TY - JOUR
T1 - Motivation and satisfaction among community health workers in Morogoro Region, Tanzania
T2 - Nuanced needs and varied ambitions
AU - Mpembeni, Rose N.M.
AU - Bhatnagar, Aarushi
AU - LeFevre, Amnesty
AU - Chitama, Dereck
AU - Urassa, David P.
AU - Kilewo, Charles
AU - Mdee, Rebecca M.
AU - Semu, Helen
AU - Winch, Peter J.
AU - Killewo, Japhet
AU - Baqui, Abdullah H.
AU - George, Asha
N1 - Funding Information:
This study was supported by USAID through the Health Research Challenge for Impact (HRC) Cooperative Agreement (#GHS-A-00-09-00004-00). The contents are the responsibility of JHSPH and MUHAS and do not necessarily reflect the views of USAID or the United States Government. The following are acknowledged for their contribution in one way or another during the planning, data collection and data management and during the development of this manuscript. JHSPH: Gupta Shivam, Joy Chebet MUHAS: Aisha Omary, Patrick Kazonda and the data collectors, Jhpiego: Giulia Besana, Elaine Charurat, Dunstan Bishanga, Maryjane Lacoste, Chrisostom Lipingu MOHSW: Neema Rusibamayila, Georgina Msemo
Publisher Copyright:
© 2015 Mpembeni et al.
PY - 2015/12/12
Y1 - 2015/12/12
N2 - Background: In 2012, the Ministry of Health and Social Welfare (MOHSW), Tanzania, approved national guidelines and training materials for community health workers (CHWs) in integrated maternal, newborn and child health (Integrated MNCH), with CHWs trained and deployed across five districts of Morogoro Region soon after. To inform future scale up, this study assessed motivation and satisfaction among these CHWs. Methods: A survey of all CHWs trained by the Integrated MNCH Programme was conducted in the last quarter of 2013. Motivation and satisfaction were assessed using a five-point Likert scale with 29 and 27 items based on a literature review and discussions with CHW programme stakeholders. Exploratory factor analysis was conducted to identify motivation and satisfaction determinants. Results: Out of 238 eligible CHWs, 96% were included in the study. Findings showed that respondents were motivated to become CHWs due to altruism (work on MNCH, desire to serve God, work hard) and intrinsic needs (help community, improve health, pride) than due to external stimuli (monetary incentives, skill utilization, community respect or hope for employment). CHWs were satisfied by relationships with health workers and communities, job aids and the capacity to provide services. CHWs were dissatisfied with the lack of transportation, communication devices and financial incentives for carrying out their tasks. Factors influencing motivation and satisfaction did not differ across CHW socio-demographic characteristics. Nonetheless, older and less educated CHWs were more likely to be motivated by altruism, intrinsic needs and skill utilization, community respect and hope for employment. Less educated CHWs were more satisfied with service and quality factors and more wealthy CHWs satisfied with job aids. Conclusion and recommendations: A combination of financial and non-financial incentives is required to support motivation and satisfaction among CHWs. Although CHWs joined mainly due to their altruistic nature, they became discontented with the lack of monetary compensation, transportation and communication support received. With the planned rollout of the national CHW cadre, improved understanding of CHWs as a heterogeneous group with nuanced needs and varied ambitions is vital for ensuring sustainability.
AB - Background: In 2012, the Ministry of Health and Social Welfare (MOHSW), Tanzania, approved national guidelines and training materials for community health workers (CHWs) in integrated maternal, newborn and child health (Integrated MNCH), with CHWs trained and deployed across five districts of Morogoro Region soon after. To inform future scale up, this study assessed motivation and satisfaction among these CHWs. Methods: A survey of all CHWs trained by the Integrated MNCH Programme was conducted in the last quarter of 2013. Motivation and satisfaction were assessed using a five-point Likert scale with 29 and 27 items based on a literature review and discussions with CHW programme stakeholders. Exploratory factor analysis was conducted to identify motivation and satisfaction determinants. Results: Out of 238 eligible CHWs, 96% were included in the study. Findings showed that respondents were motivated to become CHWs due to altruism (work on MNCH, desire to serve God, work hard) and intrinsic needs (help community, improve health, pride) than due to external stimuli (monetary incentives, skill utilization, community respect or hope for employment). CHWs were satisfied by relationships with health workers and communities, job aids and the capacity to provide services. CHWs were dissatisfied with the lack of transportation, communication devices and financial incentives for carrying out their tasks. Factors influencing motivation and satisfaction did not differ across CHW socio-demographic characteristics. Nonetheless, older and less educated CHWs were more likely to be motivated by altruism, intrinsic needs and skill utilization, community respect and hope for employment. Less educated CHWs were more satisfied with service and quality factors and more wealthy CHWs satisfied with job aids. Conclusion and recommendations: A combination of financial and non-financial incentives is required to support motivation and satisfaction among CHWs. Although CHWs joined mainly due to their altruistic nature, they became discontented with the lack of monetary compensation, transportation and communication support received. With the planned rollout of the national CHW cadre, improved understanding of CHWs as a heterogeneous group with nuanced needs and varied ambitions is vital for ensuring sustainability.
KW - Community health worker
KW - Financial incentives
KW - Motivation
KW - Non-financial incentives
KW - Satisfaction
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U2 - 10.1186/s12960-015-0035-1
DO - 10.1186/s12960-015-0035-1
M3 - Article
C2 - 26044146
AN - SCOPUS:85019212276
SN - 1478-4491
VL - 13
JO - Human resources for health
JF - Human resources for health
IS - 1
M1 - 44
ER -