Impact Of Motivation On The Performance Of Public Health Employees In Ghana (A Case Study In Accra District)

Project and Seminar Material for Public Health

Abstract

The study set out to investigate the Impact Of Motivation On The Performance Of Public Health Employees In Ghana, a Case Study In Accra District.. The study had three objectives: to examine the motivation practices used in Korle-Bu Teaching Hospital, Accra District, to examine factors affecting employee performance in Korle-Bu Teaching Hospital, Accra District, and to establish the relationship between motivation and employee performance.

The study used a case study strategy which is Korle-Bu Teaching Hospital, Accra District and an explanatory research design. To achieve the set objectives the study used stratified random sampling in sample selection by grouping the employees according to management levels. There after simple random sampling was applied to select respondents. A sample of 30 respondents was selected which comprised employees of Korle-Bu Teaching Hospital, Accra District.

The study revealed that Korle-Bu Teaching Hospital, Accra District carries out motivation of its employees in many ways including; provision of fringe benefits, paying bonuses to good workers, giving a sense of responsibility, promotion of consistently good workers and treating the workers equally. However, the study also revealed that the council does not use motivation tools including; remuneration, training, involvement of employees in decision making, and rotation of employees. The study further revealed that motivation is the major factor that affects employee performance. The study showed a direct strong and positive relationship between employee motivation and the performance of Korle-Bu Teaching Hospital, Accra District staff which is evidenced by the Pearson correlation of (r= 0.823**), significance level =0.01.

Conclusively, the researcher found out that motivation has a positive influence on employee productivity and that if the management of Korle-Bu Teaching Hospital, Accra District strengthens their motivation practices, employees would perform more excellently hence attaining organizational goals. The researcher recommends that the council should always carry out thorough study on the various motivational practices that can motivate the specific employees such that they can apply the right tools appealing to the employees since the council’s biggest challenge had been using particular motivational tools which would act as dissatisfiers to some employees.

Chapter One

Introduction

This chapter presents the background of the study, statement of the problem, purpose of the study, objectives of the study, research questions, scope of the study, significance of the study, Conceptual framework and definition of terms.

1.1 Background to the Study

Researchers and managers have believed that organizational objectives and goals are un achievable without enduring commitment of members and employees of the organization. The world is going through an enormous change. Globalization of businesses is increasing and information technologies are advancing (Dockel, 2003). These major changes reshaping our significantly, for better and for worse (Keritner, 2004). They lead to changes in the way business is done, the way employees behave and the way managers manager their employees. For companies to remain successful, they are required to adapt to these changes (Vercueil, 2001). The changes that are reshaping the world have altered the way organizations operate and have also led to changes in employee characteristics (Robbins, 2000).

According to Stoner et-al (2000), Motivation is a human psychological characteristic that contributes to a person degree of commitment in an individual behavior. Balunywa’s (2005), define employees’ motivation as identification of the desires and needs of subordinates and creating an atmosphere to attain organizational goals and objectives.
The term motivation has been defined variously by different authorities in the study of Psychology, Management and allied disciplines. According to Cole (1995), motivation is essentially about what drives a person to work in a particular way and with a given amount of effort. To Buford et al (1995), motivation is a pre-disposition to behave in a purposive manner to achieve specific needs. Lindner (2004) perceives motivation as a psychological process that gives behaviour purpose and direction. Obviously, there are divergences in these definitions, though some common threads seem to exist. What is common to the foregoing definitions, among others, is that something has to trigger an employee to perform in an exceptional way.

Motivation is operationally defined as a set of indefinite factors that cause a person (an employee) to perform his or her duties in a special way. The factors are described as indefinite because they constantly change with time, as pointed out by Kovach (1987). What is implicit in this definition is that an employee will not work in that special way if he or she is not encouraged (motivated) to do so. An understanding of this definition depends on the appreciation of some existing theories of motivation.

