Improved Human Resources for Health Policies and their Effects on the Christian Health Association of Kenya

Abstract

Background: Human resources for health (HRH) contribute to health system strengthening, universal health coverage, and improved health outcomes. Faith-based organizations (FBOs) play an important HRH role. An intervention was undertaken to improve HRH policies and management with a focus on the human element for wider impact on institutional and workforce capacity. 

Methods: Using purposive sampling of health workers in Kenya’s five regions, the evaluation included semi-structured interviews, workplace observations, and in-depth interviews. We examined perceptions of workplace status, situations, and processes before and after the intervention to assess changes over time. 

Results: HRH managers perceived large improvements in their offices, recruitment, promotion, availability of job descriptions and manuals, and appropriate payment of salaries. Perception scores started as low as 3.5 and reached as high as 9.4, with average differences ranging from 2.8 to 5.4 points. Health workers confirmed these changes as manifested by improvements in the proportion acknowledging increases in incentives and safety regulations (27% to 63.6% and 66.7%, respectively) between the time periods. Clients also perceived progress, such as more courteous workers (from 80% to 96%). 

Conclusions: CHAK’s adoption and dissemination of standard HRH policies and procedures improved its institutional capacity, HRH culture, and management practices. The positive long-term effects of such changes on the workforce and service delivery require confirmation through further research.