Document Type : Original Article

Authors

Department of Public Administration and Health Services Management, Business School, University of Ghana, Accra, Ghana

Abstract

Background: Motivation is a driver to health worker performance in most Ghanaian hospitals. In view of this, Ghana’s Ministry of Health has rolled out enough motivational policies to accentuate work performance of health workers.
Objective: The focus of this study was to examine the impact of motivation and identify how intrinsic and extrinsic motivating factors affect the work performance of health workers at Korle-Bu Teaching Hospital (KBTH). 
Methods: A qualitative approach was adopted for the study, and purposive sampling was used to select fifteen (15) health workers including both medics and paramedics. An in-depth interview guide and one-on-one interviews were adopted to collect data from the staff at Korle Bu Teaching Hospital. A thematic content analysis was used to analyze the transcribed data.
Results: Key findings from the study revealed that job satisfaction, logistic provision, and an enabling work environment are intrinsic motivating factors that affect the work performance of health workers; extrinsic factors such as financial reward, accommodation, and transportation also impact work performance. Furthermore, motivation is key to the work performance of nurses.
Conclusion: It is recommended that the National Midwifery and Nursing Council (NMC) and the Ministry of Health (MOH) adopt motivational policies based on the intrinsic and extrinsic motivational blocks.

Keywords

  1. Lambrou P, Kontodimopoulos N, Niakas D. Motivation and job satisfaction among medical and nursing staff in a Cyprus public general hospital. Hum Resour Health. 2010;8:26. [DOI]
  2. Steers RM, Porter LW, Bigley GA. Motivation and leadership at work: McGraw-Hill; 1996.
  3. Grafham E, Matheson C, Bond CM. Specialist drug misuse nurse's motivation, clinical decision-making and professional communication: an exploratory study. J Psychiatr Ment Health Nurs. 2004;11(6):690-7. [DOI]
  4. Nahavandi A, Malekzadeh AR, Mizzi PJ. Leaders and how they manage. J Bus Strategy. 1991;12(3):47-9. [DOI]
  5. Adams O, Hicks V, editors. Pay and non-pay incentives, performance and motivation. WHO’s workshop on a Global Health Workforce Strategy, Annecy, France; 2000.
  6. Henderson LN, Tulloch J. Incentives for retaining and motivating health workers in Pacific and Asian countries. Hum Resour Health. 2008;6:18. [DOI]
  7. Hongoro C, Normand C. Health workers: building and motivating the workforce. 2006.
  8. Franco LM, Bennett S, Kanfer R. Health sector reform and public sector health worker motivation: a conceptual framework. Soc Sci Med. 2002;54(8):1255-66. [DOI]
  9. Franco M, Haase H. Failure factors in small and medium-sized enterprises: qualitative study from an attributional perspective. Int Entrep Manag J. 2010;6(4):503-21. [DOI]
  10. Houston DJ. “Walking the walk” of public service motivation: Public employees and charitable gifts of time, blood, and money. J Public Adm Res Theory. 2006;16(1):67-86. [DOI]
  11. Paul F. Health Workers Motivation and the Role of Performance Based Finance Systems in Africa: A Qualitative Study on Health Worker Motivation and the Rwandan Performance Based Finance Initiative in District Hospitals. London School of Economics and Political Science working paper series. 2009:08-96.
  12. Dieleman M, Biemba G, Mphuka S, Sichinga-Sichali K, Sissolak D, van der Kwaak A, et al. 'We are also dying like any other people, we are also people': perceptions of the impact of HIV/AIDS on health workers in two districts in Zambia. Health Policy Plan. 2007;22(3):139-48. [DOI]
  13. Alhassan RK, Spieker N, van Ostenberg P, Ogink A, Nketiah-Amponsah E, de Wit TF. Association between health worker motivation and healthcare quality efforts in Ghana. Hum Resour Health. 2013;11:37. [DOI]
  14. Al-Ahmadi H. Factors affecting performance of hospital nurses in Riyadh Region, Saudi Arabia. Int J Health Care Qual Assur. 2009;22(1):40-54. [DOI]
  15. Parker PA, Kulik JA. Burnout, self- and supervisor-rated job performance, and absenteeism among nurses. J Behav Med. 1995;18(6):581-99. [DOI]
  16. Gauci Borda R, Norman IJ. Factors influencing turnover and absence of nurses: a research review. Int J Nurs Stud. 1997;34(6):385-94. [DOI]
  17. Judge TA, Thoresen CJ, Bono JE, Patton GK. The job satisfaction-job performance relationship: a qualitative and quantitative review. Psychol Bull. 2001;127(3):376-407. [DOI]
  18. Moneta GB, Siu CM. Trait Intrinsic and Extrinsic Motivations, Academic Performance, and Creativity in Hong Kong College Students. J Coll Stud Dev. 2002;43(5):664-83.
  19. AbuAlRub RF. Job stress, job performance, and social support among hospital nurses. J Nurs Scholarsh. 2004;36(1):73-8. [DOI]
  20. Huang J-J, Tzeng G-H, Ong C-S. Motivation and resource-allocation for strategic alliances through the DeNovo perspective. Math Comput Model. 2005;41(6):711-21. [DOI]
