Motivation and incentive preferences of community health officers in Ghana: An economic behavioral experiment approach

On behalf of the EMBRACE Implementation Research Team

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Health worker shortage in rural areas is one of the biggest problems of the health sector in Ghana and many developing countries. This may be due to fewer incentives and support systems available to attract and retain health workers at the rural level. This study explored the willingness of community health officers (CHOs) to accept and hold rural and community job postings in Ghana. Methods: A discrete choice experiment was used to estimate the motivation and incentive preferences of CHOs in Ghana. All CHOs working in three Health and Demographic Surveillance System sites in Ghana, 200 in total, were interviewed between December 2012 and January 2013. Respondents were asked to choose from choice sets of job preferences. Four mixed logit models were used for the estimation. The first model considered (a) only the main effect. The other models included interaction terms for (b) gender, (c) number of children under 5 in the household, and (d) years worked at the same community. Moreover, a choice probability simulation was performed. Results: Mixed logit analyses of the data project a shorter time frame before study leave as the most important motivation for most CHOs (β 2.03; 95 % CI 1.69 to 2.36). This is also confirmed by the largest simulated choice probability (29.1 %). The interaction effect of the number of children was significant for education allowance for children (β 0.58; 95 % CI 0.24 to 0.93), salary increase (β 0.35; 95 % CI 0.03 to 0.67), and housing provision (β 0.16; 95 % CI -0.02 to 0.60). Male CHOs had a high affinity for early opportunity to go on study leave (β 0.78; 95 % CI -0.06 to 1.62). CHOs who had worked at the same place for a long time greatly valued salary increase (β 0.28; 95 % CI 0.09 to 0.47). Conclusions: To reduce health worker shortage in rural settings, policymakers could provide "needs-specific" motivational packages. They should include career development opportunities such as shorter period of work before study leave and financial policy in the form of salary increase to recruit and retain them.

Original languageEnglish
Article number53
JournalHuman Resources for Health
Volume14
Issue number1
DOIs
Publication statusPublished - Aug 22 2016

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Ghana
Motivation
incentive
Economics
experiment
Health
health
community
economics
Salaries and Fringe Benefits
salary
number of children
worker
shortage
job posting
Rural Population
interaction
Developing Countries
surveillance
rural area

All Science Journal Classification (ASJC) codes

  • Public Administration
  • Public Health, Environmental and Occupational Health

Cite this

Motivation and incentive preferences of community health officers in Ghana : An economic behavioral experiment approach. / On behalf of the EMBRACE Implementation Research Team.

In: Human Resources for Health, Vol. 14, No. 1, 53, 22.08.2016.

Research output: Contribution to journalArticle

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title = "Motivation and incentive preferences of community health officers in Ghana: An economic behavioral experiment approach",
abstract = "Background: Health worker shortage in rural areas is one of the biggest problems of the health sector in Ghana and many developing countries. This may be due to fewer incentives and support systems available to attract and retain health workers at the rural level. This study explored the willingness of community health officers (CHOs) to accept and hold rural and community job postings in Ghana. Methods: A discrete choice experiment was used to estimate the motivation and incentive preferences of CHOs in Ghana. All CHOs working in three Health and Demographic Surveillance System sites in Ghana, 200 in total, were interviewed between December 2012 and January 2013. Respondents were asked to choose from choice sets of job preferences. Four mixed logit models were used for the estimation. The first model considered (a) only the main effect. The other models included interaction terms for (b) gender, (c) number of children under 5 in the household, and (d) years worked at the same community. Moreover, a choice probability simulation was performed. Results: Mixed logit analyses of the data project a shorter time frame before study leave as the most important motivation for most CHOs (β 2.03; 95 {\%} CI 1.69 to 2.36). This is also confirmed by the largest simulated choice probability (29.1 {\%}). The interaction effect of the number of children was significant for education allowance for children (β 0.58; 95 {\%} CI 0.24 to 0.93), salary increase (β 0.35; 95 {\%} CI 0.03 to 0.67), and housing provision (β 0.16; 95 {\%} CI -0.02 to 0.60). Male CHOs had a high affinity for early opportunity to go on study leave (β 0.78; 95 {\%} CI -0.06 to 1.62). CHOs who had worked at the same place for a long time greatly valued salary increase (β 0.28; 95 {\%} CI 0.09 to 0.47). Conclusions: To reduce health worker shortage in rural settings, policymakers could provide {"}needs-specific{"} motivational packages. They should include career development opportunities such as shorter period of work before study leave and financial policy in the form of salary increase to recruit and retain them.",
author = "{On behalf of the EMBRACE Implementation Research Team} and Sakiko Shiratori and Agyekum, {Enoch Oti} and Akira Shibanuma and Abraham Oduro and Sumiyo Okawa and Yeetey Enuameh and Junko Yasuoka and Kimiyo Kikuchi and Margaret Gyapong and Seth Owusu-Agyei and Evelyn Ansah and Abraham Hodgson and Masamine Jimba and Asare, {Gloria Quansah} and Keiko Nanishi and Sheila Addei and Vida Kukula and Doris Sarpong and Kwaku Poku-Asante and Charlotte Tawiah and Kwame Adjei and Emmanuel Mahama and Cornelius Debpuur and Francis Yeji and Evelyn Sakeah and Akiko Hagiwara and Yusuke Kamiya",
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T1 - Motivation and incentive preferences of community health officers in Ghana

