JOB ENRICHMENT STRATEGIES AND HEALTH WORKER PERFORMANCE IN DEVOLVED HEALTH SYSTEMS IN SELECTED COUNTIES IN KENYA

Abstract

The effectiveness of health workers in a devolved health system is vital for achieving national and global health objectives. In Kenya, performance challenges among health workers have persisted, often aggravated by industrial actions involving nurses, clinical officers, and other professionals. This study examined the influence of job enrichment strategies on health worker performance within Kenya’s devolved health system. A descriptive survey design was adopted, targeting 663 health workers across 70 Tier 3 public health facilities in Kisumu, Machakos, and Migori counties, with a sample of 399 respondents determined using Nassiuma’s formula. Data were collected through structured Likert-scale questionnaires and key informant interviews and analyzed using SPSS version 26 through linear regression analysis. Results indicated that job enrichment strategies had a statistically significant and positive effect on health worker performance. The study concludes that job enrichment strategies—such as fostering strong professional values, aligning skills with assigned tasks, providing supportive supervision, and reinforcing adherence to established norms and codes of conduct—are essential for enhancing health worker performance. These strategies not only promote accountability and professional integrity but also create an enabling work environment that motivates staff and improves service delivery. County governments and policymakers should prioritize the integration of these elements into health workforce management frameworks to strengthen staff commitment, reduce performance gaps, and improve health outcomes within Kenya’s devolved health system.