Contextual Analysis and Perceptions of Health Workers on Migration: Perspective from Kenyatta National Hospital Staff, Nairobi Kenya

Abstract

Aims: Migration of health workers constitutes a significant barrier to expanding health interventions. In Kenya, internal migration of workers, from rural to urban areas, is just as serious as international migration. Healthcare professionals are migrating vertical and horizontal within the country while others are emigrating internationally. Whereas there is extensive literature on immigration little reports indicate in-country migration. The aim was establish the determinants of migration in human resource for health. Study Design: This was a cross-sectional descriptive study. The study population was human resource for health working in the hospital. Study Area and Duration: This research was undertaken at Kenyatta National Hospital between April and May, 2013. Methodology: Qualitative and quantitative data was collected for triangulation purposes. Stratified random sampling was applied. Probability proportionate to size sampling was used at each stratum Manifest content analysis was used for qualitative data while quantitative data was analyzed using Statistical Package for Social Science (SPSS) version 20 at alpha of value (<0.05). Results: The study demonstrated that a few employees intend to migrate 132 (37.0%) to work elsewhere. Years of service were a significant predictor for migration. For example, those who had worked for less than five years were 29.6% less likely to migrate compared to those who had worked for over 15 years (AOR 0.296). Support staff and medical officers are willing migrants than clinical officers, health records and radiographers. The desire to stay or move is underpinned by several dynamic drivers. Better terms of services, improved working conditions and training opportunities are synonymous with migration. Passion, job security, experience and growth/research are descriptive retention factors. Conclusion: Human Resource for Health migration continuum in Kenyatta National Hospital is founded on several elements. The occupational skill mix is sensitive to dynamics of individual, social and institutional motivational factors relative to migration.