According to Greenberg and Baron (2003, 2000) definition of motivation could be divided into three main parts. The first part looks at arousal that deals with the drive, or energy behind individual (s) action. People turn to be guided by their interest in making a good impression on others, doing interesting work and being successful in what they do. The second part referring to the choice people make and the direction their behaviour takes. The last part deals with maintaining behaviour clearly defining how long people have to persist at attempting to meet their goals.
Motivation refers to a complexity of forces inspiring a person at work to intensify his desire and willingness to use his/ her potentialities to perform in order to achieve organizational objectives. (Mile, 2004) It actually refers to conditions which influence the arousal, direction and maintenance of behavior relevant in working setting. The motivational force is aroused as a result of needs, which have to be satisfied.(Kootz et al., 1990) Motivation of employees is an important inter control tool and should therefore be adhered to in order to attain advantages like increased employee commitment, increased productivity and efficiency. Motivation emphasizes result oriented management through setting of smart objectives and effective communication systems in an organization.

The study will show that every motivational factor is important. It will emphasize that the degree of importance of each motivational factor depends on the type of motivational theory that is adopted. The study will be established that both the employer and the employee must establish a mutual relationship by working together to agree on the best way to motivate the latter. Such a relationship will have a spiral effect because as Kreisman (2002) puts it, how long an employee works in an institution and how productive he/she is, while working in the institution, depends on his/her relationship with his/her employer. Emphasis is placed on avoidance of inequities among staff of the same rank. In as much as inequity exists, some workers would always be aggressive. The actions can damage the attitudes of other workers in the university. For example, absenteeism and tardiness on the part of aggrieved employees, and their low level of cooperation with the authorities can cause far reaching problems. Whyte, Cassandra B. (2007).
Employee performance refers to the output in terms of quantity and quality that helps the organization to realize its set objectives. In other words performance can be measured by traits, behaviors’ and/or outcomes, (Bratton and Gold, 2003). Employee performance management is a process that organizations like Bishop Stuart University use to ensure their employees are contributing to producing a high quality product or service. Employee performance management encourages the employee to get involved in the planning for the company, and therefore anticipates by having a role in the process the employee will be motivated to perform at a high level. Kreisman, B.J. (2002).

Employee performance refers to the efficiency and effectiveness of employees in achieving organizational objectives. (kootz et al., 1990) Employee performance can be evaluated by considering the level of absenteeism, quality of reports, and time of reporting for and leaving for duty. It’s important to note that after recruitment, most employees subsequently expect or demand for other benefits as compensation for their time and effort towards achievement of organizational goals apart from the standard wage or salary (Miles, 2004). If the above benefits are not offered, it usually leads to various forms of dissatisfaction which may include; high absenteeism, constant grievances, high labor turnovers, strikes and as a result low performance of their due duties. (Abuja 1998).
Financial and non-financial incentives and human resources management tools play an important role with respect to increasing motivation of health professional (Mathawe & Imhoff, 2006). There are certain things that can be done to motivate health workers. For instance, adequate human resource management tools can uphold and strengthen the professional ethics of health workers; acknowledging the career goals including recognition, career development and continuous studies; and also developing the work environment will enable health workers meet personal and organizational goals (Mathawe & Imhoff, 2006).

The World Health Organization noted that there was a growing need to strengthen health systems in developing countries to help meet the Millennium Development Goals (MDGs) (WHO, 2006). This is still relevant towards achieving the current Sustainable Development Goal (SDGs) (Report Health for All, 2014). It was entirely accepted that the main constraints to achieving the MDGs was the unavailability of properly trained and motivated workforce; and thus improving the retention of health workers was critical for the health system performance (WHO, 2006). For example, African countries need at least, one million additional workers in order to offer basic services consistent with the MDGs (Willis-Shattuck, 2008).

Alhassan et al. (2009), studied the association between health worker motivation and health care quality efforts in Ghana. These researchers identified that most of the health facilities did not document the evidence of processes for continuous quality improvement safety. On the whole staff motivation was seen as low, although workers in the private facilities perceived improved conditions than workers in the public facilities supporting the fact that more comprehensive staff motivation was needed to improve quality strategies.

Ayizem and Suuk (2012), revealed that National Health Insurance Scheme (NHIS) promoted access to healthcare among the insured. However, expanded utilization of health care services by those who were insured was leading to more workload for the provider, thus, influencing their behavior, for example, and culminating in long waiting time. Adinkrah (2014), claimed that there was abuse of services by the insured. The insured frequent the facilities with minor ailments and even attend to collect drugs for their uninsured relatives and friends. Some insured clients even offer their insurance cards to the uninsured for a fee to access health care on the account of the insured. This increased attendance and perceived service abuse by the insured had led to a rise in workload to providers. Providers work for long hours without any break time. However, providers are not motivated enough as a compensation for the increased workload (Adinkrah, 2014).

