Contextual influences on health worker motivation in district hospitals in Kenya

 

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dc.contributor.author Mbindyo, Patrick en_ZA
dc.contributor.author Gilson, Lucy en_ZA
dc.contributor.author Blaauw, Duane en_ZA
dc.contributor.author English, Mike en_ZA
dc.date.accessioned 2015-10-30T09:36:27Z
dc.date.available 2015-10-30T09:36:27Z
dc.date.issued 2009 en_ZA
dc.identifier.citation Mbindyo, P., Gilson, L., Blaauw, D., & English, M. (2009). Contextual influences on health worker motivation in district hospitals in Kenya. Implementation Science, 4(1), 43. en_ZA
dc.identifier.uri http://hdl.handle.net/11427/14544
dc.identifier.uri http://dx.doi.org/10.1186/1748-5908-4-43
dc.description.abstract BACKGROUND:Organizational factors are considered to be an important influence on health workers' uptake of interventions that improve their practices. These are additionally influenced by factors operating at individual and broader health system levels. We sought to explore contextual influences on worker motivation, a factor that may modify the effect of an intervention aimed at changing clinical practices in Kenyan hospitals. METHODS: Franco LM, et al's (Health sector reform and public sector health worker motivation: a conceptual framework. Soc Sci Med. 2002, 54: 1255-66) model of motivational influences was used to frame the study Qualitative methods including individual in-depth interviews, small-group interviews and focus group discussions were used to gather data from 185 health workers during one-week visits to each of eight district hospitals. Data were collected prior to a planned intervention aiming to implement new practice guidelines and improve quality of care. Additionally, on-site observations of routine health worker behaviour in the study sites were used to inform analyses. RESULTS: Study settings are likely to have important influences on worker motivation. Effective management at hospital level may create an enabling working environment modifying the impact of resource shortfalls. Supportive leadership may foster good working relationships between cadres, improve motivation through provision of local incentives and appropriately handle workers' expectations in terms of promotions, performance appraisal processes, and good communication. Such organisational attributes may counteract de-motivating factors at a national level, such as poor schemes of service, and enhance personally motivating factors such as the desire to maintain professional standards. CONCLUSION: Motivation is likely to influence powerfully any attempts to change or improve health worker and hospital practices. Some factors influencing motivation may themselves be influenced by the processes chosen to implement change. en_ZA
dc.language.iso eng en_ZA
dc.publisher BioMed Central Ltd en_ZA
dc.rights This is an Open Access article distributed under the terms of the Creative Commons Attribution License en_ZA
dc.rights.uri http://creativecommons.org/licenses/by/2.0 en_ZA
dc.source Implementation Science en_ZA
dc.source.uri http://www.implementationscience.com/ en_ZA
dc.subject.other Health Workers en_ZA
dc.subject.other Motivation en_ZA
dc.subject.other Kenya en_ZA
dc.title Contextual influences on health worker motivation in district hospitals in Kenya en_ZA
dc.type Journal Article en_ZA
dc.rights.holder 2009 Mbindyo et al; licensee BioMed Central Ltd. en_ZA
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Department of Public Health and Family Medicine en_ZA
uct.type.filetype Text
uct.type.filetype Image
dc.identifier.apacitation Mbindyo, P., Gilson, L., Blaauw, D., & English, M. (2009). Contextual influences on health worker motivation in district hospitals in Kenya. <i>Implementation Science</i>, http://hdl.handle.net/11427/14544 en_ZA
dc.identifier.chicagocitation Mbindyo, Patrick, Lucy Gilson, Duane Blaauw, and Mike English "Contextual influences on health worker motivation in district hospitals in Kenya." <i>Implementation Science</i> (2009) http://hdl.handle.net/11427/14544 en_ZA
dc.identifier.vancouvercitation Mbindyo P, Gilson L, Blaauw D, English M. Contextual influences on health worker motivation in district hospitals in Kenya. Implementation Science. 2009; http://hdl.handle.net/11427/14544. en_ZA
dc.identifier.ris TY - Journal Article AU - Mbindyo, Patrick AU - Gilson, Lucy AU - Blaauw, Duane AU - English, Mike AB - BACKGROUND:Organizational factors are considered to be an important influence on health workers' uptake of interventions that improve their practices. These are additionally influenced by factors operating at individual and broader health system levels. We sought to explore contextual influences on worker motivation, a factor that may modify the effect of an intervention aimed at changing clinical practices in Kenyan hospitals. METHODS: Franco LM, et al's (Health sector reform and public sector health worker motivation: a conceptual framework. Soc Sci Med. 2002, 54: 1255-66) model of motivational influences was used to frame the study Qualitative methods including individual in-depth interviews, small-group interviews and focus group discussions were used to gather data from 185 health workers during one-week visits to each of eight district hospitals. Data were collected prior to a planned intervention aiming to implement new practice guidelines and improve quality of care. Additionally, on-site observations of routine health worker behaviour in the study sites were used to inform analyses. RESULTS: Study settings are likely to have important influences on worker motivation. Effective management at hospital level may create an enabling working environment modifying the impact of resource shortfalls. Supportive leadership may foster good working relationships between cadres, improve motivation through provision of local incentives and appropriately handle workers' expectations in terms of promotions, performance appraisal processes, and good communication. Such organisational attributes may counteract de-motivating factors at a national level, such as poor schemes of service, and enhance personally motivating factors such as the desire to maintain professional standards. CONCLUSION: Motivation is likely to influence powerfully any attempts to change or improve health worker and hospital practices. Some factors influencing motivation may themselves be influenced by the processes chosen to implement change. DA - 2009 DB - OpenUCT DO - 10.1186/1748-5908-4-43 DP - University of Cape Town J1 - Implementation Science LK - https://open.uct.ac.za PB - University of Cape Town PY - 2009 T1 - Contextual influences on health worker motivation in district hospitals in Kenya TI - Contextual influences on health worker motivation in district hospitals in Kenya UR - http://hdl.handle.net/11427/14544 ER - en_ZA


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