Staff turnover in the health sector: a case study at Kumasi Metropolitan Health Directorate

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The health workforce in Ghana is estimated at a total of about 43,000 and this is considered quite inadequate to meet health service delivery for 20 million Ghanaians. This situation is continually being exacerbated by a massive “brain drain” of the health workers combined with internal mal-distribution to restrict access of service seekers to providers. Efforts by the remaining health professionals irrespective of the severe resource constraints o achieve targets of public health and institutional development is probably not making an impact. The health sector is now recording increases in infant and under-five mortality and malnutrition rates. This research is aimed among others to bring to focus issues relating to high staffing turnover and assess the factors which could be handled at the local levels so as to retain health staff and improve service delivery. It also contributes to the body knowledge of staffing turnover with special emphasis on what pertains in an urban setting in Ghana. The convenience sampling method was adopted with 100 health professionals sampled from five sub-metros in the Kumasi Metropolis. The study shows that 78% joined the service due to self interest; 66% leave the service due to low remuneration; and 49% have remained in the service due to self-interest in the job. Based on the fact that majority of the health professionals are aged (i.e. above forty years), the high interest expressed as a reason for joining and remaining in the service are very objective. It is also evident that based on the current economic state of the country and 0nsidering that the general remuneration seem farfetched. It has been recommended that Local Health Managers in the Metropolis and Districts could consider innovations to acquiring property including land and others through collaboration with Traditional Leaders and other Business organizations. In additions, the Ministry of Health should expand the spectrum of degree and post-graduate programmes through collaboration with the tertiary institutions in the country. It is suggested that some courses could be considered on distance learning bases so as to optimize the potentials and skills of the few health workers available.
A thesis submitted to the Department of Community Health, School of Medical Sciences, College of Health Sciences Kwame Nkrumah University of Science and Technology in partial fulfilment of the requirements for the award of Master of Science degree i Health Services Planning and Management, 2004