Workforce. World Bank.
[26]
Vujic, M. Zurn, P. Diallo, K. Adams, O. Dal Poz, M.R. 2004. The Role of wages in the Migration of Health Care Professionals from Developing Countries. Human Resources For health, vol.2, no.1, p.3.
[27]
WHO. 2010. World Health R eport 2010. Geneva; World Health Organisation.