Contextual influences on health worker motivation in district hospitals in Kenya

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dc.contributor.authorMbindyo, Patricken_ZA
dc.contributor.authorGilson, Lucyen_ZA
dc.contributor.authorBlaauw, Duaneen_ZA
dc.contributor.authorEnglish, Mikeen_ZA
dc.date.accessioned2015-10-30T09:36:27Z
dc.date.available2015-10-30T09:36:27Z
dc.date.issued2009en_ZA
dc.description.abstractBACKGROUND: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.identifier.apacitationMbindyo, 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/11427/14544en_ZA
dc.identifier.chicagocitationMbindyo, 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/11427/14544en_ZA
dc.identifier.citationMbindyo, 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.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
dc.identifier.urihttp://hdl.handle.net/11427/14544
dc.identifier.urihttp://dx.doi.org/10.1186/1748-5908-4-43
dc.identifier.vancouvercitationMbindyo 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.language.isoengen_ZA
dc.publisherBioMed Central Ltden_ZA
dc.publisher.departmentDepartment of Public Health and Family Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.holder2009 Mbindyo et al; licensee BioMed Central Ltd.en_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_ZA
dc.sourceImplementation Scienceen_ZA
dc.source.urihttp://www.implementationscience.com/en_ZA
dc.subject.otherHealth Workersen_ZA
dc.subject.otherMotivationen_ZA
dc.subject.otherKenyaen_ZA
dc.titleContextual influences on health worker motivation in district hospitals in Kenyaen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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