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Human Resources for Health
Published in: Human Resources for Health 1/2020

Open Access 01-12-2020 | Research

Measuring motivation among close-to-community health workers: developing the CTC Provider Motivational Indicator Scale across six countries

Authors: Frédérique Vallières, Maryse Kok, Ilias Mahmud, Malabika Sarker, Philippa Jeacocke, Robinson Karuga, Licia Limato, Aschenaki Z. Kea, Kingsley Chikaphupha, Mohsin Sidat, Brynne Gilmore, Miriam Taegtmeyer

Published in: Human Resources for Health | Issue 1/2020

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Abstract

Background

Close-to-community (CTC) health service providers are a cost-effective and important resource in the promotion of and increasing access to health services. However, many CTC provider programmes suffer from high rates of de-motivation and attrition due to inadequate support systems. Recent literature has identified the lack of rigorous approaches towards measuring and monitoring motivation among CTC providers as an important gap. Building on scales used in previous studies, we set out to develop a short, simple-to-administer scale to monitor and measure indicators of CTC provider motivation across CTC programmes implemented in six countries: Ethiopia, Kenya, Malawi, Mozambique, Indonesia, and Bangladesh.

Methods

We used focus group discussions (n = 18) and interviews (n = 106) conducted with CTC providers across all six countries, applying thematic analysis techniques to identify key determinants of motivation across these contexts. These themes were then used to carry out a systematic search of the literature, to identify existing scales or questionnaires developed for the measurement of these themes. A composite 24-item scale was then administered to CTC providers (n = 695) across the six countries. Survey responses were subsequently randomly assigned to one of two datasets: the first for scale refinement, using exploratory techniques, and the second for factorial validation. Confirmatory factor analysis was applied to both datasets.

Results

Results suggest a 12-item, four-factor structure, measuring community commitment, organisational commitment, job satisfaction, and work conscientiousness as common indicators of motivation among CTC providers across the six countries.

Conclusions

Consistent with previous studies, findings support the inclusion of job satisfaction, organisational commitment, and work conscientiousness within the CTC Provider Motivation Indicator Scale. In addition, findings further supported the addition of a fourth, community commitment, sub-scale. Practical applications of the revised scale, including how it can be applied to monitor motivation levels within CTC provider programming, are discussed.
Appendix
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Metadata
Title
Measuring motivation among close-to-community health workers: developing the CTC Provider Motivational Indicator Scale across six countries
Authors
Frédérique Vallières
Maryse Kok
Ilias Mahmud
Malabika Sarker
Philippa Jeacocke
Robinson Karuga
Licia Limato
Aschenaki Z. Kea
Kingsley Chikaphupha
Mohsin Sidat
Brynne Gilmore
Miriam Taegtmeyer
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Human Resources for Health / Issue 1/2020
Electronic ISSN: 1478-4491
DOI
https://doi.org/10.1186/s12960-020-00495-7

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