Incentives among Health Workers in a Remote Kenyan District: Implications for Proposed County Health System

Introduction. Attracting and retaining health workers in remote rural areas is a challenge in Kenya. Devolution of the Kenyan health system may negatively affect worker retention; incentives may play a role in retaining health workers. Methods. Semi-structured questionnaires were administered to health workers and human resource data reviewed. Analysis was for descriptive and emerging themes. Results. Health workers were employed under three different terms of service. The majority receive a monthly hardship allowance in the range of $7.5–94. Only five percent of health workers were able to engage in private practice. Available housing, water supply, electricity supply, and educational facilities were cited as inadequate. With the proposed devolution to county governments, 97.3% of respondents preferred to work in a different county. Conclusion. There may be need to harmonize the terms of service, improve the incentives, and amenities available to health workers in remote Kenyan counties in order to improve retention.