Factors associated with motivation among health care workers in public primary health care facilities in Dar es Salaam Tanzania

Abstract

Health workers' motivation is an important workforce challenge in Africa, which leads to a serious public health problem as far as delivery of health care services is concerned. Tanzania's health care system is foundationally built upon Primary Health Care Facilities (PHCF's). However, factors that motivate health workers to perform well at these essential facility levels are not clearly understood. Understanding the level of motivation to perform and associated factors among health workers at PHCF's is crucial in order to provide empirical bases for policy decisions and interventions to improve the quality of service especially in the light of ongoing Primary Health Service Development Program (PHSDP). A cross-sectional survey using a structured interview guide was carried out among 326 health care workers in the three municipalities of Dar es Salaam to assess the level of motivation to perform among health care workers working at public primary health care facilities. Data were analyzed using Stata program where univariate and multivariate analyses by Ordinal Least Square model was used to assess the factors associated with health workers motivation. The study results revealed that 71.8% of the health workers were motivated to perform their tasks well while 28.2% were de-motivated. Factors associated with motivation were observed at three main levels: the individual, organizational and socio-culturallevels. Both financial and non-financial incentives were seen to influence motivation. However, the main factors were found to be: community recognition/appreciation, fairness in performance assessment, reward system and education level. It is recommended that efforts be made by the MoHSW and PMO-RALG to formulate national guidelines for motivating the health workforce, council authorities to work out reward schemes for health workers; and health facility managers to establish mechanisms for good relations with communities and fair assessment procedures among health workers working at public primary health care facilities in Dar es Salaam.