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Table 6 Overview of HRM bundles in relation to performance outcomes

From: The effect of human resource management on performance in hospitals in Sub-Saharan Africa: a systematic literature review

Author, year, country HRM themes Performance outcomes MMAT Score
Empowerment -Enhancing practices Motivation-Enhancing practices Skills-Enhancing practices Employee outcome Organizational outcome Patient Outcome
Ajemigbitse et al., 2013, Nigeria [68] supportive supervision   job-based skill training   improved prescribing errors among junior physicians   ***
Ackerman & Phil, 2007, S.Africa [70] teamwork management support, scheduling   improved job satisfaction    **
Francis & Roger, 2012, Ghana [71] supervision salary, supplementary allowances, leadership support, recognition job-based skill training improved retention and staff motivation    ****
Simiyu & Moronge, 2015, Kenya [72] teamwork, work-life balance, communication practice salary, supplementary benefits recruitment improved performance    ****
Allegrazi et al., 2010, Mali [73] feedback on performance   training   improved patient safety   ****
Akinyemi & Atilola, 2013, Nigeria [74]   salaries training improved job satisfaction    ****
Abubeker et al., 2014, Nigeria [76]   compensation training reduced turnover intention    ***
Asegid et al., 2014, Ethiopia [77]   salary, supplementary allowances training improved job satisfaction and reduced intention to leave    ****
Ackerman & Bezuidenhout, 2007, S.Africa [78] teamwork scheduling(flexi-time system)   staff turnover(continued)    ***
Ashmore, 2013, S.Africa [79]   supplementary allowances job-based skill training improved job satisfaction and reduced moonlighting    ****
Nyakundit et al., 2012, Kenya [81]   recognition, incentives training improved performance improved quality of care   ***
Atambo et al., 2013, Kenya [82]   recognition, incentives training improved performance improved efficiency in service delivery   ****
Aveling et al., 2015, Rwanda & Ethiopia [84] teamwork   training, staffing   improved quality of care and safety of care   ****
Awasses et al., 2013, Namibia [85]   recognition, staff performance appraisal, remuneration, supplementary financial allowances in-service training improved performance of nurses    ***
Ayeiko et al., 2011, Kenya [86] supervision, feedback   training   improved quality of care   ****
Waju et al.,2011, Ethiopia [87]   management support staffing, training improved performance   improved patient satisfaction ****
Bhengu, 2000, S. Africa [88]   rostering & scheduling, salary   reduced intention to leave improved motivation    ****
Bradley et al., 2008, Ethiopia [89]    mentorship, training   improvement in hospital management skills (efficiency)   ****
Bradley & McAuliffe, 2009, Malawi [90]   remuneration training improved performance improved staff retention    ***
Dagne et al., 2015, Ethiopia [91] communication/supervisor feedback job content management of schedules, performance review, financial incentives, recognition staffing improved motivation of health professionals improved quality of care   ****
De Brouwere et al., 2009, Senegal [92] teamwork, task shifting      improved maternal mortality ***
Dieleman et al., 2006, Mali [93]   salary, performance appraisal, reward system training improved motivation    ****
Hall, 2004, S. Africa [97]   salary, supplementary incentives/ allowances, scheduling   reduced intention to leave    **
Honda & Vio, 2015, Mozambique [98]   incentives, scheduling, salaries job-based skill training improved job satisfaction and retention    ***
Libeziako et al., 2013, S. Africa [99] teamwork practice salary, supplementary allowances   improved motivation    **
Jack, 2013, Ghana [101] teamwork compensation, allowances recruitment/staffing, training improved retention    **
Kamanzi & Nikosi, 2011, Rwanda [104]   remuneration, recognition job-based skill training improved level of motivation    ****
Kekana et al., 2007, S.Africa [105] teamwork performance appraisal, remuneration, scheduling   improved job satisfaction    ****
Khamis & Njau, 2014, Tanzania [106]   salary, allowances, management support, rostering & scheduling staffing, training   improved quality of care at outpatient   ****
Kotzee & Couper, 2006, S. Africa [107]   salaries, allowances, recognition training, mentorship improved retention of doctors    ****
Kruger & Bezuidenhout, 2015, S. Africa [108]   scheduling, promotion, management support training reduced female doctors dissatisfaction in balancing professional work and family lives    ****
Liphoko et al., 2006, S.Africa [109]   performance appraisal, promotion, management support job-based skill training improved job satisfaction of nurses    ***
Leshabari et al., 2008, Tanzania [110] communication/ feedback performance evaluation, salaries   improved job satisfaction and motivation    ****
Longmore & Ronnie, 2014, S.Africa [111] communication salaries, performance appraisal training improved retention of doctors    *
Luboga et al., 2011, Uganda [112]   compensation/salaries, benefits, recognition, scheduling workload, management support training, staffing improved job satisfaction and retention of physicians    **
Makapela & Useh, 2015, S.Africa [113]   salary, management support, allowance job-based skill training improved retention    ***
Mathauer & Imhoff, 2006, Benin & Kenya [114] supervision recognition, allowances, salary job-based skill training improved motivation    ****
Mbindyo et al., 2009, Kenya [115] employee engagement, communication promotion, leadership support, performance appraisal, incentives    improved quality of care   ****
McAuliffe et al., 2009, Malawi [116] teamwork management support staffing improved task performance    **
