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. 2006 Aug 29:4:24.
doi: 10.1186/1478-4491-4-24.

Health worker motivation in Africa: the role of non-financial incentives and human resource management tools

Inke Mathauer  1 , Ingo Imhoff
Affiliations

Health worker motivation in Africa: the role of non-financial incentives and human resource management tools

Inke Mathauer et al. Hum Resour Health. .

Abstract

Background: There is a serious human resource crisis in the health sector in developing countries, particularly in Africa. One of the challenges is the low motivation of health workers. Experience and the evidence suggest that any comprehensive strategy to maximize health worker motivation in a developing country context has to involve a mix of financial and non-financial incentives. This study assesses the role of non-financial incentives for motivation in two cases, in Benin and Kenya.

Methods: The study design entailed semi-structured qualitative interviews with doctors and nurses from public, private and NGO facilities in rural areas. The selection of health professionals was the result of a layered sampling process. In Benin 62 interviews with health professionals were carried out; in Kenya 37 were obtained. Results from individual interviews were backed up with information from focus group discussions. For further contextual information, interviews with civil servants in the Ministry of Health and at the district level were carried out. The interview material was coded and quantitative data was analysed with SPSS software.

Results and discussion: The study shows that health workers overall are strongly guided by their professional conscience and similar aspects related to professional ethos. In fact, many health workers are demotivated and frustrated precisely because they are unable to satisfy their professional conscience and impeded in pursuing their vocation due to lack of means and supplies and due to inadequate or inappropriately applied human resources management (HRM) tools. The paper also indicates that even some HRM tools that are applied may adversely affect the motivation of health workers.

Conclusion: The findings confirm the starting hypothesis that non-financial incentives and HRM tools play an important role with respect to increasing motivation of health professionals. Adequate HRM tools can uphold and strengthen the professional ethos of doctors and nurses. This entails acknowledging their professionalism and addressing professional goals such as recognition, career development and further qualification. It must be the aim of human resources management/quality management (HRM/QM) to develop the work environment so that health workers are enabled to meet their personal and the organizational goals.

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Figures

Figure 1
Figure 1
Motivational determinants and processes.
Figure 2
Figure 2
Self-assessment of motivation level.
Figure 3
Figure 3
Aspects that encourage to do one's work well, in %, in Benin (N = 62), Kenya (N = 37).
Figure 4
Figure 4
Benin: "How to boost your spirit and willingness to perform" (in %, multiple responses, N = 62).
Figure 5
Figure 5
Preferred source of appreciation.
See this image and copyright information in PMC

References

    1. World Bank World Development Report 2004: Making Services Work for Poor People Washington, DC. 2003.
    1. World Health Organization Working Together for Health The World Health Report 2006 Geneva. 2006.
    1. Mutizwa-Mangiza D. The Impact of Health Sector Reform on Public Sector Health Worker Motivation in Zimbabwe Major Applied Research 5, Working Paper 4. Bethesda, Maryland: Partnership for Health Reform Project; 1998.
    1. Franco LM, Bennett S, Kanfer R, Stubblebine P. Health Worker Motivation in Jordan and Georgia: A Synthesis of the Results Major Applied Research 5, Technical Paper 3. Bethesda, Maryland: Partnership for Health Reform Project; 2000.
    1. Schmidt-Ehry B, Seidel W. Human resources development. In: GTZ, editor. The District Health System Experience and Prospects in Africa Manual for Public Health Practitioners. Eschborn: GTZ; 2003. pp. 121–144.

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