Health Worker Absenteeism in Selected Health Facilities in Enugu State

Do Internal and External Supervision Matter

Bibliographic Data

ID22084804
AuthorsDivine Ndubuisi Obodoechi (0000-0001-7873-1856, University of Nigeria, corresponding author), Obinna Onwujekwe (0000-0002-1214-4285, University of Nigeria), Martin Mckee (0000-0002-0121-9683, London School of Hygiene & Tropical Medicine), Blake Angell (0000-0002-7188-7740, UNSW Sydney), Prince Agwu (0000-0001-9224-7622, University of Nigeria), Charles T Orjiakor (0000-0001-5379-8915, University of Nigeria), Charles Orjiakor, Chukwudi Nwokolo (0000-0003-3434-0866, University of Nigeria), Aloysius Odii (0000-0002-2222-0835, University of Nigeria), Eleanor Hutchinson (0000-0002-9718-2407, London School of Hygiene & Tropical Medicine), Dina Balabanova (0000-0001-7163-3428, London School of Hygiene & Tropical Medicine)
Year2021
Volume9
Pages752932-752932
Publication date2021-10-11
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2021.752932
PMID34708020
OpenAlexW3205608063
LanguageEN
Citations received7
References cited21

Background: Absenteeism is widespread in Nigerian health facilities and is a major barrier to achievement of effective Universal Health Coverage. We have examined the role of internal (by managerial staff within facilities) and external (by managers at a higher level) supervision arrangements on health worker absenteeism. Specifically, we sought to determine whether these forms of supervision have any role to play in reducing health worker absenteeism in health facilities in Enugu State Nigeria. Methods: We conducted interviews with 412 health workers in urban and rural areas of Enugu State, in South-Eastern Nigeria. We used binary logistic regression to estimate the role of different types of supervision on health worker absenteeism in selected health facilities in Enugu State. Results: Internal supervision arrangements significantly reduce health worker absenteeism (odds ratio = 0.516, p = 0.03). In contrast, existing external supervision arrangements were associated with a small but significant increase in absenteeism (OR = 1.02, 0.043). Those reporting a better financial situation were more likely to report being absent (OR = 1.36, p < 0.01) but there was no association with age and marital status of respondents. Our findings also pointed to the potential for alternative forms of supervision, provided in a supportive rather than punitive way, for example by community groups monitoring the activities of health workers but trying to understand what support these workers may need, within or beyond the work environment. Conclusion: The existing system of external supervision of absenteeism in health facilities in Nigeria is not working but alternatives that take a more holistic approach to the lived experiences of health workers might offer an alternative

Absenteeism · Business · Environmental health · Health facility · Health services · Logistic regression · Marital status · Occupational safety and health · Population · Global Health Care Issues · Healthcare Policy and Management · Healthcare Systems and Reforms · Medicine · Nursing · Psychology · Social Psychology

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