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Table 5.4. Staff motivation and job satisfaction: Service providers’ perspective (percent) Lusaka (n = 69)

Kabwe (n = 71)

Mumbwa (n = 35)

Issue

A

D

U

A

D

U

A

D

U

Motivation is generally high among staff delivering non-HIV services

30

22

48

18

4

78

23

11

66

Teamwork is generally good among other service delivery staff

39

12

12

87

3

10

76

12

12

Training is sufficient to perform the job well

71

9

20

60

4

36

74

0

26

Incentives have improved at this facility in the last 12 months

17

15

68

20

10

70

20

17

63

In the last 12 months, the workload at this facility has become more manageable

22

13

65

34

0

46

46

11

13

Overall, you are satisfied with your job

51

16

33

63

3

34

60

9

31

Source: Global HIV/AIDS Initiatives Network 2008. Note: A=Agree; D=Disagree; U=Undecided.

A combination of monetary and nonmonetary factors are the most cited reasons for low staff motivation. The 2006 PETS (Picazo 2008) found that staff dissatisfaction stems mainly from stressful workloads (42 percent) and low salaries (34 percent). Only 7 percent reported bad facility management while 17 percent cited “other reasons.” Focus group discussions (Ferrinho and others 2008) with nursing staff in rural health centers found that “most of us get our salaries from Lusaka; and they should re-introduce rural hardship allowance” (withdrawn 2 months ago due to re-categorization of Luangwa Boma as not being rural). A lack of adequate transportation and housing are also demotivating staff in Zambia. Nurses argued that “if we could have transport to be taken there, that can be motivating enough, and just for staff, build more houses, accommodation is a big problem in rural areas.” A survey on staff motivation in Luangwa (Furth 2006) found that monetary compensation (salary and bonuses) does li le to motivate health workers. Conversely, aspects relating to performance management, continued learning, and improving peoples’ health are all deemed to be important motivators (figure 5.11). Figure 5.11. Factors affecting staff motivation in Luangwa Strongly agree 5 Agree 4 Survey 1

Neither agree 3 or disagree

Survey 2 Survey 3

Disagree 2

Survey 4

ds co g ma nitio na n b ge y Cl rs ien ta pp re cia Co tio n nti nu ed op le po ar rtu nin nit g es Re

ing ov pr Im Source: Furth 2006.

Aw ar

s Bo

nu

se

y lar Sa

pe o he ple’s alt h

Strongly disagree 1

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