The study is aimed at exploring the influence of motivation on health worker performance. This would contribute to identifying priority areas of intervention at the level to improve health worker delivery of care to clients. and improving the health status of Ghanaians as a whole (Aladwan, Bhanugopan, & Fish, 2013).

1.2 Statement of the Problem

The workload on staff at the Korle Bu Teaching Hospital (KBTH) has seen a significant increase over the years especially, since the introduction of the NHIS as compared to the pre-insurance era. From 2010 to 2013, the general outpatient attendances recorded were 357,086; 365,387; and 369,798 respectively (KBTH, 2013) as compared to the pre insurance era 2006 to 2009 recorded 280,975, 296,339 and 323,752 respectively.(KBTH 2010) It is believed that this does not correspond with the rate of increase in staff numbers by way of recruitment.

The Korle Bu Teaching Hospital cannot exempt itself from health worker motivation. It is assumed that the compelling and competing demands facing the hospital are affecting the best delivery of health care to Ghanaians since it is the nation‟s premier teaching hospital. It was reported that most of the challenges that the hospital faced were inadequate staff and inadequate and frequently broken down equipment (KBTH, 2013).

It is believed that the shortage of staff cuts across all clinical staff, including nurses, doctors, midwives, biomedical scientists and pharmacists. The surgical department reported that it lost 20 nurses in 2014, through resignation, retirement and death. These had not been replaced as at first half of 2015 (KBTH, 2015).

It is anticipated that the implication of this trend affects provision of quality health care to the clients because there is inadequate human resource, thus increasing workload. It is becoming increasingly difficult as this trend is affecting the motivation and performance of staff. Even though management had instituted some motivational packages, including award to staff members, it is believed that more could be done to cover a greater number of staff as the current coverage is limited (KBTH, 2015).

It is known that migration/emigration of health workers from Korle Bu Teaching Hospital to better and well-endowed clinics and hospitals is becoming common. This migration has created problems of understaffing and demotivation of staff due to excessive workload, poor supervision and lack of continuous education programmes for staff. It has been observed that request from staff to be transferred outside the hospital are being turned down (KBTH, 2015). Managers at all levels need to think of how to get their workforce to work towards achieving their organizational goals of providing quality health care to meet the expectations of clients and to achieve the Millennium Development Goals (MDGs) now Sustainable Development Goals (SDGs) (WHO, 2015) The key to achieving these goals in improving the motivation and performance of health workers (Willis- Shattuck et al., 2008).

1.3 Purpose of the Study

The study is sought to establish the relationship between motivation and the Performance Of Public Health Employees In Ghana.

1.4 Objectives of the Study

To examine the motivation practices used in Korle-Bu Teaching Hospital, Accra District.
To examine factors affecting employee performance in Korle-Bu Teaching Hospital, Accra District.
To establish the relationship between motivation and employee performance.

1.5 Research Questions

Which motivation practices are used in Korle-Bu Teaching Hospital, Accra District?
What are the factors affecting employee performance in Korle-Bu Teaching Hospital, Accra District?
What is the relationship between motivation and employee performance?

1.6 Hypothesis of the Study

The following hypothesis was formulated and tested by the study

Ho: There is no significant relationship between motivation and employee performance
H1: There is a significant relationship between motivation and employee performance

1.7 Scope of the Study

1.7.1 Content Scope

The study looked mainly on motivation as the independent variable and public health employee performance as the dependent variable.

1.7.2 Time Scope

The research covered a period of 5 years from between 2009 to 2013 was used in books in literature review mainly because this is the time when Korle-Bu Teaching Hospital, Accra District has been experiencing the problem of poor motivation and poor employee performance.

1.8 Significance of the Study

The research may be of great importance to various groups of people like to the current researcher, policy makers, future researchers and the management of Korle-Bu Teaching Hospital, Accra District. This is discussed further as shown below;

The research may be of great importance to me as a researcher because I hope to acquire research skills which I can apply to conduct research in other subjects. Skills like developing questionnaires, interacting with new people and get the necessary information and analyzing data.

