TOTAL REWARDS AND NURSE RETENTION IN LEVEL FOUR FAITHBASED HOSPITALS IN NYANZA REGION, KENYA: THE MODERATING ROLE OF ORGANIZATIONAL CULTURE
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Date
2025-08
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Volume Title
Publisher
THE CATHOLIC UNIVERSITY OF EASTERN AFRICA
Abstract
Poor retention among registered nurses is a global issue, with nursing experiencing higher turnover rate than that of other professions in the healthcare field. This study examined the relationship between total rewards and nurse retention in Level 4 faithbased hospitals in the Nyanza Region of Kenya. The study specifically investigated how compensation, learning and development, employee recognition, and work-life balance affect nurse retention, with organizational culture as a moderating variable. Anchored on Maslow’s Hierarchy of Needs Theory and guided by other theories such as Social Exchange Theory, Equity Theory, and Work/family Border Theory, the research aimed to address empirical gaps, including contextual, conceptual, and methodological dimensions. The unit of analysis consisted of Level 4 faith-based hospitals in Nyanza region, while the unit of observation was nurses. Adopting a pragmatist philosophy, the study employed an explanatory research design which targeted 442 registered nurses in these hospitals. A sample of 210 nurses was selected using Yamane’s formula, stratified sampling with proportional allocation, and simple random sampling techniques. A pilot study which involved 21 nurses in Kericho County established the reliability and validity of the questionnaires. Data collection and analysis employed quantitative approach. Partial Least Squares Structural
Equation Modeling (PLS-SEM) was employed for data analysis and hypothesis testing using SmartPLS 4.0 software. The study revealed that total rewards alone accounted for 53.3% of the variance in nurse retention, while the inclusion of
organizational culture increased the explained variance to 57%, indicating a modest additional contribution. Among the components of total rewards, compensation had a weak statistically significant effect on nurse retention (β = 0.128, p = 0.049). Learning and development as well as employee recognition demonstrated positive but non-significant effects. Work-life balance emerged as the most influential factor, showing a strong positive and significant effect (β = 0.575, p = 0.000) on retention. This underscores the critical importance of creating supportive work environments that enable nurses to balance their professional and personal lives effectively. While organizational culture exhibited some moderating effects on the relationship between total rewards and retention, these effects were minimal and statistically nonsignificant. The study recommends that hospitals prioritize work-life balance policies that support schedule flexibility, adequate leave days, and manageable workloads for nurses. These should be implemented alongside competitive compensation and continuous employee development. This study enhances knowledge on nurse retention by establishing work-life balance as the most significant factor, challenging conventional emphasis on compensation. It contributes to literature on organizational culture, revealing its limited moderating role, and questions the effectiveness of
traditional recognition programs. Further research should focus on public and private hospitals with a broader scope beyond Nyanza region.
Description
Dissertation
Keywords
Total rewards, nurse retention, organizational culture, employee retention strategies, healthcare human resource management, faith-based hospitals, Nyanza Region, Kenya