Theses (PhD)

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    Determinants of human resource retention for healthcare in Tanzania’s public health facilities
    (Mzumbe University, 2017) Issaya, Hassanal
    Various strategies for retaining Human Resources for Health (HRH) in public health facilities are growing in the countries of the Global South. For instance, Tanzania is a glaring example of African states which have high incidence of retention crisis for HRH that affect provision of healthcare. While several measures have been undertaken to address the problem, little is known whether the retention indicators established by various Tanzania’s health reports are consistent with the factors causing the happening in the demand side of HRH. The current study examined the determinants of human resource retention for healthcare in Tanzania’s public health facilities while utilising an adopted Herzberg’s theoretical framework. The study adopted an explanatory research design revolving around quantitative sequential qualitative mixed research approaches. It also utilised a sample size of 408 participants in which 384 were sampled through random sampling and snow ball techniques and surveyed through the use of questionnaires to generate quantitative information. Also, the study sampled 24 participants purposively to generate qualitative information for this study through interviews. The study relied on both descriptive and inferential statistics in the analysis of quantitative data as well as content analysis for analysis of qualitative data. Overall, the study found that retention of Human Resource for Health (HRH) is not determined by a single factor but by a multi-dimensional of factors. Among others include demographic and socio-economic factors which offers mixed results to the extent to which HRH are retained in Tanzania’s health systems. This implies that despite implementation of various HRH retention strategies in health facilities, there is a mismatch between retention indicators established by various Tanzania’s health performance reports and the determinants of HRH retention from the demand side of health workforce. This is due to failure of meeting context specific demands in line with the demographic and socio-economic factors of HRH within the context of rural-urban set ups. Further, it was revealed that salary and other extrinsic motivations provided by the government were inadequate to warrant retention of HRH. However, when multiple regressions were conducted, the results indicate that working environment and recognition are the most statistical significant related positively to retention of HRH. Seemingly, this is partly contributed by the fact that individual employees respond to different contexts differently. On contrary, more than a half of surveyed HRH had negative perceptions on the retention strategies used by the government to retain them in the public health facilities. Based on these findings, the study concludes that the implementation of government policies and public intervention related to HRH retention should be based on both job and context related motivators, as well as reflecting local settings. The study also recommends for the government to device policies that reflects the demand and supply needs of working infrastructure in the public hospitals to attract more and retain HRH.