IFGH 2012: Influences on the Motivation, Performance and Job Satisfaction of Primary Health Care Providers in Rural Tanzania

Authors:Prytherch H.¹, Kakoko DCV. 2, Leshabari MT.², Marx M. 1, Sauerborn R.¹

Author Affiliations: 1Institute of Public Health, University of Heidelberg, Germany, 2 School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Tanzania

Option 1– Scientific / Empirical Research Findings

Presented as – Oral Presentation

Aims:

This study was conducted in the frame of the QUALMAT research project which seeks to improve the quality of Maternal and Neonatal health (MNH) care in rural sub-Saharan Africa. It was undertaken in Tanzania to gain a detailed insight into the influences on MNH provider motivation, performance and job satisfaction.

Methods:

35 in-depth interviews were conducted with primary level MNH providers and their managers. The interview guideline development was led by Tanzanian psychologists, sociologists and health professionals.

Results:

Key sources of encouragement include community appreciation, perceived government and development partner support for MNH, and on-the-job learning. Discouragements are overwhelmingly financial in nature, but also include facility understaffing and the resulting workload, malfunction of the promotion system as well as health and safety and security issues. Low level cadres are found to be particularly discouraged. Difficulties and weaknesses in the management of rural facilities are found. Basic steps that could improve performance appear to be overlooked. Motivation is generally referred to as being fair or low. The providers derive quite a strong degree of satisfaction, of an intrinsic nature, from their work.

Discussion/conclusions/ implications:

The influences on MNH provider motivation, performance and satisfaction are shown to be complex and to span different levels. Variations in the use of terms and concepts pertaining to motivation are revealed, and further clarification is needed. Intrinsic rewards play a role in continued provider willingness to exert an effort at work. The critical nature of MNH and the rural setting readily expose a health workers performance. The causes of discouragement can be broadly divided into those requiring renewed policy attention and those which could be addressed by strengthening the skills of rural facility managers, enhancing the status of their role and increasing the support they receive from higher levels of the health system.