1. Charles Normand Trinity College Dublin for the Motivation Project Team
The Relative Importance of Different Motivational Determinants for Different Categories of Health Workers in South Africa, Tanzania And Malawi
Charles Normand
Trinity College Dublin
for the Motivation Project Team

2. Rationale & Objectives
Well-defined list of factors influencing the motivation of health workers
But no data on the relative importance of different motivational incentives
Little known about preferences of different categories of health workers in different countries
Use a Discrete Choice Experiment (DCE) to measure the relative importance of different motivational incentives to different categories of health workers in South Africa, Tanzania and Malawi

3. Methods Discrete choice experiment (DCE) Preparatory work
Quantify relative importance of different motivational attributes on respondent choices
Survey of health professionals in each country
Stratified cluster sample
Self-administered questionnaire
Preparatory work
Literature review, Country case studies, Several iterations of design, Pilot studies
Used SAS program to generate optimal D-efficient design

4. DCE Questionnaire Generic design Two choices 8 different incentives
16 choice sets
Focus on Motivation

5. DCE Results

6. DCE Ranking – By Country

7. DCE Rank – By HW in Malawi

8. Statistically Significant Interactions: Malawi
Male
<30 yrs
Single
Children
Compared to EN
Satisfied RN CO
Allied
Small town +
Large town
Main city –
25% Salary increase
50% Salary increase
75% Salary increase
Staffing levels
Availability of drugs & equipment
Training opportunities
Promotion opportunities
Recognition from manager
Respect from local community

9. Conclusions
The relative importance of different motivational incentives differs between countries.
Training opportunities and salary are the most important motivational incentives.
Doctors and registered nurses are less motivated to work in rural areas.
Satisfied health workers are less motivated by financial incentives.
South African health workers have high levels of dissatisfaction and low organisational commitment.

10. Policy Recommendations
Developing training opportunities would be a powerful motivational incentive.
Health workers will need to be compensated to persuade them to work in rural areas.
Need to pay more attention to building respect from managers and local community.
Regular staff satisfaction surveys should be part of HR management information systems.

11. The End Thank you for your attention