Reward Management Practices and Employee Retention in Public Referral Hospitals in Nairobi City County, Kenya.

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Date
2025-05
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Kenyatta University
Abstract
Retention of healthcare workers in Kenya is a challenge occasioned by high brain drain, shortages and increased workload for the remaining employees. The ratio between health workers and patients is high over the standard set by World Health Organization. The referral hospitals report that its workers who are specialist medical workers do not intend to stay citing bad work conditions, low and delayed salaries and no room for growth. This study sought to find ways of improving retention of healthcare workers. The general objective of the study was to investigate the reward management practices and employee retention in public referral hospitals in Nairobi City County, Kenya. The specific objectives included financial incentives, career development opportunities, employee recognition and employee benefits and effects on employee retention in public referral hospitals in Nairobi City County, Kenya. The study was anchored on job embeddedness theory and supported by total reward and equity theories. The study adopted a descriptive research design and the target population consisted of 5,626 healthcare workers in the five public referral hospitals. Stratified and simple sampling technique was used and the Yamane formula employed to get the sample size of 373 respondents who were proportionately distributed across the strata. Primary data was collected using semi-structured questionnaires that yielded quantitative and qualitative data. The instrument was pilot tested using 18 healthcare workers at Kiambu County Referral Hospital and later excluded from the final research. The pilot test helped detect weakness in the instrument and after editing it was pronounced as valid and aggregate Cronbach alpha of 0.804 confirmed the instrument as reliable for use in the final study. A response rate of 71.6% was obtained from the returned 267 questionnaires. The researcher conducted analysis with the help of statistical package for social sciences program version 28 and findings presented in tables. The conducted descriptive analysis showed that respondents agreed that components of reward management practices led to retention of employees in the public referral hospitals. The study also found significant and positive effect between career development (r =0.616, β2 =0.369), employee recognition (r =0.681, β3 =0.904) and employee benefits (r =0.651, β4 =0.781) while financial incentives (r =0.413, β1 =0.235) had a moderate effect to employee retention in the referral hospitals. The regression analysis showed differences in magnitude of effect among the four study variables, where employee recognition had the largest effect, followed by employee benefits, then career development and lastly financial incentives. Therefore, the study concluded that employee retention in the public referral hospital was significantly affected by reward management practices although financial incentives had moderate effect. The study recommends establishment of formal reward management programs to solve the challenge of employees leaving the sector to European nations. The management in the referral hospitals need to allocate funds and develop programs for training in the quest of equipping the employees. It was suggested to increase salaries and wages to align with economic situation and have employees stay and continue working in the referral hospitals.
Description
A Research Project Submitted to the School of Business, Economics and Tourism in Partial Fulfillment for the Award of Degree of Master of Business Administration (Human Resource Management) of Kenyatta University, May 2025. Supervisor Jedidah Muli
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