This paper describes factors affecting health worker motivation and satisfaction in the public sector in Ghana. The data are from a survey of public sector health care providers carried out in January 2002 and repeated in August 2003 using an interviewer administered structured questionnaire. It is part of a continuous quality improvement (CQI) effort in the health sector in the Greater Accra region of Ghana. Workplace obstacles identified that caused dissatisfaction and de-motivated staff in order of the most frequently mentioned were low salaries such that obtaining basic necessities of daily living becomes a problem; lack of essential equipment, tools and supplies to work with; delayed promotions; difficulties and inconveniences with transportation to work; staff shortages; housing, additional duty allowances and in-service (continuous) training. Others included children's education, vehicles to work with such as ambulances and pickups, staff transfer procedures, staff pre-service education inadequate for job requirements, and the effect of the job on family and other social factors. There were some differences in the percentages of staff selecting a given workplace obstacle between the purely rural districts, the highly urbanized Accra metropolis and the districts that were a mixture of urbanized and rural. It is unlikely that the Ghana Health Service can provide high quality of care to its end users (external customers) if workplace obstacles that de-motivate staff (internal customers) and negatively influence their performance are not properly recognized and addressed as a complex of inter-related problems producing a common result--dissatisfied poorly motivated staff and resulting poor quality services.
This qualitative study investigated community and family members' perceptions and attitudes toward persons living with HIV/AIDS (PLWHAs) in rural Ghana and how PLWHAs viewed themselves. The purpose was to provide insights into the nature and extent of HIV/AIDS-related stigma for program and policy interventions. Interviews and focus group discussions examined the stigma. Seventy-four participants 18 years and above (60 community members, 10 PLWHAs, 2 family members of PLWHAs, and 2 HIV/AIDS counselors) participated. Results showed that PLWHAs experienced various forms of negative perceptions, were stigmatized by community and family members, and held strong negative views of HIV/AIDS, which negatively affected the way they lived. To reduce HIV/AIDS related stigma in rural areas, HIV/AIDS education programs that call for strong community and family member support for PLWHAs are essential.
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