Factors associated with health workers' absenteeism at Jinja regional referral hospital :

Abstract

Health worker absenteeism is one of the contributing factors to poor health service delivery in Uganda. While several health management interventions have been tried in the past, absenteeism remains very high affecting the quality of health care to the public. The objective of this study was to assess the factors associated with health worker absenteeism at Jinja Regional Referral Hospital (JRRH). Quantitative and qualitative methods of data collection. Proportionate stratified random sampling involving professional councils was done to obtain the study sample. Quantitative data were collected using a semi-structured questionnaire whilst key informant interviews were conducted to obtain qualitative data. A health worker was presumed to be absent if noted on duty attendance log by ward in charge as absent three days from the day of the interview. Data were collected on socio-demographics (age, education, sex, cadre, employment type, marital status,) and other associated factors such as, performance plan, performance appraisal work environment and use of biometric machine. Place of residence was categorized as resident in staff quarters or outside of the staff quarters, when a performance plan was done, categorized as having a performance plan done at the beginning of the year, end of year or any time of the year. At bivariate analysis, logistic regression analysis was done to determine factors crudely associated with health worker absenteeism, only performance appraisal and the residence out of hospital quarters were the only factors seen to be significant. At multivariate analysis, logistic regression was done to test for the independent relationship with absenteeism after adjusting for potential confounders. Deductive thematic content analysis was used to provide a deeper understanding of the perceived causes of health worker absenteeism at JRRH. Results: Of the 161 health workers sampled, 158 (98.1%) were interviewed. The mean age was 38.3 years (SD= 9.5), 63.3% (100/158) were females and 59.5% (94/158) were married, majority of health workers were certificate and diploma holders, 64(40.6) and 74(46.8%) respectively,120 (76%) were on permanent employment with 92(58.2%) having worked in the hospital for ten years and below. 89(56.3%) of the health workers were residents in the staff quarters yet 70.3% of the nonresidents stay about 5km distance from the hospital. The prevalence of absenteeism was 13.3% (n=16). The certificate holder was less absent as compared to degree holder and above (11.8% and 15.4%), Health workers who stayed in the hospital quarters/premises were more likely to be absent than those who were non-residents (21.3% vs. 8.2%, P= 0.025), Non-residents staying 10km or longer distances from the hospital were more likely to be absent than those who stayed in a distance of less than 10km (27.3% vs. 12.5%, P=0.047). Residing out of the staff quarters and having a performance plan developed any time were the two factors independently associated with absenteeism of health workers at JRRH (aOR = 5.7, 95% CI [1.2-26.0], p value = 0.025 and (aOR = 0.1, 95% CI= [0.0-0.9], p value= 0.047), respectively. Conclusion: In this study, place of residence and performance plan developed any time were the factors found to influence absenteeism of health workers at JRRH. Recommendation: Performance planning should be practiced in hospitals at all times of the performance period to reduce absenteeism. There is a need for further research to gain a deeper understanding of how staying out of the hospital quarters within 10 km distance would reduce absenteeism in JRRH.