Intrinsic and extrinsic motivational factors of frontline health workers in Ghana

Abstract

Background: Human resources are vital for delivering health services, and health systems cannot function effectively without enough skilled, motivated, and well-supported health workers. Even though several studies have addressed job satisfaction among healthcare professionals in different parts of the world, there is limited research examining intrinsic and extrinsic motivational factors involved in job satisfaction, particularly in low-and-middle-income countries. Methods: This was a facility-based quantitative cross-sectional study conducted in 34 primary health care facilities, across three out of the 26 districts in the Eastern Region of Ghana, between February and March 2018, analyzing job satisfaction and underlying factors. Randomly selected public health workers (n=287) from health facilities were included in the study. The two-factor theory was adopted as the measurement model for this study. Results: The odds of staff that had received management training in the past 12 months being intrinsically satisfied was 3.73 (95% CI:2.03,6.86) times higher than staff with no management training (p<0.001). Compared to staff working in hospitals, Community-based Health Planning and Services (CHPS) staff showed lower levels of satisfaction on factors relating to intrinsic motivation. Technical staff had higher odds of being intrinsically and extrinsically satisfied compared to non-technical staff. Conclusions: Public healthcare workers working at primary health facilities in Ghana, at higher levels of service delivery, showed higher satisfaction compared to lower-level staff, both in terms of intrinsic and extrinsic factors underlying satisfaction. Thus, to enhance healthcare services, health facilities’ administrators should take measures to improve the working conditions of staff at all levels of service delivery, since the hierarchy of service delivery in the health system makes the contributory role of all staff critical in improving the quality of primary healthcare.