In the recent past, Kenyan Health facilities have been on the spotlight for how they deliver services. This is because of various instances where health facilities have been exposed for providing poor services.
A report from a research done by the National Council for Population and Development (NCPD) on health service delivery has revealed interesting facts about the same. The report has revealed how absenteeism has been rampant health facilities and how it leaves the facility understaffed.
The report said that the Absence rate was at 52.8% with public sector absenteeism at 56.7% compared to 47.5% in the private sector. The absence rate was slightly higher in Nairobi where 57.6 percent of health providers were absent. Among various levels of health facilities, hospitals (60.4%) had the highest absenteeism whereas dispensaries and clinics had the lowest (44.5%).
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Doctors had the highest absenteeism rate of 60.7%, followed by nurses at 54.5% and lastly clinical officers at 49.5%. Doctors are more likely to be absent, as confirmed in a multivariate analysis. Urban health providers are generally more likely to be absent than their rural counterparts except for dispensaries and clinics. Health workers from public facilities had higher absenteeism at 56.7% than private facilities which stood at 47.5%. The regression results further show that older providers have higher absence rates.
Among the counties, absenteeism rates were the highest in West Pokot with 68% and lowest in Makueni with 25%. Among doctors, Kilifi, Lamu, Murang’a, Embu, Homa Bay, and Turkana had all doctors absent. West Pokot had the highest absenteeism among clinical officers 78.4% and Wajir among nurses 80.7%.
In any workplace setting, absence may be authorized or non authorized but from the consumer’s perspective, these providers are not available to deliver services at the health facility – whether authorized or not.
Apart from having the requisite number of skilled staff in place, the staff should be available in the facilities to provide services. When they were conducting research, NCPD found that more than half of clinical staff were absent during their unannounced visit. In fact, most of these absence were approved.
County governments are advised to ensure establishing systems for tracking staff availability during the facility operation hours to reduce absenteeism. Rational approval of staff leaves can be undertaken by the facility heads or county health managers so as not interfere with efficient service delivery.
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