Indigenous Psychological Contract Violation and Community Health Worker Retention in Rural Kenya: A Discrete-Choice Experiment on Reciprocity Norms and Public-Sector Accountability

Community health worker (CHW) attrition in rural Kenya is often attributed to low stipends, yet retention remains poor even where stipends are paid. Because no primary data were collected, the paper reports a design and power analysis for the proposed experiment. The analysis characterises the operating characteristics of a before-after-control-impact estimator under a declared variance structure with an intraclass correlation of 0.64, between-cluster SD of 6.0 and residual SD of 4.5. Power was estimated across 2000 replications per design cell for cluster counts of 8, 16, 24 and 32 and effect sizes of 3, 5 and 8 percentage points. The design attains 80% power at 56 clusters for a 5-percentage-point effect. Retention policy which treats CHWs as atomised incentive-seekers mis-specifies the contract, and that reciprocity-based obligations are a measurable and policy-relevant dimension of public-sector accountability in rural Kenya.