Health worker motivation in Africa: the role of non-financial incentives and human resource management tools.
Health worker motivation in Africa: the role of non-financial incentives and human resource management tools.
复制标题
DOI：
10.1186/1478-4491-4-24
复制
发表时间：
2006-08-29
影响因子：
4.5
通讯作者：
Imhoff, Ingo
中科院分区：
文献类型：
--
作者：
Mathauer, Inke;Imhoff, Ingo
发展中国家，特别是非洲国家的卫生部门存在严重的人力资源危机。挑战之一是卫生工作者的积极性低。经验和证据表明，在发展中国家，任何最大限度地调动卫生工作者积极性的综合战略都必须包括财政和非财政激励措施。本研究评估了贝宁和肯尼亚两个国家的非经济激励措施对激励的作用。这项研究的设计需要半结构化的定性访谈的医生和护士从公共，私人和非政府组织在农村地区的设施。卫生专业人员的选择是分层抽样过程的结果。在贝宁，与卫生专业人员进行了62次访谈;在肯尼亚，进行了37次访谈。个别访谈的结果得到了焦点小组讨论信息的支持。为了进一步了解情况，对卫生部和地区一级的公务员进行了访谈。对访谈材料进行编码，并对定量数据进行SPSS软件分析。研究表明，卫生工作者总体上受到其职业良知和与职业精神有关的类似方面的强烈指导。事实上，许多卫生工作者之所以丧失动力和感到沮丧，正是因为他们无法满足自己的职业良知，而且由于缺乏手段和用品以及人力资源管理工具不足或应用不当，他们从事职业的努力受到阻碍。该文件还指出，即使是一些人力资源管理工具的应用可能会对卫生工作者的积极性产生不利影响。研究结果证实了初始假设，即非经济激励措施和人力资源管理工具在提高卫生专业人员的积极性方面发挥了重要作用。适当的人力资源管理工具可以维护和加强医生和护士的专业精神。这就需要承认他们的专业精神，并解决专业目标，如认可、职业发展和进一步的资格。人力资源管理/质量管理的目标必须是发展工作环境，使卫生工作者能够实现其个人和组织目标。
There is a serious human resource crisis in the health sector in developing countries, particularly in Africa. One of the challenges is the low motivation of health workers. Experience and the evidence suggest that any comprehensive strategy to maximize health worker motivation in a developing country context has to involve a mix of financial and non-financial incentives. This study assesses the role of non-financial incentives for motivation in two cases, in Benin and Kenya. The study design entailed semi-structured qualitative interviews with doctors and nurses from public, private and NGO facilities in rural areas. The selection of health professionals was the result of a layered sampling process. In Benin 62 interviews with health professionals were carried out; in Kenya 37 were obtained. Results from individual interviews were backed up with information from focus group discussions. For further contextual information, interviews with civil servants in the Ministry of Health and at the district level were carried out. The interview material was coded and quantitative data was analysed with SPSS software. The study shows that health workers overall are strongly guided by their professional conscience and similar aspects related to professional ethos. In fact, many health workers are demotivated and frustrated precisely because they are unable to satisfy their professional conscience and impeded in pursuing their vocation due to lack of means and supplies and due to inadequate or inappropriately applied human resources management (HRM) tools. The paper also indicates that even some HRM tools that are applied may adversely affect the motivation of health workers. The findings confirm the starting hypothesis that non-financial incentives and HRM tools play an important role with respect to increasing motivation of health professionals. Adequate HRM tools can uphold and strengthen the professional ethos of doctors and nurses. This entails acknowledging their professionalism and addressing professional goals such as recognition, career development and further qualification. It must be the aim of human resources management/quality management (HRM/QM) to develop the work environment so that health workers are enabled to meet their personal and the organizational goals.