College of Arts and Social Sciences, University of Rwanda, Kigali, Rwanda.
Institute of Development Studies, Moi University, Eldoret, Kenya.
Pan Afr Med J. 2019 Nov 5;34:129. doi: 10.11604/pamj.2019.34.129.16514. eCollection 2019.
The contribution of the health workforce for better health care service provision is undoubtedly of great merit to any health system. However, the public district hospitals in Rwanda have been faced with the challenges of retaining the health personnel. This study looks into the management approach to address this challenge by investigating into the effect of employee involvement in the hospital decision-making processes on the retention of professional health workers.
A cross-sectional design with quantitative approach was used. With a population of 469 health workers from 3 hospitals, a sample of 252 respondents was considered. Data collection was done by use of survey questionnaire. For data analysis, we used descriptive statistics to report perceived levels of involvement of health workers and intents to stay, and multiple logistic regression at 95% of confidence intervals to assess the effect of health workers? involvement in the hospital decision-making processes on the retention.
The findings revealed that health workers who perceived a high level of involvement in the hospital decision-making processes through the determination of teams for quality improvement in the health care service delivery were more likely to stay in the hospital (OR=100.111; P=0.001; CI=5.984-16.747) than those who perceived this function as low. It was also found that while an average level of involvement of health workers in the establishment of systems for suggestion in the hospital was associated with 6 odds of staying (OR=6.005; P=0.010; CI=1.529-23.571), health workers who perceived a high level of involvement were nearly 11 times more likely to stay (OR=10.952; P=0.001; CI=7.730-15.519) than their counterparts with low levels of perceptions.
Although there are positive associations between involvement of health workers in the hospitals decision-making processes and the intentions to stay, the existing level of staff involvement may have a negative effect on retention capacity in the public district hospitals.
卫生人力对改善医疗服务提供的贡献无疑对任何卫生系统都具有重要意义。然而，卢旺达的公立区医院一直面临着留住卫生人员的挑战。本研究通过调查员工参与医院决策过程对留住专业卫生工作者的影响，探讨了管理方法来应对这一挑战。
采用定量的横断面设计。在 3 家医院的 469 名卫生工作者中，考虑了 252 名受访者的样本。通过问卷调查收集数据。为了数据分析，我们使用描述性统计来报告卫生工作者的参与程度和留任意向，并使用 95%置信区间的多变量逻辑回归来评估卫生工作者参与医院决策过程对留任的影响。
研究结果表明，通过确定医疗服务质量改进团队，在医院决策过程中感知到高度参与的卫生工作者比那些感知到这一功能较低的卫生工作者更有可能留在医院（OR=100.111；P=0.001；CI=5.984-16.747）。还发现，虽然卫生工作者平均参与医院建议制度的建立与留任的 6 倍几率相关（OR=6.005；P=0.010；CI=1.529-23.571），但感知到高度参与的卫生工作者留任的可能性几乎是感知到低度参与的卫生工作者的 11 倍（OR=10.952；P=0.001；CI=7.730-15.519）。
尽管员工参与医院决策过程与留任意愿之间存在积极的关联，但现有的员工参与程度可能对公立区医院的留任能力产生负面影响。
