title: Motivation and retention of health workers in Ghana's district hospitals: addressing the critical issues.
abstract: OBJECTIVE
  This study seeks to undertake a systematic review to consolidate existing empirical evidence on the impact of financial and non-financial incentives on motivation and retention of health workers in Ghana's district hospitals.
  
  
  METHODS
  The study employed a purely quantitative design with a sample of 285 health workers from ten district hospitals in four regions of Ghana. A stepwise regression model was used in the analysis.
  
  
  RESULTS
  The study found that financial incentives significantly influence motivation and intention to remain in the district hospital. Further, of the four factor model of the non-financial incentives, only three (leadership skill and supervision, opportunities for continuing professional development and availability of infrastructure and resources) were predictors of motivation and retention.
  
  
  CONCLUSIONS
  A major limitation of the study is that the sample of health workers was biased towards nurses (n = 160; 56.1 percent). This is explained by their large presence in remote districts in Ghana. A qualitative approach could enrich the findings by bringing out the many complex views of health workers regarding issues of motivation and retention, since quantitative studies are better applied to establish causal relationships.
  
  
  CONCLUSIONS
  The findings suggest that appropriate legislations backing salary supplements, commitment-based bonus payments with a set of internal regulations and leadership with sound managerial qualities are required to pursue workforce retention in district hospitals.
authors.affiliation: Department of Public Administration and Health Services Management, University of Ghana Business School, Accra, Ghana. fadzei@ug.edu.gh
authors.forename: Francis A
authors.initials: FA
authors.lastname: Adzei
authors.forename: Roger A
authors.initials: RA
authors.lastname: Atinga
mesh_terms: D000328:Adult; D004649:Employee Incentive Plans / Q000458:organization & administration; D005260:Female; D005869:Ghana; D006282:Health Personnel; D006767:Hospitals, District; D006801:Humans; D008297:Male; D009042:Motivation; D010557:Personnel Administration, Hospital / Q000379:methods*; D010558:Personnel Loyalty; D036301:Qualitative Research; D012044:Regression Analysis