Motivation and incentive preferences of community health officers in Ghana: an economic behavioral experiment approach

Human Resources for Health

Research

Junko Yasuoka¹  Akira Shibanuma¹  Kimiyo Kikuchi¹  Sumiyo Okawa¹  Masamine Jimba¹  Margaret Gyapong²  Enoch Oti Agyekum³  Sakiko Shiratori⁴  Seth Owusu-Agyei⁵  Yeetey Enuameh⁶  Abraham Oduro⁷  Evelyn Ansah⁸  Abraham Hodgson⁸ 

[1] Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, 113-0033, Tokyo, Japan;Dodowa Health Research Centre, P.O Box DD1, Dodowa, Accra, Ghana;Japan International Cooperation Agency Health Section, 2nd Floor, The Elizabeth, No. 68A Senchi Link, Airport Residential Area, Accra, Ghana;Japan International Research Center for Agricultural Sciences, 1-1, Ohwashi, 305-8686, Tsukuba, Ibaraki, Japan;Kintampo Health Research Centre, P.O. Box 200, Kintampo, Brong-Ahafo Region, Ghana;Kintampo Health Research Centre, P.O. Box 200, Kintampo, Brong-Ahafo Region, Ghana;Department of Epidemiology & Biostatistics, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana;Navrongo Health Research Centre, P.O. Box 114, Navrongo, Upper-East Region, Ghana;Research and Development Division, Ghana Health Service, MB 190, Accra, Ghana;

关键词: Community health;    Discrete choice experiment;    Ghana;    Health worker;    Incentive;    Job preference;    Mixed logit;    Motivation;   

DOI  :  10.1186/s12960-016-0148-1

 received in 2015-07-21, accepted in 2016-08-04,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundHealth worker shortage in rural areas is one of the biggest problems of the health sector in Ghana and many developing countries. This may be due to fewer incentives and support systems available to attract and retain health workers at the rural level. This study explored the willingness of community health officers (CHOs) to accept and hold rural and community job postings in Ghana.MethodsA discrete choice experiment was used to estimate the motivation and incentive preferences of CHOs in Ghana. All CHOs working in three Health and Demographic Surveillance System sites in Ghana, 200 in total, were interviewed between December 2012 and January 2013. Respondents were asked to choose from choice sets of job preferences. Four mixed logit models were used for the estimation. The first model considered (a) only the main effect. The other models included interaction terms for (b) gender, (c) number of children under 5 in the household, and (d) years worked at the same community. Moreover, a choice probability simulation was performed.ResultsMixed logit analyses of the data project a shorter time frame before study leave as the most important motivation for most CHOs (β 2.03; 95 % CI 1.69 to 2.36). This is also confirmed by the largest simulated choice probability (29.1 %). The interaction effect of the number of children was significant for education allowance for children (β 0.58; 95 % CI 0.24 to 0.93), salary increase (β 0.35; 95 % CI 0.03 to 0.67), and housing provision (β 0.16; 95 % CI −0.02 to 0.60). Male CHOs had a high affinity for early opportunity to go on study leave (β 0.78; 95 % CI −0.06 to 1.62). CHOs who had worked at the same place for a long time greatly valued salary increase (β 0.28; 95 % CI 0.09 to 0.47).ConclusionsTo reduce health worker shortage in rural settings, policymakers could provide “needs-specific” motivational packages. They should include career development opportunities such as shorter period of work before study leave and financial policy in the form of salary increase to recruit and retain them.

【 授权许可】

CC BY   
© The Author(s). 2016