Absenteeism of Health Care Providers in Machakos District, Kenya: Incidence, Determinants and Consequences

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The study draws results from unannounced visits made to a sample of public health facilities in Machakos District with the intention of documenting the incidence, determinants and consequences of absenteeism of critical service providers in the health sector.

It was the first of its kind in Kenya. The average rate of absenteeism was 25 per cent and after disaggregating by key health cadres, it was 41.6 per cent for pharmacists, followed by laboratory technicians (39.1 per cent), doctors at 28.5 per cent, clinical officers at 21.5 per cent and nurses at 18.9 per cent. The important determinants of health care provider absenteeism found from this analysis include the place where the health facility is located (remoteness), the level of job satisfaction, length of service in the current facility, job stress, and whether a married provider lives with his/her spouse. The direct and indirect costs of absenteeism established from the study were: significant financial resource wastage, reduced productivity, and disruption of provision of health care among others. To minimise absenteeism there is need for increasing the frequencies of inspections and local internal control measures like use of reporting registers, unannounced meetings, etc. In addition, a deliberate policy should be designed to encourage health care providers’ retention and minimisation of transfers from dispensaries and health centres to district/ sub-district hospitals, especially in remote rural areas. This may involve allocating higher hardship and risk allowance to health care providers serving in remote areas.