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Performance of employees in the Ministry of Health, Nairobi City County has been dismal. There have been instances of inability amongst employees to meet deadlines, low efficiency, and dismal productivity. The objectives of the study included; assessing the influence of recruitment, career management, reward and performance appraisal practices on performance of employees in the Ministry of Health. The study was guided by the strategic management and performance theories. The study adopted mixed methods approach and thus applied descriptive research design. The target population comprised of 15 Departmental Heads and 425 employees all totaling to 440. Using the Central Limit Theorem, 132 respondents, that is, 30.0% of 440, was selected. Stratified sampling was applied to create five strata based on the number of departments in the Ministry of Health Nairobi. Heads of department will be selected using purposive sampling whereas 25 employees will be selected from each department using simple random sampling to avoid bias. This procedure enabled the researcher to realize a sample of 5 heads of departments and 127 employees. The questionnaire was used to collect data from employees whereas interviews with heads of departments. Qualitative data were analyzed thematically along the objectives and presented in narrative forms whereas quantitative data were analyzed descriptively using frequencies and percentages and inferentially analyzed using ANOVA Test Analysis with the help of SPSS Version 23. The study established that, at the Ministry of Health in Nairobi County, employees’ efficiency, productivity and ability to meet deadlines are low. It is also evident that strategic human resource management practices such as recruitment, career management, reward and performance appraisal practices have not been fully exhausted. Thus, the study recommends that the Ministry of Health should endeavor to train their employees in order to improve the organizational performance. The Ministry of Health should provide employees opportunity to make decisions on how to go about their tasks, seeking employees’ input in managerial decisions, delegating to them tasks that they can handle, equipping them with skills required by their jobs, setting achievable targets and incorporating employees in fair evaluation of performance, salary increase and fair administration of rewards. Job performance should be considered in determining the compensation of employee’s performance.
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