McAuliffe et al., 2013, Malawi, Tanzania & Mozambique [117] job autonomy, task shifting, teamwork, supervision leadership support   improved job satisfaction and reduced intention to leave    ***
Mokoka et al., 2010, S.Africa [118]   salary, rostering & scheduling, management support training improved retention of nurses    ***
Mubyazi et al., 2012, Tanzania [119] supervision Incentives staffing, training improved motivation    ***
Pieterson, 2005, S.Africa [123]   pay, management support, scheduling, promotion   improved job satisfaction    ***
Pillay, 2009, S.Africa [124] teamwork, job autonomy, job security rostering & scheduling training improved job satisfaction and motivation    ****
Prytherch et al., 2012, Tanzania [125]   rostering & scheduling, salaries, incentives, recognition/promotion   increased job performance    ***
Selebi & Minnaar, 2007, S.Africa [127] supportive supervision salaries   improved job satisfaction    ***
Sikwese et al., 2010, Zambia [128]    staffing/ selection, training   improved efficiency of service delivery   ***
Siril et al., 2011, Tanzania [129] supervision, teamwork compensation, rostering & scheduling training   improved quality of care   ****
Ssengooba et al., 2002, Uganda [130]   rostering & scheduling staffing   improved hospital performance (efficiency and effectiveness)   **
Stodel & Stewart-Smith, 2011, S.Africa [131] supervision scheduling training, mentorship improved retention    ***
Tabatabai et al., 2013, Tanzania [132] employee engagement salary, incentives, scheduling, management support training reduced internal migration (public to private)    **
Thatte & Choi, 2014, Kenya [133] supervision   written job descriptions, training   improved service quality   **
Uwaliraye et al., 2013, Rwanda [134] feedback   training improved performance of nurses and midwives    ***
Yami et al., 2011, Ethiopia [135] teamwork supplementary allowances, salary training improved job satisfaction    ****
Bekker et al., 2015, S. Africa [136] communication rostering & scheduling   enhanced job satisfaction    ***
Chandler et al., 2009, Tanzania [137]   salary, management support, rostering & scheduling training improved performance improved quality of care   ****
Chi et al., 2015, Burundi & Uganda [138]   rostering & scheduling, remuneration staffing   improved quality of maternal care   ***
Chirwa, 2000, Malawi [139]   performance appraisal Staffing   improved quality of care   ***
Hollup, 2012, Mauritius [140] job security and safety salary   improved staff motivation    ****
Klopper et al., 2012, S.Africa [141]   wages, study leave opportunities skills-training for career advancement job dissatisfaction    **
Lasebitan & Oyetundt, 2012, Nigeria [142]   rostering & scheduling, wages staffing improved retention    ****
Mudaly & Nkosi, 2015, S.Africa [143]   scheduling, promotion, pay, rewards/incentives training, staffing reduced absenteeism    ***
Tibandebage et al., 2015, Tanzania [144] supervision incentives, salaries, leadership support, rostering & scheduling Staffing improved performance    ***
Courtright et al., 2007, Malawi, Uganda, Tanzania & Kenya [145] supervision management support Training improved performance    ****
Doherty et al., 2013, S.Africa [147] supervision, task shifting     improved quality of care, reduced staff shortage and workload   ***
Kamau & Omondi, 2015, Kenya [149]   supplementary allowances/incentives job-based skill training improved staff retention    ****
Madzimbamuto et al., 2014, Botswana [151] supervision   Training   improved quality of care   **
Mahlo & Muller, 2000, S.Africa [152] communication   Training   improved quality of care   ****
Manongi et al., 2009, Tanzania [153]   Salary Training improved performance    ***
Nabirye, 2010, Uganda [156]   scheduling, pay, incentives/allowances   improved performance of nurses and job satisfaction    ***
Ndetei et al., 2008, Kenya [157]   Salary Training reduced migration of health workforce (retention)    ***
Okeke, 2008, Nigeria [159]   salary Recruitment improved retention    **
Rauf et al., 2008, S.Africa [163] task shifting scheduling, performance evaluation/appraisal    reduced waiting time (maximized efficiency)   **
Thomas & Valli, 2006, S.Africa [165]   scheduling, salary training, staffing improved job satisfaction    ****
Yeboha et al., 2014, Ghana [167] communication management support Training improved retention    ***
Rawlins et al., 2003, Kenya [168] feedback, teamwork management support staffing, written job descriptions   improved organizational performance (efficiency)   ***
Giuseppe et al., 2002, Kenya [169] communication, work-life balance scheduling, management support Training improved task performance and improved retention of resident doctors    ***
Ngao, 2013, Kenya [170]    recruitment/staffing, training, mentorship   improved quality of care   **
Kotagal et al., 2009, Rwanda [171]   leadership support staffing    improved patient satisfaction **
Dowing, 2016, Uganda [173]    training, mentorship improved nurses’ performance    ***
Faye et al., 2013, Senegal & Mali [174]   salary, supplementary allowances, scheduling, management support training improved job satisfaction    ****
Doef et al., 2011, Kenya, Tanzania & Uganda [175]   scheduling, management support, supplementary allowances staffing improved job satisfaction and reduced level of burnout    ****
Srofenyoh et al., 2012, Ghana [176] teamwork, communication leadership support training improved employee performance   improved patient satisfaction and clinical outcomes ***
Woldegabriel et al., 2016, Ethiopia [177] communication scheduling, performance appraisal selection/recruitment, training improved intrinsic motivation of health workforce    ****
Puoane et al., 2008, S.Africa [178] teamwork, supervision, feedback leadership support, monitoring performance in-service training and induction of new nurses improved task performance improved quality of care in the better performing hospitals   ****