T2 - An economic behavioral experiment approach

AU - On behalf of the EMBRACE Implementation Research Team

AU - Shiratori, Sakiko

AU - Agyekum, Enoch Oti

AU - Shibanuma, Akira

AU - Oduro, Abraham

AU - Okawa, Sumiyo

AU - Enuameh, Yeetey

AU - Yasuoka, Junko

AU - Kikuchi, Kimiyo

AU - Gyapong, Margaret

AU - Owusu-Agyei, Seth

AU - Ansah, Evelyn

AU - Hodgson, Abraham

AU - Jimba, Masamine

AU - Asare, Gloria Quansah

AU - Nanishi, Keiko

AU - Addei, Sheila

AU - Kukula, Vida

AU - Sarpong, Doris

AU - Poku-Asante, Kwaku

AU - Tawiah, Charlotte

AU - Adjei, Kwame

AU - Mahama, Emmanuel

AU - Debpuur, Cornelius

AU - Yeji, Francis

AU - Sakeah, Evelyn

AU - Hagiwara, Akiko

AU - Kamiya, Yusuke

PY - 2016/8/22

Y1 - 2016/8/22

N2 - Background: Health worker shortage in rural areas is one of the biggest problems of the health sector in Ghana and many developing countries. This may be due to fewer incentives and support systems available to attract and retain health workers at the rural level. This study explored the willingness of community health officers (CHOs) to accept and hold rural and community job postings in Ghana. Methods: A discrete choice experiment was used to estimate the motivation and incentive preferences of CHOs in Ghana. All CHOs working in three Health and Demographic Surveillance System sites in Ghana, 200 in total, were interviewed between December 2012 and January 2013. Respondents were asked to choose from choice sets of job preferences. Four mixed logit models were used for the estimation. The first model considered (a) only the main effect. The other models included interaction terms for (b) gender, (c) number of children under 5 in the household, and (d) years worked at the same community. Moreover, a choice probability simulation was performed. Results: Mixed logit analyses of the data project a shorter time frame before study leave as the most important motivation for most CHOs (β 2.03; 95 % CI 1.69 to 2.36). This is also confirmed by the largest simulated choice probability (29.1 %). The interaction effect of the number of children was significant for education allowance for children (β 0.58; 95 % CI 0.24 to 0.93), salary increase (β 0.35; 95 % CI 0.03 to 0.67), and housing provision (β 0.16; 95 % CI -0.02 to 0.60). Male CHOs had a high affinity for early opportunity to go on study leave (β 0.78; 95 % CI -0.06 to 1.62). CHOs who had worked at the same place for a long time greatly valued salary increase (β 0.28; 95 % CI 0.09 to 0.47). Conclusions: To reduce health worker shortage in rural settings, policymakers could provide "needs-specific" motivational packages. They should include career development opportunities such as shorter period of work before study leave and financial policy in the form of salary increase to recruit and retain them.

AB - Background: Health worker shortage in rural areas is one of the biggest problems of the health sector in Ghana and many developing countries. This may be due to fewer incentives and support systems available to attract and retain health workers at the rural level. This study explored the willingness of community health officers (CHOs) to accept and hold rural and community job postings in Ghana. Methods: A discrete choice experiment was used to estimate the motivation and incentive preferences of CHOs in Ghana. All CHOs working in three Health and Demographic Surveillance System sites in Ghana, 200 in total, were interviewed between December 2012 and January 2013. Respondents were asked to choose from choice sets of job preferences. Four mixed logit models were used for the estimation. The first model considered (a) only the main effect. The other models included interaction terms for (b) gender, (c) number of children under 5 in the household, and (d) years worked at the same community. Moreover, a choice probability simulation was performed. Results: Mixed logit analyses of the data project a shorter time frame before study leave as the most important motivation for most CHOs (β 2.03; 95 % CI 1.69 to 2.36). This is also confirmed by the largest simulated choice probability (29.1 %). The interaction effect of the number of children was significant for education allowance for children (β 0.58; 95 % CI 0.24 to 0.93), salary increase (β 0.35; 95 % CI 0.03 to 0.67), and housing provision (β 0.16; 95 % CI -0.02 to 0.60). Male CHOs had a high affinity for early opportunity to go on study leave (β 0.78; 95 % CI -0.06 to 1.62). CHOs who had worked at the same place for a long time greatly valued salary increase (β 0.28; 95 % CI 0.09 to 0.47). Conclusions: To reduce health worker shortage in rural settings, policymakers could provide "needs-specific" motivational packages. They should include career development opportunities such as shorter period of work before study leave and financial policy in the form of salary increase to recruit and retain them.

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DO - 10.1186/s12960-016-0148-1

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