Module 4: Building a Community of Health Workers(1)
The Problem of Low Motivation Among Health Workers
In developing countries, low motivation among health workers is a serious human resource problem in the health sector. Their low motivation stems from:
- A poorly-equipped healthcare system that lacks the means and supplies to facilitate high quality healthcare delivery. Health workers are deeply committed to their profession, and when they are unable to perform at the optimal level due to the lack of healthcare tools, they become frustrated.
- A deficient human resource management (HRM) system. This deficiency is a result primarily of poor leadership, lack of communication, and lack of feedback to evaluate health workers’ performance.
Combating Low Motivation to Improve Healthcare Delivery
“Efforts to strengthen health worker motivation must protect, promote and build upon the professional ethos of medical doctors and nurses. This entails appreciating their professionalism and addressing health workers’ professional goals such as recognition, career development and further qualification. It must be the aim of HRM and quality management to develop the work environment so that health workers are enabled to meet personal and organizational goals. This requires strengthening health workers’ self-efficacy by offering training and supervision, but also by ensuring the availability of essential means, materials and supplies as well as equipment and the provision of adequate working conditions that enable them to carry out their work appropriately.” (2)
While brain drain has crippling effects on healthcare systems in developing countries, low motivation of health workers is considered the second most urgent health workforce problem. Though rural healthcare facilities have a high demand for their services, they are often ill-equipped to deal with many health problems, an obstacle which demoralizes health workers because they are unable to operate effectively. Since low motivation is a “push factor” for migration of health workers from rural areas to the cities and overseas, HRM must draw upon its tools, comprising “the policies, practices and activities at the disposal of managers to obtain, develop, use, evaluate, maintain and retain the appropriate number, skill mix and motivation of employees to accomplish the organization’s objectives.”(3) HRM can try to combat low motivation in the following ways:
- Putting motivated, conscientious leaders in charge. Leaders must support and recognize the contributions of health workers. They must maintain communication with the health workers and treat them with respect. They should serve as role models to the health workers, keeping them motivated to meet organizational goals. In short, they should develop good working relationships with the health workers. In particular, superiors at healthcare facilities must possess good leadership skills. Ultimately, they have a direct impact on health workforce motivation because they shape the “style of participation, supervision and feedback, performance management and quality improvement activities.”(4)
- Client satisfaction surveys can be done to strengthen staff motivation. While recognition and appreciation from superiors are important, client satisfaction is of even greater importance. Health workers want to know that their work is having a positive impact on their patients.
- Health workers should be sent for periodic training sessions to upgrade their skills. After training, health workers in Kenya and Benin reported that they were more confident and comfortable in their work afterwards. By filling in the gaps in their knowledge, for example in HIV/AIDS treatment and management, they could carry out their duties more effectively. Moreover, they could also take on more demanding responsibilities as a result of the new skills acquired during their training stint.
- Health workers are motivated by the possibility of rising within the hierarchy of the health system. They want to reach a higher status and earn a higher income. Sponsoring the further education of health workers could boost their motivation.
- Health workers should be invited to participate in the decision making process within the healthcare facility. By holding regular meetings where they could share ideas and suggestions for improvements, health workers feel that their opinions matter. This increases workplace satisfaction, and motivation.
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Footnotes
(1) Adapted from Mathauer, Inke, and Ingo Imhoff . "Health worker motivation in Africa: the role of non-financial incentives and human resource management tools," Human Resources for Health 2006 4, 24 (2006): http://www.human-resources-health.com/content/pdf/1478-4491-4-24.pdf (accessed June 10, 2009).
(2) Ibid.
(3) Ibid.
(4) Ibid.