2023-09-28 14:46:10 +00:00
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abstract: 'Public-sector healthcare providers are on the frontline of family
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planning service delivery in low- and middle-income countries like
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Kenya, yet research suggests public-sector providers are frequently
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absent. The current prevalence of absenteeism in Western Kenya, as well
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as the impact on family planning clients, is unknown. The objective of
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this paper is to quantify the prevalence of public-sector healthcare
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provider absenteeism in this region of Kenya, to describe the potential
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impact on family planning uptake and to source locally-grounded
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solutions to provider absenteeism. We used multiple data collection
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methods including unannounced visits to a random sample of 60
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public-sector healthcare facilities in Western Kenya, focus group
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discussions with current and former family planning users, key informant
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interviews with senior staff from healthcare facilities and both
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governmental and non-governmental organizations, and journey mapping
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activities with current family planning providers and clients. We found
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healthcare providers were absent in nearly 60\% of unannounced visits
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and, among those present, 19\% were not working at the time of the
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visit. In 20\% of unannounced visits, the facility had no providers
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present. Provider absenteeism took many forms including providers
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arriving late to work, taking an extended lunch break, not returning
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from lunch, or being absent for the entire day. While 56\% of provider
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absences resulted from sanctioned activities such as planned vacation,
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sick leave, or off-site work responsibilities, nearly half of the
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absences were unsanctioned, meaning providers were reportedly running
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personal errands, intending to arrive later, or no one at the facility
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could explain the absence. Key informants and focus group participants
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reported high provider absence is a substantial barrier to contraceptive
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use, but solutions for resolving this problem remain elusive.
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Identification and rigorous evaluation of interventions designed to
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redress provider absenteeism are needed.'
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affiliation: 'Tumlinson, K (Corresponding Author), Univ N Carolina, Gillings Sch Global
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Publ Hlth, Dept Maternal \& Child Hlth, Chapel Hill, NC 27515 USA.
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Tumlinson, K (Corresponding Author), Univ N Carolina, Carolina Populat Ctr, Chapel
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Hill, NC 27515 USA.
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Tumlinson, Katherine; Williams, Caitlin R., Univ N Carolina, Gillings Sch Global
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Publ Hlth, Dept Maternal \& Child Hlth, Chapel Hill, NC 27515 USA.
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Tumlinson, Katherine, Univ N Carolina, Carolina Populat Ctr, Chapel Hill, NC 27515
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USA.
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Britton, Laura E., Columbia Univ, Sch Nursing, New York, NY USA.
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Williams, Caitlin R., Inst Clin Effectiveness \& Hlth Policy, Dept Mother \& Child
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Hlth, Buenos Aires, DF, Argentina.
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Wambua, Debborah Muthoki, Innovat Poverty Act Kenya IPA K, Nairobi, Kenya.
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Onyango, Dickens Otieno, Kisumu Cty Dept Hlth, Kisumu, Kenya.
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Onyango, Dickens Otieno, Inst Trop Med, Antwerp, Belgium.'
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author: Tumlinson, Katherine and Britton, Laura E. and Williams, Caitlin R. and Wambua,
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Debborah Muthoki and Onyango, Dickens Otieno
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author-email: ktumlin@email.unc.edu
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author_list:
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- family: Tumlinson
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given: Katherine
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- family: Britton
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given: Laura E.
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- family: Williams
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given: Caitlin R.
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- family: Wambua
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given: Debborah Muthoki
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- family: Onyango
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given: Dickens Otieno
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da: '2023-09-28'
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doi: 10.1093/heapol/czac022
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earlyaccessdate: MAR 2022
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eissn: 1460-2237
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files: []
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issn: 0268-1080
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journal: HEALTH POLICY AND PLANNING
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keywords: 'Absenteeism; low- and middle-income countries; universal health
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coverage; Kenya; family planning; quality of care; maternal health'
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keywords-plus: HEALTH-WORKERS; OUTCOMES; IMPACT
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language: English
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month: MAY 12
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number: '5'
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number-of-cited-references: '28'
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orcid-numbers: 'Tumlinson, Katherine/0000-0001-8314-8219
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Williams, Caitlin Rain/0000-0002-4925-869X'
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pages: 575-586
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papis_id: 7d1d3cc0e56f66c57f76fd474abbea74
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ref: Tumlinson2022absenteeismfamily
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researcherid-numbers: 'Tumlinson, Katherine/E-6975-2013
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'
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times-cited: '3'
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title: 'Absenteeism Among Family Planning Providers: A Mixed-Methods Study in Western
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Kenya'
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000769088500001
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usage-count-last-180-days: '0'
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usage-count-since-2013: '2'
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volume: '37'
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web-of-science-categories: Health Care Sciences \& Services; Health Policy \& Services
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year: '2022'
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