Health worker motivation to deliver quality care in western Nigeria

Abstract

Background: Motivation of health service providers (HSPs) is an important factor for delivering quality services and achieving client satisfaction. Understanding the motivation to perform is therefore important in providing evidence for interventions. Aim: To assess motivation to deliver quality service among antenatal care service providers in public secondary health facilities in western Nigeria. Methods: A cross-sectional, facility-based study was conducted using a validated, semi- structured self-administered questionnaire. 280 HSPs were recruited using multi-stage sampling method. Data were analyzed using Epi-info statistical software. Inferential statistics such as Chi- square and binary regression were applied. Results: Factors with high mean scores as motivators were those related to individual aspects especially conscientiousness, cooperativeness, timeliness and attendance, and appreciation from patients. Factors with the lowest mean scores were those linked with work organization such as limited resources (insufficient staff and equipment) and poor promotion processes. Overall, only 69 (24.5%) of HSPs reported that they were motivated to deliver quality care. Predictors of motivation were non-physician cadre and longer years of service. Nurse/midwives, lab scientist/lab technicians and pharmacist/pharmacy technicians were all more likely to be motivated than physicians. HSPs with more than 10 years experience on their current job were almost 9 times more likely to be motivated than those who had spent a lesser duration (OR 1.14, 95%CI 1.06 – 1.22). Conclusion: HSPs were not motivated to deliver quality care especially physicians and those who had spent lesser duration on the current job. Interventions should focus on provision of adequate resources and improving promotion process.