265032 Unpacking the Drivers of Intrinsic Motivation for Health Workers in Malawi

Wednesday, October 31, 2012 : 9:15 AM - 9:30 AM

Allison Goldberg, PhD Candidate , Department of Sociomedical Sciences, Columbia University, Mailman School of Public Health, New York, NY
Ilana Ron Levey, MSc , International Health Division, Abt Associates Inc., Bethesda, MD
Background: Increasingly, human resource management efforts recognize that the intrinsic motivation of health workers is associated with higher levels of retention and service delivery performance. However, there are few nationally representative studies that measure and determine the predictors of intrinsic motivation across the entire health system, including for public, private for-profit and faith-based health workers.

Methods: The USAID-funded Health Systems 20/20 project conducted a nationally representative study in Malawi that employed both qualitative and quantitative data collection methods to assess statistically significant drivers of intrinsic motivation. 602 health workers of every cadre and 612 randomly sampled clients were included in the study.

Results: Across sectors and cadres, health workers' overall level of satisfaction with absolute levels of compensation is not significantly associated with their overall level of intrinsic motivation. However, satisfaction with the fairness of compensation is a significant driver of motivation. The strongest drivers of motivation are not financial and include professional development opportunities, facility recognition, and opportunities for promotion. Contrary to anecdote, public sector workers demonstrated the highest levels of intrinsic motivation. Analyses indicate weak relationships between clients' overall satisfaction with their provider and health workers' perceptions about their jobs.

Conclusions: Non-financial incentives are sustainable and are statistically associated with increases in intrinsic motivation and job satisfaction for health workers. Motivation-based incentives may be more effective in promoting job satisfaction and retention than financial incentives. Client perceptions of care and satisfaction with services are associated with variables other than health worker motivation levels.

Learning Areas:
Public health or related research

Learning Objectives:
Determine the levels of intrinsic motivation, retention, and performance for health workers in public, faith-based (Christian Health), and private for-profit facilities in Malawi Determine the drivers of intrinsic motivation for health workers in the public, faith-based (Christian Health), and private for-profit facilities in Malawi Determine whether client perceptions of the quality of the health services that they receive impact health worker motivation and job satisfaction in Malawi

Keywords: Workforce, International Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an Associate at Abt Associates. In this role, I led the study design and data collector training for this study. I also co-authored the study report that was disseminated to USAID and the Ministry of Health of Malawi.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.