Factors affecting health workers’ motivation in a fragile state

Abstract

Background: This study was conducted in Juba, the capital city of the Republic of South Sudan. Special consideration was to study the motivation of health workers in Juba Teaching Hospital (JTH) which is the only national referral hospital in the youngest African country which got its independence on July 11th 2011 after more than 20 years of civil war. Special consideration in this study was given to the situation of post conflict of South Sudan within FCAS. Objective: The study was aiming at knowing the motivation of health workers in Juba teaching Hospital and determined Factors that influence their motivation, especially in context of post war and instability. The four specific objectives undertaken to achieve the results were; to assess the level of motivation of health workers, particularly medical doctors, clinical officers, nurses, midwives and laboratory staff; to determine factors that affects their motivation; to assess the extent of the influence of war and instability on their motivation; and to examine strategies put in place by respective authorities to support health workers overcome the challenges and effects of war on their motivation. Methodology: This was a descriptive cross-sectional study which used a mixed method (both qualitative and quantitative) in order to determine the motivation of health workers in Juba teaching hospital. A total of 201 health workers in the hospital composed of medical doctors, clinical officers, nurses, midwives and laboratory staffs were proportionally sampled and interviewed using self administered questionnaires, FGD, and KII. The statistical software IBM SPSS version 20, Microsoft Excel 2007 and Microsoft word document 2007 were used for raw data coding, entry and analysis. Results: The results of the study showed that 66% of health workers at Juba Teaching Hospital were de-motivated. Reasons for their de-motivation being poor salary, poor working conditions, non availability of policies and guidelines enacted, and slow decision making process by respective authorities. Considering the level of motivation of each cadre showed that medical doctors were more motivated that the rest of the cadres with 64.26%. It was also found out that 72% of all the respondents were happy with their profession although 54.23% would quit work in the hospital for reasons mentionned above if they get another employer within the medical field.This study revealded that health workers in JTH have a high patriostic spirit that maintain them faithful to their duties. v In time of war and instability community support, team spirit among staff motivated them to work. However, harassement, life threat and lack of transport to ensure their protection contributed to their de-motivation. The study revealed a positive Pearson correlation between working in war and instability on staff motivation with a significance of 0.713 two tailled.