This study sought to establish the influence of performance appraisal practices on employee retention in the health sector in the County Government of Kakamega with a view of proposing a mechanism to manage employee retention. The study was anchored on Equity Theory. The study employed a descriptive survey design. The target population was 1,153 health workers in Kakamega County drawn from 11 health facilities and a sample size of 297 respondents was used. The Data was collected by the questionnaires which was the main instrument to collect primary data. Quantitative data was analysed using descriptive inferential statistics (correlations and regression analyses). Performance appraisal practices and employee retention results revealed a positive and significant relationship in the health sector in the County Government of Kakamega. It was concluded that performance appraisal practices accounted for 36.9 percent of employee retention in the health sector in the County Government of Kakamega. The study recommended that organizations should effectively implement performance appraisal practices in various departments. The study findings may help to streamline the retention of staff in the health sector in Kakamega County by providing strategies of employee retention. The study provided a basis for future scholars, researchers and other stakeholders to use the results as a reference while also enabling researchers to carry out more investigation on other strategies that would increase employee retention. The County health sector HRM department would also gain from the findings of the study which would further enhance their skills in handling challenges of employee retention and understand factors which may have led to lack of employee retention.

Key Words: Performance appraisal, Employee Retention, County Government of Kakamega