Beyond the Scorecard: Performance Appraisal as a Strategic Lever for Public Health Officer Involvement in RTI Prevention

Abstract

Introduction: Road traffic injuries (RTIs) remain a critical public health challenge globally, with low- and middle-income countries (LMICs) like Kenya bearing a disproportionate burden. In Nairobi County, RTIs are among the top causes of morbidity and mortality, highlighting the need for effective prevention strategies. Public Health Officers (PHOs) are key actors in these efforts, yet their participation is influenced by organisational factors, including performance appraisal (PA) systems. While PA is often treated as a routine administrative process, this study explores its strategic potential to enhance PHO motivation, accountability, and alignment with RTI prevention goals. Drawing on global and regional evidence, the study examines how elements such as feedback, goal-setting, and transparency within PA systems impact PHO engagement, aiming to inform policies that strengthen public health workforce performance in Kenya and similar settings. Methods: The current study adopted a descriptive cross-sectional study design using both quantitative and qualitative approaches. Data was collected from a saturated sample of 120 PHOs operating in Nairobi County and 6 supervisors. Quantitative data were analysed descriptively and presented in the form of tables. Qualitative data were analysed using deductive thematic analysis and presented in verbatim quotes. Results: Performance appraisal systems that provided timely feedback (72.3%), involved PHOs in goal setting (74.6%), and used results for career development and recognition (75.8%) boosted participation in RTI prevention. Conclusion: The study concludes that leadership support, organisational structure, and performance appraisal systems play a critical role in shaping the participation of Public Health Officers (PHOs) in road traffic injury (RTI) prevention. Supportive leadership practices, a clear organisational structure, and an effective performance appraisal system are enablers for enhancing participation of PHOs in RTI prevention. Therefore, addressing organisational barriers and investing in leadership, structure, and performance systems is essential for empowering PHOs to effectively contribute to RTI prevention efforts and broader public health goals.