An Assessment of the Effect of Education, In-Service Training (IST) and Tenure on Healthcare Performance: A Cost-Optimizing Perspective

Healthcare institutions, governments and other stakeholders have over the years used employee education, in-service training and tenure prolongation to enhance the job performance of health professionals, which is termed healthcare performance in this study. The lack of adequate financial resources may however leave employers with the sole option of applying only one of these methods. This study attempts to identify the best predictor of healthcare performance that can be prioritized in cost-optimizing situations. Self-reported and supervisor- or superior-reported questionnaires were used to collect data from 1,163 health professionals in Accra North, who were selected using random sampling methods. Confirmatory Factor Analysis was used to test the study's hypotheses. The resulting model is of good fit at 5% significance level [Chi-square (χ²) = 1.492; p = 0.222], with training found to be the ultimate method applicable if the need to use a single method arises. Nonetheless, the role of training as the ultimate applicable method is driven by tenure prolongation. The study concludes that in-service training is the ultimate method applicable for enhancing healthcare performance. Nevertheless, simultaneous application of training and tenure prolongation in non-financial or cost-optimizing terms is recommended.