Voices from the Capacity Project

In health facilities across Kenya, many workers are struggling to do their jobs in less-than-ideal conditions. Work climate issues such as poor working environments, unfriendly colleagues, disorganized facility functions and ineffective supervision have been hindering workers’ performance and productivity—and contributing to low retention. At Hola District Hospital, for example, morale was low. “Work schedules weren’t well organized,” says Dr. Muriuki Meme, district medical services officer, and “the management was not friendly towards the staff.” As Capacity Project consultant Dr. Betty Chirchir phrases the issue, “Many times people have come in and improved the facilities and the supply of goods, but what about the health workers themselves?”

A recent study on retention of health workers in Kenya identified workplace climate among the nonfinancial factors affecting morale and motivation. Other studies also show that where motivation is low, the resulting poor practices may contribute to low service use. George Okore, former deputy director of human resource development at the Ministry of Medical Services, points to the bottom line: “If the environment is not conducive, then the productivity of the workers is lowered.”

The Capacity Project is participating in an ongoing series of workshops designed to define the scope of practice of Rwandan nurses and midwives at the local, district and country levels.