How to do (or not to do)… Measuring health worker motivation in surveys in low- and middle-income countries

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J Borghi, J Lohmann, E Dale, F Meheus, J Goudge, K Oboirien, A Kuwawenaruwa , 2017

A health system’s ability to deliver quality health care depends on the availability of motivated health workers, which are insufficient in many low income settings.

Motivation is key to performance and quality of care outcomes, and as a result policy and researcher attention is increasingly directed towards understanding what drives health worker motivation and how different policy interventions affect motivation. This has led to a growing interest among researchers in measuring motivation within health worker surveys. However, there is currently limited guidance on how to conceptualise and approach measurement and how to validate or analyse motivation data collected from health worker surveys, resulting in inconsistent and sometimes poor quality measures.

This paper:

  • discusses how motivation can be conceptualised.
  • sets out steps for developing questions to measure motivation within health worker surveys and for ensuring data quality through validity and reliability tests.
  • discusses analysis of the resulting motivation measure/s.
  • aims to promote high quality research that will generate policy relevant and useful evidence.

It provides a useful introduction for those wanting to gain a better understanding of the methodology and the process of designing surveys to measure motivation in LMICs and the methods used to analyse and interpret their findings.

The lead author, Josephine Borghi, has also published a blog about the paper in health policy and planning: STEP-BY-STEP: How to measure health worker motivation in Low- and Middle Income Countries (LMICs)

Journal publication | Health workforce
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