Health sector reform and public sector health worker motivation: a conceptual framework
Health sector reform and public sector health worker motivation: a conceptual framework
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DOI：
10.1016/s0277-9536(01)00094-6
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发表时间：
2002-04-01
影响因子：
5.4
通讯作者：
Kanfer, R
中科院分区：
文献类型：
--
作者：
Franco, LM;Bennett, S;Kanfer, R
工作环境中的动机可以定义为个人为实现组织目标而努力并保持努力的意愿程度。卫生部门的绩效在很大程度上取决于工作人员的积极性，服务质量、效率和公平性都直接取决于工作人员是否愿意投入工作。资源的可利用性和员工的能力是必不可少的，但不足以确保理想的员工绩效。虽然经济激励可能是员工激励的重要决定因素，但它们本身不能也没有解决所有的员工激励问题。员工激励是一个复杂的过程，跨越了许多学科的界限，包括经济学，心理学，组织发展，人力资源管理和社会学。本文讨论了影响卫生工作者动机的多个层面：内部的个人层面的决定因素，在组织运作的决定因素，卫生部门的改革可能会影响到组织文化、报告结构、人力资源管理、问责渠道，类型的互动与客户和社区等。本文所描述的概念模型阐明了如何影响工人的动机，以及如何健康看到，或改革可以积极影响工人的动机。还有其他人卫生部门决策者可以更好地促进目标一致性（工人与其工作的组织之间的关系），并通过在设计和实施卫生部门改革时考虑以下因素，提高工人的积极性：解决激励工人的多种渠道，认识到沟通和领导对改革的重要性，确定可能促进或阻碍改革实施的组织和文化价值观，和理解改革可能对不同的卫生工作者骨干产生不同的影响。(C)2002爱思唯尔科技有限公司版权所有。
Motivation in the work context can be defined as an individual's degree of willingness to exert and maintain an effort towards organizational goals. Health sector performance is critically dependent on worker motivation, with service quality, efficiency, and equity, all directly mediated by workers' willingness to apply themselves to their tasks. Resource availability and worker competence are essential but not sufficient to ensure desired worker performance.While financial incentives may be important determinants of worker motivation, they alone cannot and have not resolved all worker motivation problems, Worker motivation is a complex process and crosses many disciplinary boundaries, including economics, psychology, organizational development, human resource management, and sociology. This paper discusses the many layers of influences upon health worker motivation: the internal individual-level determinants, determinants that operate at organizational (work context) level, and determinants stemming from interactions with the broader societal culture.Worker motivation will be affected by health sector reforms which potentially affect organizational culture, reporting structures, human resource management, channels of accountability, types of interactions with clients and communities, etc.The conceptual model described in this paper clarifies ways in which worker motivation is influenced and how health see, or reform can positively affect worker motivation. Among others. health sector policy makers can better facilitate goal congruence (between workers and the organizations they work for) and improved worker motivation by considering the following in their design and implementation of health sector reforms: addressing multiple channels for worker motivation, recognizing the importance of communication and leadership for reforms, identifying organizational and cultural values that might facilitate or impede implementation of reforms, and understanding. that reforms may have differential impacts on various cadres of health workers. (C) 2002 Elsevier Science Ltd. All rights reserved.