Factors influencing performance of nutritionists in teaching and referral hospitals, Kenya

Abstract

Assessing staff performance is a key aspect of personal appraisal in any organization. It is not unusual to find staff that work and perform at the or close to the required level. It is more common to find employees who have issues which make them not to perform to expectation. Despite the importance of nutrition care in patients’ management, health sector strategic and investment plan show that there is a shortage of nutritionists across the country with patientsnutritionists ratio being 38.6 million against 563. Evidence show that staff shortage greatly affects job performance negatively. It would be very difficult to advocate for more nutritionists to be employed without ascertaining that staff shortage among other factors affect performance. A lot has been done to assess staff performance but very little has been done to assess factors affecting their performance, as a way of understanding why interventions that require behavior change either succeed or fail. The aim of this study was to explore factors which influence performance of nutritionists at three teaching and referral hospitals in Kenya. It specifically determined the performance of the nutritionists and system and organizational factors which influenced performance of nutritionists, established individual and social factors which influence their performance and lastly established the factors which best predict performance of nutritionists at the three teaching and referral hospitals in Kenya. A hospital based crosssectional study was conducted at Kenyatta National Hospital, Moi Teaching and Referral Hospital and Jaramogi Oginga Odinga Teaching and Referral Hospital which are accredited to offer clinical nutrition services by KNDI for a period of twelve months. To get the sample size saturated sampling technique was used. Principal factor analysis was used for data reduction and hierarchical regression analysis was used to establish factors that best determine performance. A structured questionnaire was used to collect data from 94 participants out of 103 nutritionists giving a 91.2% response rate. Majority of the respondents were female 78.7%, with a mean age of 38.4 years. Most respondents were university graduates (68.09%). The results exhibited positive relationship between performance and system and organizational factors, individual factors as well as social factors accounting for variances of 62.36%, 61.7% and 48.73% respectively. Among the three domains of conceptual factors, only social factors elicited statistical significant relationship with performance based on t-test beta-value (p<0.05). Since the results revealed significant relationship between key indicators of social factors (community expectation and peer pressure) and performance, nutrition managers and policy makers should design programs to address social issues affecting nutritionists.