title: Health worker (internal customer) satisfaction and motivation in the public sector in Ghana.
abstract: This paper describes factors affecting health worker motivation and satisfaction in the public sector in Ghana. The data are from a survey of public sector health care providers carried out in January 2002 and repeated in August 2003 using an interviewer administered structured questionnaire. It is part of a continuous quality improvement (CQI) effort in the health sector in the Greater Accra region of Ghana. Workplace obstacles identified that caused dissatisfaction and de-motivated staff in order of the most frequently mentioned were low salaries such that obtaining basic necessities of daily living becomes a problem; lack of essential equipment, tools and supplies to work with; delayed promotions; difficulties and inconveniences with transportation to work; staff shortages; housing, additional duty allowances and in-service (continuous) training. Others included children's education, vehicles to work with such as ambulances and pickups, staff transfer procedures, staff pre-service education inadequate for job requirements, and the effect of the job on family and other social factors. There were some differences in the percentages of staff selecting a given workplace obstacle between the purely rural districts, the highly urbanized Accra metropolis and the districts that were a mixture of urbanized and rural. It is unlikely that the Ghana Health Service can provide high quality of care to its end users (external customers) if workplace obstacles that de-motivate staff (internal customers) and negatively influence their performance are not properly recognized and addressed as a complex of inter-related problems producing a common result--dissatisfied poorly motivated staff and resulting poor quality services.
authors.affiliation: Regional Health Administration, Greater Accra Region, Adabraka, Accra, Ghana. iagyepong@ighmail.com
authors.forename: Irene Akua
authors.initials: IA
authors.lastname: Agyepong
authors.forename: Patricia
authors.initials: P
authors.lastname: Anafi
authors.forename: Ebenezer
authors.initials: E
authors.lastname: Asiamah
authors.forename: Evelyn K
authors.initials: EK
authors.lastname: Ansah
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Ashon
authors.forename: Christiana
authors.initials: C
authors.lastname: Narh-Dometey
mesh_terms: D000328:Adult; D005260:Female; D005869:Ghana; D019981:Health Care Sector / Q000592:standards; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D009042:Motivation; D017150:Public Sector; D017749:Total Quality Management