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Key factors influencing motivation among health extension workers and health care professionals in four regions of Ethiopia: a cross-sectional study

Article scientifique 2020 Anglais

Résumé

Abstract Background: Although Ethiopia has improved access to health care in recent years, quality of care remains low. Health worker motivation is an important determinant of performance and affects quality of care. This study explores the level and construction of motivation among health extension workers (HEWs) and health care professionals in Ethiopia in baseline data collection of an evaluation of a quality improvement program run by the Institute of Healthcare Improvement (IHI). Methods: We conducted face to face quantitative surveys with providers to elicit motivation level and construction. We sampled 401 health system workers: skilled providers including nurses and midwives (n=110), HEWs (n=210), and non-patient facing health system staff (n=81). Participants completed a 30-item Likert scale ranking tool which asked questions across 17 domains. We used exploratory factor analysis to explore motivation construction, and ordinary least squares (OLS) regression to explore determinants of motivation level and construction. Results: Of the 397 interviewees with complete data, 61% (95% CI 56%-66%) self-reported motivation as “very good” or “excellent”. Significant variation in motivation was seen across regions with Southern Nations Nationalities and People’s Region (SNNPR) being significantly lower score on the Likert scale by 0.35 points (P=0.003). Those who had a medium workload were significantly less motivated compared to participants with a light workload by 0.48 Likert points (P=0.024). The exploratory factor analysis identified a three-factor model to best fit with factors described as: personal and altruistic goals; pride and personal satisfaction; and recognition and support. Personal and altruistic goals varied across regions with Oromia and SNNPR being significantly lower by 0.13 (P=0.018) and 0.12 Likert points (P=0.039) respectively. A regression analysis found that as job satisfaction increased by 1 personal and altruistic goal, increased by 0.34 (P=0.001). Pride and personal satisfaction scores vary among regions with SNNPR being significantly lower by 0.11 Likert points (P=0.051) as compared to Amhara region. Recognition support was significantly higher in health care providers relative to HEWs by 0.12 Likert point (P=0.053). Conclusions: Overall, motivation was high among participants and varied across region, cadre, and age. Workload, leave, and job satisfaction were associated factors with motivation.

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Adillo, M., Mulissa, Z., Desta, B., Alemayehu, A., Kefale, A., Keraga, D., Gebreselassie, H., Ahmed, Y., Estifanos, A., Magge, H., Parry, G., Quaife, M. (2020). Key factors influencing motivation among health extension workers and health care professionals in four regions of Ethiopia: a cross-sectional study. https://doi.org/10.21203/rs.3.rs-15944/v1

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Auteur(s)

Mehiret Abate Adillo Zewdie Mulissa Befikadu Bitewulign Desta Abiyou Kiflie Alemayehu Abera Biadgo Kefale Dorka Woldesenbet Keraga Haregeweyni Alemu Gebreselassie Yakob Seman Ahmed Abiy Seifu Estifanos Hema Magge Gareth Parry Matthew Quaife

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