  21. Fort AL, Voltero L. Factors affecting the performance of maternal health care providers in Armenia. Hum Resour Health. 2004;2(1):8. [DOI]
  22. Mrayyan MT, Modallal R, Awamreh K, Atoum M, Abdullah M, Suliman S. Readiness of organizations for change, motivation and conflict-handling intentions: senior nursing students' perceptions. Nurse Educ Pract. 2008;8(2):120-8. [DOI]
  23. Vohs JL, Lysaker PH, Nabors L. Associations of personality with intrinsic motivation in schizophrenia. Psychiatry Res. 2013;208(1):78-80. [DOI]
  24. Dartey-Baah K, Amoako GK. Application of Frederick Herzberg's Two-Factor theory in assessing and understanding employee motivation at work: a Ghanaian Perspective. Eur J Bus Manag. 2011;3(9):1-8.
  25. Olu Ogunrin F, Ogunrin O, Akerele A. Motivating Nigerian doctors for improved health care delivery. Int J Health Care Qual Assur. 2007;20(4):290-306. [DOI]
  26. Hennessey B, Moran S, Altringer B, Amabile TM. Extrinsic and intrinsic motivation. Wiley Encyclopedia of Management. 2005.
  27. Robbins SP, Judge T. Essentials of organizational behavior: Prentice Hall Upper Saddle River; 2003.
  28. Bandura A. Social cognitive theory of personality. Handbook of personality: Theory and research. 1999:154-96.
  29. Amabile TM. Motivational synergy: Toward new conceptualizations of intrinsic and extrinsic motivation in the workplace. Hum Resour Manag Rev. 1993;3(3):185-201. [DOI]
  30. Lindenberg S. Intrinsic motivation in a new light. Kyklos. 2001;54(2‐3):317-42. [DOI]
  31. Deci EL, Ryan RM. The" what" and" why" of goal pursuits: Human needs and the self-determination of behavior. Psychol Inquiry. 2000;11(4):227-68. [DOI]
  32. Hornby P, Sidney E. Motivation and Health Systems Performance. WHO, WHO/EDUC/88.196; 1988.
  33. Van Lerberghe W, Conceicao C, Van Damme W, Ferrinho P. When staff is underpaid: dealing with the individual coping strategies of health personnel. Bull World Health Organ. 2002;80(7):581-4.
  34. Agyepong IA, Anafi P, Asiamah E, Ansah EK, Ashon DA, Narh-Dometey C. Health worker (internal customer) satisfaction and motivation in the public sector in Ghana. Int J Health Plann Manage. 2004;19(4):319-36. [DOI]
  35. Beaglehole R, Bonita R. Global public health: a new era: Oxford University Press; 2009. [DOI]
  36. Lepper MR, Greene D. Turning play into work: Effects of adult surveillance and extrinsic rewards on children's intrinsic motivation. J Pers Soc Psychol. 1975;31(3):479. [DOI]
  37. Neuman SB, Dickinson DK. Handbook of early literacy research: Guilford Press; 2003.
  38. Chaudry J, Jain A, McKenzie S, Schwartz RW. Physician leadership: the competencies of change. J Surg Educ. 2008;65(3):213-20. [DOI]
  39. Edward D, Ryan R. Intrinsic Motivation and Self-Determination in Human Behavior. New York: Pantheon. 1985.
  40. 40. Weissbein DA, Huang JL, Ford JK, Schmidt AM. Influencing learning states to enhance trainee motivation and improve training transfer. J Bus Psychol. 2011;26(4):423-35. [DOI]
  41. Oudejans R. Linking extrinsic and intrinsic motivation to job satisfaction and to motivational theories: a comparison between the public sector (nurses) and the private sector (call centre agents)(Top Thesis). 2007.
  42. Suominen T, Leino-Kilpi H, Merja M, Doran DI, Puukka P. Staff empowerment in Finnish intensive care units. Intensive Crit Care Nurs. 2001;17(6):341-7. [DOI]
  43. Yildiz Z, Ayhan S, Erdogmus S. The impact of nurses' motivation to work, job satisfaction, and sociodemographic characteristics on intention to quit their current job: an empirical study in Turkey. Appl Nurs Res. 2009;22(2):113-8. [DOI]
  44. Moody RC, Pesut DJ. The motivation to care: application and extension of motivation theory to professional nursing work. J Health Organ Manag. 2006;20(1):15-48. [DOI]
  45. Lopes SDF. Destination image: Origins, developments and implications. Pasos. 2011;9(2):305-15.
  46. 46. Adzei FA, Atinga RA. Motivation and retention of health workers in Ghana's district hospitals: addressing the critical issues. J Health Organ Manag. 2012;26(4-5):467-85. [DOI]
  47. Abdulsalam D, Mawoli MA. Motivation and job performance of academic staff of state universities in Nigeria: the case of Ibrahim Badamasi Babangida University, Lapai, Niger State. Intl J Bus Manag. 2012;7(14):142. [DOI]
  48. Chaudry J, Jain A, McKenzie S, Schwartz RW. Physician leadership: the competencies of change. J Surg Educ. 2008;65(3):213-20. [DOI]
  49. Mukuma Kyambi J. Influence of Human Resource Diversity Management Practices on Performance of Non-Commercial Government Agencies in Kenya. Kenya: Mukuma Kyambi Justin; 2015.
  50. Franko DL, Cousineau TM, Trant M, Green TC, Rancourt D, Thompson D, et al. Motivation, self-efficacy, physical activity and nutrition in college students: randomized controlled trial of an internet-based education program. Prev Med. 2008;47(4):369-77. [DOI]
  51. Snir R, Harpaz I, Burke R, Douglas EJ, Morris RJ. Workaholic, or just hard worker? Career Dev Int. 2006;11(5):394-417. [DOI]