Can performance-based incentives improve motivation of nurses and midwives in primary facilities in northern Ghana? A quasi-experimental study
Autor: | Helen Prytherch, Gifty Apiung Aninanya, Natasha Howard, Eunice Karanja Kamara, Svetla Loukanova, John Williams, Easmon Otupiri, Benjamin Apam |
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Přispěvatelé: | Authors thank study participants for their contributions. We are grateful to Dr Cornelius Depbuur and Mr.Timothy Awine for technical support. Special thanks to Mr Vitus Atuah, Mr Moro Ali, and Mr Daniel Atinboan for assisting with data collection. Thanks |
Jazyk: | angličtina |
Rok vydání: | 2016 |
Předmět: |
health worker
Health Systems Maternal Health Public Health Qualitative property Performance-based incentives and Health worker motivation Ghana 03 medical and health sciences 0302 clinical medicine Nursing motivation Medicine 030212 general & internal medicine constructs of motivation performance-based incentives Service quality business.industry lcsh:Public aspects of medicine 030503 health policy & services Health Policy Public Health Environmental and Occupational Health Attendance lcsh:RA1-1270 Difference in differences Incentive Structured interview Workforce Job satisfaction Original Article 0305 other medical science business |
Zdroj: | Global Health Action; Vol 9 (2016): incl Supplements Global Health Action Global Health Action, Vol 9, Iss 0, Pp 1-10 (2016) |
ISSN: | 1654-9716 1654-9880 |
Popis: | Background : Lack of an adequate and well-performing health workforce has emerged as the biggest barrier to scaling up health services provision in sub-Saharan Africa. As the global community commits to the Sustainable Development Goals and universal health coverage, health workforce challenges are critical. In northern Ghana, performance-based incentives (PBIs) were introduced to improve health worker motivation and service quality. Objective : The goal of this study was to determine the impact of PBIs on maternal health worker motivation in two districts in northern Ghana. Design : A quasi-experimental study design with pre- and post-intervention measurement was used. PBIs were implemented for 2 years in six health facilities in Kassena-Nankana District with six health facilities in Builsa District serving as comparison sites. Fifty pre- and post-intervention structured interviews and 66 post-intervention in-depth interviews were conducted with health workers. Motivation was assessed using constructs for job satisfaction, pride, intrinsic motivation, timelines/attendance, and organisational commitment. Quantitative data were analysed to determine changes in motivation between intervention and comparison facilities pre- and post-intervention using STATA™ version 13. Qualitative data were analysed thematically using NVivo 10 to explore possible reasons for quantitative findings. Results : PBIs were associated with slightly improved maternal health worker motivation. Mean values for overall motivation between intervention and comparison health workers were 0.6 versus 0.7 at baseline and 0.8 versus 0.7 at end line, respectively. Differences at baseline and end line were 0.1 ( p =0.40 and p =0.50 respectively), with an overall 0.01 difference in difference ( p =0.90). Qualitative interviews indicated that PBIs encouraged health workers to work harder and be more punctual, increasing reported pride and job satisfaction. Conclusions : The results contribute evidence on the effects of PBIs on motivational constructs among maternal health workers in primary care facilities in northern Ghana. PBIs appeared to improve motivation, but not dramatically, and the long-term and unintended effects of their introduction require additional study. Keywords: Ghana; performance-based incentives; motivation; constructs of motivation; health worker (Published: 13 October 2016) Citation: Glob Health Action 2016, 9 : 32404 - http://dx.doi.org/10.3402/gha.v9.32404 |
Databáze: | OpenAIRE |
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