Factors associated with motivation of healthcare workers in Mavoko Sub-County, Machakos County, Kenya

Abstract

Background: Healthcare workers (HCW) are the various cadres of qualified health professionals offering healthcare services. The healthcare system in Kenya faces critical human resources challenges for health demands like many other African countries. These include, among other things, acute shortages of essential cadres, unfavorable working conditions, and insufficient supply or nonexistence of necessary medical and non-medical equipment. Motivation is defined as an employee’s degree of willingness towards achieving individual goals that are in line with the goals of the organization. Mavoko Sub-County has overstretched and inadequately equipped health facilities. These consequently affect the services quality and ultimately impede the realization of universal health coverage. Objectives: To determine the sociodemographic, environmental, psychosocial, and health system factors associated with the motivation of HCWs in Mavoko Sub-County, Machakos County. Methods: A cross-sectional study using qualitative and quantitative approaches was employed. The study population was all (n=168) HCWs working in eight healthcare facilities in Mavoko Sub-County. Questionnaires were utilized to collect quantitative and key informant interviews were utilized for qualitative data. Descriptive data were analyzed using frequencies, percentages, mean and range while qualitative data were analyzed thematically. Motivation factors were analyzed as Likert type data using frequencies. The relationship between the different factors with employee motivation was determined using the Chi Square test. Results: A total of 108 completed the questionnaire. The mean age of the participants was 34 years with more females (55%) than males (45%). Those who reported being motivated were n=48 (45%) while n=40 (37%), were unmotivated. From the findings, n=102 (94%) of the HCWs had either moderate, severe, or extreme levels of job stress, and in 68% of the cases it was attributed to high workload. Motivation of HCWs was highly influenced by age (x²=31.177, p=0.002). Environmental factors such as occupational health and safety (x²=67.691, p=0.001) and health system factors including workplace policies (x²=51.363, p=0.001) were strongly associated with motivation. Psychosocial factors, namely work-life balance (x²=79.947, p=0.001), social support (x²=100.538, p=0.001), as well as mental health and wellness (x²=109.0, p=0.001) had a statistically significant association with motivation. The qualitative findings showed that workload and job stress contributed to healthcare workers’ motivation. Conclusion: Younger HCWs had higher levels of motivation compared to their older colleagues. Policies safeguarding health professionals in the workplace, sufficient medical supplies and equipment, timely payment of salaries, having good support structures and work-life balance were associated with higher motivation levels among HCWs, whereas gender and marital status were not significant determinants of motivation. Recommendations: The National and County Governments Ministries of Health should prioritize mental health and wellness and reduce work stress among HCWs. The HCWs should have a healthy work-life balance, a safe working environment and foster good relationships with their supervisors.