Phase three which involved document analysis, was used to as a cross reference for the data obtained in the first two phases in order to appreciate the extent of turnover of nurses. Figure? Illustrates the mixed methods design adopted for the study.
The choice of a mixed methods approach was relevant to (1) complement the methods in order to minimize the disadvantages of one approach over the other and utilize the advantages of each method and (2) triangulating the findings so they can be mutually corroborated (Bryman, 2006).
Figure? Mixed Methods design for the study
Sampling and sample size
Study population and sampling
Data collection
Pilot testing
Data analysis
Table ??? Characteristics of participating
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Each of the selected health facilities represented different levels of healthcare service delivery within the hierarchy of healthcare provision in Kenya. Thus the Jaramogi Teaching and Referral Hospital (JOOTRH), Kisumu County Hospital (KCH) and St. Monica’s Hospital (faith-based, private health facility.
The total sample for the quantitative component of the study consisted of 72 maternal care nurses, thus nurses working in the maternity ward (antenatal, labour and post-natal wards) and MCH clinics (antenatal and post-natal clinics). These were enrolled, registered, baccalaureate and postgraduate nurses employed at the facilities by the time of the research. A total of 58 out of the 72 maternal care nurses contacted returned completed questionnaires (effective response rate of 80.6%). The participants consisted of 7 males and 51 females with a mean age of …..years (range 24 – 59 years) (Table ??).
Consecutive sampling method was used so as to include all participants available at the time of the research as part of the
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The selected sub-county is Kisumu East Sub-county.
c) Health facilities
A total of three (3) health facilities were purposively sampled. Each of the selected health facilities represented different levels of healthcare service delivery within the hierarchy of healthcare provision in Kenya. Thus the Jaramogi Teaching and Referral Hospital (JOOTRH), Kisumu County Hospital (KCH) and St. Monica’s Hospital (faith-based, private health facility.
d) Study participants
The study participants were selected using consecutive sampling technique, thus:
• Maternal care nurses (i.e. nurses working in the maternity ward, ante natal clinic and post-natal clinic)
• Health facility administrators/in-charges in the respective health facilities
• Deputy County Nursing Officer
3.4 Data Collection Procedures and Methods
The study combined both quantitative and qualitative methods from primary and secondary sources. The cross-sectional data collection took place from 8th June to 26th June 2015. The exposures that were investigated were location of health facility, incentives, job satisfaction and retention factors. The expected outcomes include turnover rate and effects of internal turnover on quality of healthcare