Motivation and satisfaction among community health workers in Morogoro Region, Tanzania: nuanced needs and varied ambitions

Human Resources for Health

Asha George³  Abdullah H Baqui³  Japhet Killewo²  Peter J Winch³  Helen Semu⁴  Rebecca M Mdee¹  Charles Kilewo²  David P Urassa²  Dereck Chitama²  Amnesty LeFevre³  Aarushi Bhatnagar³  Rose N M Mpembeni² 

[1] Jhpiego, Bagamoyo Road, Victoria Area, Dar es Salaam, Tanzania;Muhimbili University of Health and Allied Sciences, School of Public Health and Social Sciences, Dar-es-Salaam, Tanzania;Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore 21205, MD, USA;Tanzania Ministry of Health and Social Welfare, Health Promotion Section, 6 Samora Machel Avenue, Dar es Salaam, 11478, Tanzania

关键词: Financial incentives;    Non-financial incentives;    Satisfaction;    Motivation;    Community health worker;   

Others  :  1213772
DOI  :  10.1186/s12960-015-0035-1

 received in 2014-11-24, accepted in 2015-05-22,  发布年份 2015

【 摘 要 】

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.

【 授权许可】

   
2015 Mpembeni et al.

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