Developing a tool to measure health worker motivation in district hospitals in Kenya
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BioMed Central
Open Access
Methodology
Developing a tool to measure health worker motivation in district hospitals in Kenya Patrick M Mbindyo*1, Duane Blaauw2, Lucy Gilson2,3 and Mike English1,4 Address: 1Kenya Medical Research Institute Centre for Geographic Medical Research Coast-Wellcome Trust Collaborative Programme, Nairobi, Kenya, 2Centre for Health Policy, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa, 3Health Policy Unit, London School of Hygiene and Tropical Medicine, London, UK and 4Department of Paediatrics, University of Oxford, John Radcliffe Hospital, Oxford, UK Email: Patrick M Mbindyo* - [email protected]; Duane Blaauw - [email protected]; Lucy Gilson - [email protected]; Mike English - [email protected] * Corresponding author
Published: 20 May 2009 Human Resources for Health 2009, 7:40
doi:10.1186/1478-4491-7-40
Received: 8 July 2008 Accepted: 20 May 2009
This article is available from: http://www.human-resources-health.com/content/7/1/40 © 2009 Mbindyo et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: We wanted to try to account for worker motivation as a key factor that might affect the success of an intervention to improve implementation of health worker practices in eight district hospitals in Kenya. In the absence of available tools, we therefore aimed to develop a tool that could enable a rapid measurement of motivation at baseline and at subsequent points during the 18-month intervention study. Methods: After a literature review, a self-administered questionnaire was developed to assess the outcomes and determinants of motivation of Kenyan government hospital staff. The initial questionnaire included 23 questions (from seven underlying constructs) related to motivational outcomes that were then used to construct a simpler tool to measure motivation. Parallel qualitative work was undertaken to assess the relevance of the questions chosen and the face validity of the tool. Results: Six hundred eighty-four health workers completed the questionnaires at baseline. Reliability analysis and factor analysis were used to produce the simplified motivational index, which consisted of 10 equally-weighted items from three underlying factors. Scores on the 10-item index were closely correlated with scores for the 23-item index, indicating that in future rapid assessments might be based on the 10 questions alone. The 10-item motivation index was also able to identify statistically significant differences in mean health worker motivation scores between the study hospitals (p < 0.001). The parallel qualitative work in general supported these conclusions and contributed to our understanding of the three identified components of motivation. Con
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