Measuring health workers’ motivation composition: validation of a scale based on Self-Determination Theory in Burkina Faso

Lohmann, Julia; Souares, Aurélia; Tiendrebeogo, J P; Houlfort, Nathalie; Robyn, Paul Jacob; Somda, Serge; Allegri, Manuela De

doi:10.1186/s12960-017-0208-1

Cited by 36 publications

(52 citation statements)

References 39 publications

(54 reference statements)

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“…PBF is a policy reform that aims to directly influence health worker behavior through several mechanisms, including changes to institutional arrangements, accountability structures, and financial incentives based on performance [ 20 , 23 – 25 ]. The increasing use of PBF demands a more in-depth and comprehensive understanding of how PBF influences health worker motivation and behavior [ 25 – 27 ]. Research on PBF indicates that some PBF schemes do have the capacity to enhance overall motivation for providing PBF-targeted services [ 18 , 28 – 31 ].…”

Section: Discussionmentioning

confidence: 99%

Performance-based financing kick-starts motivational “feedback loop”: findings from a process evaluation in Mozambique

Gergen¹,

Rajkotia²,

Lohmann

et al. 2018

Hum Resour Health

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BackgroundPerformance-based financing (PBF) reforms aim to directly influence health worker behavior through changes to institutional arrangements, accountability structures, and financial incentives based on performance. While there is still some debate about whether PBF influences extrinsic or intrinsic motivators, recent research finds that PBF affects both. Against this backdrop, our study presents findings from a process evaluation of a PBF program in Mozambique, exploring the perceived changes to both internal and external drivers of health worker motivation associated with PBF.MethodsWe used a qualitative research design with in-depth, semi-structured interviews with health workers, which included a rank order exercise and focus group discussions. Interviews were analyzed by two researchers using thematic analysis techniques. Rank order frequency was calculated using weighted average methodology.ResultsHealth workers reported that PBF, overall, positively influenced their motivation by introducing or reinforcing both internal and external motivational drivers. Internal drivers included enhanced self-efficacy driven by goal orientation, healthy competition among colleagues, and job satisfaction. External drivers included an organized work environment, enhanced access to equipment and supplies, financial incentives, teamwork, and regular consultations with verifiers (a type of supervision). PBF stimulates an interactive relationship between internal and external motivational drivers, creating a feedback loop involving responsibility, achievement, and recognition, which increased perceived motivation.ConclusionsThe PBF program helped workers feel that they had well-defined and achievable goals and that they received recognition from verification teams, management committees, and colleagues due to enhanced accountability and governance. Our paper shows that financial incentives could serve as the “driver” to kick-start the feedback loop, of responsibility, achievement, and recognition, in environments that lack other drivers. Understanding how PBF programs can be designed and refined to reinforce this feedback loop could be a powerful tool to further enhance and track positive motivational changes. For countries thinking about PBF, we recommend that policymakers assess the loop in their contexts, identify drivers, determine whether these drivers are sufficient, and consider PBF if they are not.Trial registrationWe obtained ethical approval for the study protocol, data collection instruments, and informed consent forms from the Ethics Review Committee of the Centers for Disease Control and Prevention (CDC) [IRB 2015–190] and the Ethics Review Committee of the Mozambique Ministry of Health.

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Section: Discussionmentioning

confidence: 99%

Performance-based financing kick-starts motivational “feedback loop”: findings from a process evaluation in Mozambique

Gergen¹,

Rajkotia²,

Lohmann

et al. 2018

Hum Resour Health

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“…Because we assumed that diff erent individual and organizational characteristics can potentially infl uence the motivation level of healthcare employees, a set of such questions has been included in the questionnaire. As recommended (Borghi et al, 2018;Lohmann et al, 2017), in the case of developing a new (or modifi ed) measurement scale, the measuring instrument has been pretested.…”

Section: Research Instrument and Variablesmentioning

confidence: 99%

“…To validate the measurement model, it was assessed in term of fi t indices, unidimensionality, validity and reliability.  e structural validity analyses aimed to confi rm that the scale measures the motivation dimensions as intended (Lohmann et al, 2017). A er the fi rst iteration, examining the modifi cation index (MI), two error terms of the same factor (physiological needs) were allowed to covariate.…”

Section: Confi Rmatory Factor Analysis -Testing Hypotheses H1mentioning

confidence: 99%

“…However, despite the increased a ention grounded in motivation and its individual and organizational implications, there are still some underling aspects which are not well understood, one of the reasons being the lack of an appropriate instrument for measuring motivation (Borghi et al, 2018;Lohmann et al, 2017). Even if motivation and job satisfaction have been both mentioned as critical determinants of health workers performance and retention, they are abstract concepts which cannot be directly measured (Mbindyo et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

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Implications of Maslow’s Hierarchy of Needs Theory on Healthcare Employees’ Performance

Ștefan

Popa

Albu

2020

TRAS

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The purpose of this study is to provide a new perspective of the motivation-performance link, and the infl uence of satisfying each basic human needs, described by Maslow's hierarchy of needs, on employees' professional performance. We assumed that the positive relationship between each dimension of motivation and professional performance is mediated by work satisfaction. The proposed conceptual model was operationalized by seven latent constructs (the fi ve dimensions of motivation, inspired by the Maslow's hierarchy of needs, job satisfaction and the professional performance), each of them measured by several observed indicators. The survey conducted for this occasion, was fi lled in by 824 employees from Romanian health organizations. Based on the research results, we can state that the Romanian health system employees are mostly motivated by meeting the needs of higher level, especially the need of self-actualization, and to a lesser extent by meeting the lower level ones. Those fi ndings may serve as useful insights for health system policy makers and managerial practices in designing and implementing the most effective motivational strategies, able to generate increased professional performance.

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“…An increasing body of research aims to understand health worker motivation LMICs (5)(6)(7)(8)(9)(10)(11)(12). A recent paper outlines the steps required in developing a high-quality motivation scale-which refers to a set of statements or questions in a survey intending to measure motivation (13).…”

Section: Introductionmentioning

confidence: 99%

Measuring the motivation of health workers: a reflection on the methodological issues and lessons learnt

Maini

Lohmann

Mounier-Jack

et al. 2019

Preprint

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Objective: In this article, we reflect on our experiences in developing and validating an instrument to measure health worker motivation in the Democratic Republic of Congo. Specifically, we recount what actually happened and identify what could have been improved upon at the design, sampling, data collection and analysis stages. Results: Key issues manifesting at the analytical and interpretative stage largely related to shortcomings in the preparatory phase, due to lack of time and resources as well as psychometric and motivation-related expertise at the outset. The main lessons learnt were that the design stage is critical as it lays the foundations for meaningful data collection and analysis. Any shortcomings at this stage inevitably reveal themselves at the analysis stage, both in technical terms as well as in regards to the interpretation of results. It is therefore worth investing time and resources when developing a motivation instrument, particularly within a sound and culturally appropriate conceptualisation of motivation. We hope by openly sharing our experience with other public health researchers working in this area that they will be more aware of some of the common pitfalls to avoid thus helping them to improve future practice.

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Measuring health workers’ motivation composition: validation of a scale based on Self-Determination Theory in Burkina Faso

Cited by 36 publications

References 39 publications

Performance-based financing kick-starts motivational “feedback loop”: findings from a process evaluation in Mozambique

Performance-based financing kick-starts motivational “feedback loop”: findings from a process evaluation in Mozambique

Implications of Maslow’s Hierarchy of Needs Theory on Healthcare Employees’ Performance

Measuring the motivation of health workers: a reflection on the methodological issues and lessons learnt

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