The research also helps the management of Korle-Bu Teaching Hospital, Accra District to discover the effect of motivation on employee performance. This help them come up with better motivation techniques which result into improved employee performance.

The research may also benefit the future researchers who will carry out research about the same topic of motivation and employee performance and will learn more about motivation practices, factors affecting employee performance, the relationship between motivation and employee performance among others.

The study may benefit policy makers like the International Labor Organization, Workers’ Union and other government organizations to come up with effective realistic policies of motivating employees.

This proposed study may improve employees’ performance at the workplace, to retain employees and to help companies establish a good image as required by the government of Uganda. If a company’s employees do not acquire this motivation then the company could lose large amounts of money, customers or even go out of business.

On the other hand if that company’s employees are well trained and motivated by their employers it could have great income potential, keep loyal customers and gain a lot of market share.

This study may help many managers and leaders in our society to identify the things that they need to do in order to successfully motivate their employees to perform at their best. As a leader this knowledge may therefore help me to understand what new strategies I could implement in order to motivate employees to achieve optimal business results. It is evident that there is a need for this study because of the many companies that are constantly spending money on various ways to increase employee motivation.

The study may be significant in adding on the existing literature on motivation and employee performance hence providing reference for future studies carried out on the same problem.

1.8 Limitations of the Study

This research work is specifically on the Impact Of Motivation On The Performance Of Public Health Employees In Ghana, a Case Study In Accra District. In the limitation on research work of this magnitude or nature can be carried out without limitation. Hence, during the course, certain constraints were encountered.

Cost:

The cost of thorough research is not what can be afforded by a student. The prices of materials needed for this work has gone up and transport fee has also gone up.

Time:

The time was one of the limitations in the process of carrying out this research work.

Scarcity of Literature:

The research encountered some problems in collection of literature especially on the bank History and operations. This are hindered the smooth running of this work.

1.8 Definition of Terms

Performance:

Means staff being available, competent, productive and responsive.

Motivation:

The set of forces that lead people to behave in particular ways. It is also defined as the fuel that drives people towards achieving their goals and objectives.

Extrinsic Motivation:

Are those factors that are external to the task of the job, such as pay, work condition, job security and environmental conditions of the work.

Intrinsic Motivation:

Are those rewards that can be termed psychological motivation. For example, it includes the opportunity to use one‟s ability, a sense of challenge and achievement, receiving appreciation and positive recognition.

Chapter Five

Summary, Conclusions and Recommendations

5.1 Introduction

This chapter presents the summary of the findings of the study for the previous four chapters. This chapter also includes conclusions, recommendations for the study, and areas of further research suggested.

5.2 Summary of Major Findings

5.2.1 Tools of motivation used by Korle-Bu Teaching Hospital, Accra District.

The study found out that the council uses many different tools to motivate its employees. These include; provision of fringe benefits, paying bonuses to workers who put in extra effort, giving a sense of responsibility, promotion of consistently hardworking employees and treating the workers equally.

However, the study also found out that Korle-Bu Teaching Hospital, Accra District does not use salary as a tool to motivate its employees as most of them were not satisfied by the management’s salary scheme. It was also found out that the council does not carry out training of its employees. The study also found out that the council does not rotate its employees or involve them in decision making as a way of motivating them.

These findings can be related with J.S. Chandan who argued that there are four types of motivation such as, positive motivation which involves proper recognition of employees efforts and appreciation of employees contributions towards the organizational goal, negative or fear motivation which is based upon force, fear and threats, intrinsic motivation which is concerned with the state of self actualization and, satisfaction of accomplishing something worth and extrinsic motivation which is induced by external factors that are primarily financial in nature. These external motivators include; higher pay, fringe benefits like retirement plans, stock options, profit sharing schemes, health and medical insurance. Maternity leave, paid vocation among others (J.S. Chandan 1987).

