Motivation and satisfaction among community health workers in Morogoro Region, Tanzania: nuanced needs and varied ambitions
Language: 
English
Short Title: 
Motivation and satisfaction among community health workers in Morogoro Region, Tanzania
Abstract: 

BACKGROUND: In 2012, the Ministry of Health and Social Welfare (MOHSW), Tanzania, approved national guidelines and training materials for community health workers (CHWs) in integrated maternal, newborn and child health (Integrated MNCH), with CHWs trained and deployed across five districts of Morogoro Region soon after. To inform future scale up, this study assessed motivation and satisfaction among these CHWs. METHODS: A survey of all CHWs trained by the Integrated MNCH Programme was conducted in the last quarter of 2013. Motivation and satisfaction were assessed using a five-point Likert scale with 29 and 27 items based on a literature review and discussions with CHW programme stakeholders. Exploratory factor analysis was conducted to identify motivation and satisfaction determinants. RESULTS: Out of 238 eligible CHWs, 96†% were included in the study. Findings showed that respondents were motivated to become CHWs due to altruism (work on MNCH, desire to serve God, work hard) and intrinsic needs (help community, improve health, pride) than due to external stimuli (monetary incentives, skill utilization, community respect or hope for employment). CHWs were satisfied by relationships with health workers and communities, job aids and the capacity to provide services. CHWs were dissatisfied with the lack of transportation, communication devices and financial incentives for carrying out their tasks. Factors influencing motivation and satisfaction did not differ across CHW socio-demographic characteristics. Nonetheless, older and less educated CHWs were more likely to be motivated by altruism, intrinsic needs and skill utilization, community respect and hope for employment. Less educated CHWs were more satisfied with service and quality factors and more wealthy CHWs satisfied with job aids. CONCLUSION AND RECOMMENDATIONS: A combination of financial and non-financial incentives is required to support motivation and satisfaction among CHWs. Although CHWs joined mainly due to their altruistic nature, they became discontented with the lack of monetary compensation, transportation and communication support received. With the planned rollout of the national CHW cadre, improved understanding of CHWs as a heterogeneous group with nuanced needs and varied ambitions is vital for ensuring sustainability.

Author(s): 
Mpembeni, Rose N. M.
Bhatnagar, Aarushi
LeFevre, Amnesty
Chitama, Dereck
Urassa, David P.
Kilewo, Charles
Mdee, Rebecca M.
Semu, Helen
Winch, Peter J.
Killewo, Japhet
Baqui, Abdullah H.
George, Asha
Item Type: 
Journal Article
Publication Title: 
Human Resources for Health
Journal Abbreviation: 
Hum Resour Health
Publication Date: 
6/5/2015
Publication Year: 
2015
Pages: 
44
Volume: 
13
ISSN: 
1478-4491
DOI: 
10.1186/s12960-015-0035-1
Library Catalog: 
PubMed
Extra: 
PMID: 26044146 PMCID: PMC4458000

Turabian/Chicago Citation

Rose N. M. Mpembeni, Aarushi Bhatnagar, Amnesty LeFevre, Dereck Chitama, David P. Urassa, Charles Kilewo, Rebecca M. Mdee, Helen Semu, Peter J. Winch, Japhet Killewo, Abdullah H. Baqui and Asha George. 6/5/2015. "Motivation and satisfaction among community health workers in Morogoro Region, Tanzania: nuanced needs and varied ambitions." Human Resources for Health 13: 44. 10.1186/s12960-015-0035-1.

Wikipedia Citation

<ref> {{Cite journal | doi = 10.1186/s12960-015-0035-1 | issn = 1478-4491 | volume = 13 | pages = 44 | last = Mpembeni | first = Rose N. M. | coauthors = Bhatnagar, Aarushi, LeFevre, Amnesty, Chitama, Dereck, Urassa, David P., Kilewo, Charles, Mdee, Rebecca M., Semu, Helen, Winch, Peter J., Killewo, Japhet, Baqui, Abdullah H., George, Asha | title = Motivation and satisfaction among community health workers in Morogoro Region, Tanzania: nuanced needs and varied ambitions | journal = Human Resources for Health | date = 6/5/2015 | pmid = | pmc = }} </ref>