Health Care Human Resource Capacity Building Initiatives Influencing Sustainability of Hiv/aids Services at Siaya County Referral Hospital, Kenya

Abstract

The HIV prevalence in Siaya County is 24.8 percent (4.2 times higher than the national prevalence) according to the Kenya HIV Estimates 2015. It is estimated that by the end of 2015, a total of 126,411 people were living with HIV in the County. There is a need for improvement in the County’s cascade of HIV care to achieve the unmet gaps of the UNAIDS 95:95:95 targets in identification, linkage, and viral suppression. Timely HIV diagnosis, optimal linkage and retention to care for persons diagnosed with HIV, increased coverage of ART and viral suppression can only be achieved with a competent Healthcare workforce. The Kenya Healthcare system however, experiences an acute shortage of qualified and competent Human Resources for Health (HRH) in addition to their uneven distribution both geographically and within facilities. Focusing on Siaya County Referral Hospital (SCRH), this project sought to determine the Healthcare Human Resource Capacity Building Initiatives Influencing Sustainability of HIV/AIDS Services. Project objectives included: to identify the human resource capacity gaps in terms of knowledge, skills, competencies and numbers; to identify the human resource capacity building initiatives currently being applied at Siaya County Referral Hospital; to determine the influence of terms of engagement, remuneration, performance appraisal, work environment and turnover intent of staff; and to identify the program level challenges faced by development partners all of which influence sustainability of HIV/AIDS services at Siaya County Referral Hospital. Applying survey research design and using simple random sampling as well as purposive sampling, a sample of forty five hospital staff, four hospital executives and four partner program officers was drawn for the baseline survey. Researcher administered questionnaires and Interview Schedules were used to collect primary data which resulted in a response rate of 81.95%. The survey findings revealed that the major human resource capacity gap was staff numbers with specific skills and competencies. The widely used human resource capacity building initiative at SCRH was formal training and on-job training/mentorship. The terms of engagement, remuneration, performance appraisal and work environment greatly influenced the staff turnover intent and ultimately employee satisfaction. The main program level challenge faced by the HIV development partner was lack of sustainability plans for the HIV programs at SCRH. It was therefore recommended that an SCRH Human Resource Capacity Building Committee be established whose mandate would be to develop a HR Needs Assessment Report, a HR Capacity Building Plan, a Staff Engagement and Performance Status Report which would guide the development and implementation of a HIV Program Sustainability Plan for SCRH. The project could eventually be rolled out to the sub-county hospitals in Siaya County as well as other facilities offering HIV clinical services in Nyanza region and Kenya at large. A recommendation for further research is to identify factors hindering development and implementation of sustainability plans for HIV Programs in Kenya.