5.2.2 Factors that affect employee performance in Korle-Bu Teaching Hospital, Accra District.

The study found out that motivation is the major factor that affects the level of employee performance. This is because when the respondents were asked about whether motivation is the most important factor in employee performance, 73 percent of them agreed. However, the study also found out that the organization needs to consider whether the tools they are using are matching the needs of the employees such that they can apply the right tools which appeal to the employees. The study also found out that there are other factors that affect the level of employee performance in Korle-Bu Teaching Hospital, Accra District and these included; goal clarity, knowledge of the structures, the working conditions which was ranked as number two following motivation, the use of modern technology and ability, training and experience of employees.

The results can be compared with information that high motivation is the key to success in any endeavor. It may come from within a person (intrinsic motivation) or from external influences (extrinsic motivation). For example, intrinsic motivation is derived from engaging in exercise for its own sake, for the satisfaction and the sheer enjoyment it brings, and for no external reasons. Those who are intrinsically motivated give up less easily and generally achieve higher levels of fitness than those who are solely motivated by external rewards such as praise, money, and trophies, McCoy (1992).

But, McCoy (1992), argued that high motivation is the key to success in any endeavor. It may come from within a person (intrinsic motivation) or from external influences (extrinsic motivation). For example, intrinsic motivation is derived from engaging in exercise for its own sake, for the satisfaction and the sheer enjoyment it brings, and for no external reasons. Those who are intrinsically motivated give up less easily and generally achieve higher levels of fitness than those who are solely motivated by external rewards such as praise, money, and trophies.

5.2.3 Relationship between motivation and employee performance.

The findings revealed that motivation makes employees do extra tasks for better performance and that there is a direct strong and positive relationship between employee motivation and the performance of Korle-Bu Teaching Hospital, Accra District staff. This is evidenced by the Pearson correlation of 0.823; this figure shows a very strong and positive relationship between motivation and employee productivity at Korle-Bu Teaching Hospital, Accra District.

5.3 Conclusion

From the findings, it can be concluded that motivation can be categorized in two types basing on whether the motivational states are internally or externally derived. These included intrinsic motivation and extrinsic motivation. It can also be concluded that there are two types of motivation tools an organization can use; the financial and the non-financial tools. It can also be said that though the non-financial tools such as reducing the workload, job security, acknowledgment are all good motivators, financial tools such as salary and performance related pay are better motivators. It can also be concluded the management of Korle-Bu Teaching Hospital, Accra District is the trying to motivate its employees though the tools it is using do not exactly match with the expectations of the employees.

About the factors that affect employee performance, it can be concluded that motivation is the most important factor that organization should look upon. However, it can also be concluded that there are other factors that affect the level of employee performance. These include; goal clarity, working conditions, knowledge of the structure, use of modern technology, ability, training and experience.

The research also concludes that there is a very strong positive relationship between motivation and employee productivity. However, it can also be concluded that the root cause of poor performance in Korle-Bu Teaching Hospital, Accra District is not motivation in its self rather it is the tools of motivation used by the council which are not what the employees want as motivators.

5.4 Recommendations of the Study

Basing on the study findings, the following recommendations were highlighted as follows;

Government involvement should take part in recommending the provision of motivational needs through adjusting in the labour laws. This will ensure that all organizations provide basic requirements to their employees and eventually enable them to work hard for improved performance.

The study also recommended that there should a greater balance between employees’ needs and organizational needs. It is the duty of all stake holders to ensure that this is achieved as this will reduce employees’ selfishness at their places of work.

The council should consider further informing and training of its staff to equip them with more skills in order to improve their performance. Also informing the employees about the procedures that must be gone through if they want for example, a salary increment is recommended.

It was found out that the tools the council uses to motivate its employees are not exactly the tools that can motivate the employees. The researcher therefore recommends that the council should carry out a study before using a particular tool.

5.5 Areas for Further Research

The researcher recommends the following areas for future investigations which were not researched satisfactorily.
Choosing the right motivation tool for a given employee. This is a very important aspect for the employer to consider. The researcher was not satisfactorily able to make a thorough study on how to choose the right motivation tool for a given employee and therefore recommends it for further research.

The impact of employees’ salary on their level of motivation. The researcher also did not go deep into finding out the impact of employees’ salary on their level of performance and therefore recommends it for future investigations.
Problems encountered by employers when motivating employees. The major problems encountered by employers when motivating employees were not looked at exhaustively and therefore the researcher recommends it to be researched for by future researchers.

