“I’m Proud to Be a Health Worker”: Improving HR Management at Faith-Based Organizations in Kenya
Mary Kinyariro works at Kijabe Hospital in Kenya. For a long time, she thought managers paid little attention to making sure employees were qualified and supported. “Patient attendants even gave medicines in those days, as well as feed the patient or make beds. I never saw meetings of managers and staff.” Her colleague John Kuria lacked clarity about his job. “Things were not clear. I was never appraised on my performance.”
Kijabe Hospital is affiliated with the Christian Health Association of Kenya (CHAK). Faith-based organizations make a major contribution to health service delivery: CHAK and the Kenya Conference of Catholic Bishops (KCCB) provide about 40% of the country’s health care through approximately 900 facilities.
But without a clear set of policies and guidelines to organize their vast network of staff, these facilities didn’t operate as effectively as they could have. Some positions lacked job descriptions, performance appraisals were infrequent, criteria for promotion were absent or subjective, salary payments were uncertain, safety issues went overlooked, and so on. Employees’ job satisfaction suffered, and many left their jobs.
Looking at the whole cycle
CapacityPlus’s Doris Mwarey worked with CHAK and KCCB to develop a comprehensive generic human resources management policy document, which they used to guide the implementation of a set of policies and procedures for the workforce and the working environment. “HR management is all the practices and procedures that you put in place to attract, maintain, and develop an employee,” says Mwarey. “In simple terms, it is looking at that whole cycle of an employee working for an institution.” This process began under the USAID-funded Capacity Project and went forward with the support of CapacityPlus and Capacity Kenya.
Mwarey and CapacityPlus’s Alfredo Fort are contributing to an evaluation of how CHAK’s and KCCB’s work with HR management policies has affected family planning and HIV service delivery. Recently they interviewed several people as part of this process.
Kijabe Hospital
Charles Thiong’o is HR director at Kijabe Hospital (a CHAK affiliate), which has about 700 employees. He and Mary Njuguna, education coordinator, used the generic policy to develop a document specific to their setting. “Having the policy framework made us look at all the facets of human resources,” Thiong’o remarked, “from the point of recruiting and how we contract to how we manage performance and even issues that would have probably been overlooked, like sexual harassment. We’ve been able to approach issues from a strategic viewpoint of how to manage health workers in the health sector. This was a real big boost for us, at I would say zero cost.”
In a participatory process, they involved the heads of all departments, then senior management and the board, which declared the new policy a “big win.” All staff received training on the details of the policy. “It has brought a lot of satisfaction to the employees,” Njuguna reported, “because they feel that every employee is to be taken in a fair way—there is a document that is being followed.”
She added, “I’m proud to have helped introduce this document, and I’m proud to be a health worker.”
“We’ve been able to achieve very many things,” commented Thiong’o, “including revamping our performance management system, working on tools that will accompany the document, and even salary schemes that will help us manage compensation in a way that is fair.” The HR department has grown from one staff member to five, including a director position that didn’t exist before. He shared that “the HR policy has really boosted my confidence. I’m really proud to be part of that team, coming up with solutions to solve the health workers’ needs. And I think one of these days we shall be a model of retention of health workers.”
The hospital is also using CapacityPlus’s iHRIS software to keep track of its health workforce data and use the information for decision-making. Capacity Kenya is supporting this process.
For his part, John Kuria has much greater clarity about his role. “I started setting targets and goals, which are reviewed quarterly,” he reported. Mary Kinyariro added, “I have seen big changes in HR.” Communication improved, and there are regular meetings of managers and staff. New hires receive an appointment letter and orientation. “The HR office has been supportive,” she praised. “Kijabe has improved my life.” And their colleague Grace Njoroge, a nurse, said she appreciates having easy access to the policies along with support from HR in interpreting them.
Jamaa Mission Hospital
George Audi is deputy hospital administrator and HR manager at Jamaa Mission Hospital, affiliated with KCCB. “Things were very disorganized,” he said. “Now we have policies which incorporate all aspects of HR management from recruitment, training, performance evaluation, and separations, as well as staff development.”
Audi’s wealth of experience and skills gained over this period has seen him grow into a key resource for other organizational projects, including sister organizations in Uganda and South Sudan. He began as an accountant and introduced electronic accounting and payroll processes. Through his involvement with the HR management work, he was inspired to earn a master’s degree in strategic management and HR. “Were it not for Capacity,” he reflected, “I think I would have not made a big turnaround in my life to see the need to engage people in a different area other than finance.” He’s now invited to board meetings and enjoys innovating to make things run more effectively. “I have saved [the institution] money,” he remarked. He eliminated the need to pay penalties by making tax payments on time, reduced the institution’s dependence on consultants, and negotiated with the banks to obtain favorable rates for staff members’ personal loans to buy land or cars. Audi also made sure to adhere to the Federation of Kenya Employers guidelines: “Now there’s all the benefits of the law—maternity, sick leave, retirement.”
He continued, “Without this intervention many health institutions [that are part of KCCB and CHAK] would have not benefited. The intervention helped many of these institutions to put in place policies which helped them manage their areas of HR and also continue to evaluate what they are doing, continue to train supervisory staff on what needs to be done. That has made an impact in all the faith-based organizations in Kenya,” he affirmed.
“Through my work in this area I feel very fulfilled,” Audi concluded, “and I’m proud to be a health worker who is able to make a difference through my involvement in HR issues.”
Learning from Kenya
Since learning of these successful experiences, the Christian Health Associations in Ghana, Malawi, and Lesotho have adopted similar approaches in developing their own HR policies and guidelines to align with national labor laws and increase retention and motivation at the facility level.
CapacityPlus’s evaluation and final report will be completed in the next few months.
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Photos by Alfredo Fort (Mary Kinyariro, Doris Mwarey, Grace Njoroge, and John Kuria at Kijabe Hospital; Charles Thiong’o and Mary Njuguna; George Audi)
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