Role of monetary incentives on motivation and retention of community health workers: an experience in a Kenyan community

Abstract

Objective: The aim of the study was to assess the role of monetary incentives on motivation and retention of Community Health Workers in Kibwezi Sub-county. Methods: It was a cross-sectional comparative study in which retention of community health workers receiving monetary incentives and those not receiving monetary incentives was compared. Data was collected using a structured questionnaire, key informant interview guide and focus group discussion guide. Relationships between variables were determined using logistics regression Results: Monetary incentives were cited as the main motivator with majority of the CHWs reporting a salary as the factor that would motivate them the most. There was higher attrition rates (13%) among those not receiving any form of monetary incentives compared to those receiving monetary incentives (4%). There was a statistical significant difference in attrition rate between CHW’s receiving monetary incentives and those not receiving monetary incentives. 80% of CHWs not receiving monetary incentives had ever contemplated dropping out of their CHW roles compared to 66% among CHWs receiving monetary incentives. The main reasons cited for attrition of CHWs included financial constraints and inadequate compensation for work done. Conclusion: The study findings show that provision of monetary incentives has an influence on the attrition of CHWs. The attrition rates were higher for CHWs not receiving monetary incentives compared to CHWs receiving monetary incentives. Financial incentives are the most reported incentives to enhance the retention of CHWs. Provision of monetary incentives to CHWs should be explored to enhance their retention.