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Frequently Asked Questions

Why is motivation relevant for health workers?

Motivation is relevant for organizational effectively perform his/her duties with the needed attention. maximum output from employees. Health workers are motivated by intrinsic and extrinsic factors.

Is there a motivation influence on employee performance?

These issues are widely discussed by many researchers and professionals and seem to bring more opposing views. This is why it will be shown separately below. discoveries. Definitely there is a motivation influence on employee performance. Motivation can be described as intrinsic and extrinsic. Some factors are more motivated than others.

Why are health workers frustrated with their performance?

This is a source of frustration for many health workers and affects their motivation, which in turn affects their performance. Many feel that a career in the health sector has become less attractive. These frustrations are rooted in a number of more specific complaints.

What is the impact of work experience on job performance?

If employees make work experience to be significant, they are motivation to do better [Hackman & Oldham, 2010]. Features that deliver improved job performance of employees will bring intrinsic rewards.

What motivates a health worker?

Generally, a health worker will be motivated and express job satisfaction if they feel that they are effective at their jobs and performing well. Factors contributing to motivation and job satisfaction also include strong career development, an adequate compensation, and adequate working and living conditions .

What is motivation and why does it matter?

Motivation is closely linked to job satisfaction, which retains workers at their jobs over time. Health worker retention reduces costs to the health system of having to recruit, hire, and orient new workers and also reduces the likelihood of vacant posts.

What is motivation in health care?

Motivation can be defined as a person’s degree of willingness toward achieving an individual goal that is consistent with that of the organization and the reasons underlying behavior which can be either intrinsic or extrinsic. 1, 2 The health system is labor and capital intensive.

Why is employee motivation important?

There are several reasons why employee motivation is important. Mainly because it allows management to meet the company’s goals. Without a motivated workplace, companies could be placed in a very risky position.

What is the impact of motivation on employee performance?

This suggests the importance of motivating employees. Motivation acts as a technique for improving the performance of employees working at different levels. Motivation of employees is one function which every manager has to perform along with other managerial functions. A manager has to function as a friend and motivator of his subordinates.

What are the factors that affect the productivity of health workers?

Productivity of health workers is determined by the setting in which they work, their level of motivation, work organization, management capacity, the division of labor and other resources (e.g., equipment, drugs, examination rooms, and other characteristics of the setting) available.5 Quality Quality of care is the function of the …

Why are healthcare workers crucial?

Four Reasons Healthcare Workers are Crucial! Healthcare workers are of the utmost importance here in the United States as well as around the globe. Healthcare workers include every single person in the health system who delivers care either directly or on an indirect basis.

Why do healthcare workers behave disrespectfully?

Why Disrespectful Behavior Arises Disrespectful behavior can arise in any health care setting, and both the stressful nature of the environment and human nature play roles in this destructive behavior. We are driven to function in “survival” mode when forced to cope with difficult personal frustrations and system failures.

What is workforce health & wellness?

The focus has shifted to a broader view of workforce health, including the physical, mental, work and life components of health. This is sometimes referred to as Total Health. Organizations are starting to see that focusing on workforce health helps the bottom line.

How can you improve your work performance at work?

Improve your communication skills If you are working on a big project with some of your work colleagues, communication will be essential for the overall performance of the team. So, ensuring that you communicate with them everything from good to bad will be key to successfully complete the task.

What are the benefits of positive workplace behaviors?

Being positive helps reduce stress, increases productivity as well as interpersonal relations with others. Don’t be afraid to show your passion! Always deliver high-quality work and make sure others know they can trust you to get the job done. By demonstrating competence, it will leave a lasting impression.

How to prioritize tasks at work to improve performance?

As an employee, you are often going to be allocated a wide range of tasks that you will need to deal with by a particular deadline. It is not uncommon for you to have more tasks than you can handle and so, the best way to ensure that you maintain your performance at work is to prioritize your tasks in an order judging by importance.

How can I make an impact at work?

Here are 10 ways to make an impact: Take the time to be proactive and originate new concepts. While out-of-the-box thinking may be out of your comfort zone, you’ll generate more possibilities, learn a lot and inspire others. A good colleague supports his or her coworkers.