Your health our concern, our health whose concern?': Perceptions of injustice in organizational relationships and processes and frontline health worker motivation in Ghana

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dc.contributor.author Aberese-Ako, M.
dc.contributor.author Van Dijk, H.
dc.contributor.author Gerrits, T.
dc.contributor.author Arhinful, D.K.
dc.contributor.author Agyepong, I.A.
dc.date.accessioned 2018-11-26T09:35:06Z
dc.date.available 2018-11-26T09:35:06Z
dc.date.issued 2014-09
dc.identifier.other https://doi.org/10.1093/heapol/czu068
dc.identifier.other Volume 29, Issue suppl_2
dc.identifier.uri http://ugspace.ug.edu.gh/handle/123456789/25787
dc.description.abstract Taking a perspective of frontline health workers as internal clients within health systems, this study explored how perceived injustice in policy and organizational matters influence frontline health worker motivation and the consequent effect on workers' attitudes and performance in delivering maternal and neonatal health care in public hospitals. It consisted of an ethnographic study in two public hospitals in Southern Ghana. Participant observation, conversation and in-depth interviews were conducted over a 16-month period. Ethical approval and consent were obtained from relevant persons and authorities. Qualitative analysis software Nvivo 8 was used for coding and analysis of data. Main themes identified in the analysis form the basis for interpreting and reporting study findings. Findings showed that most workers perceived injustice in distributive, procedural and interactional dimensions at various levels in the health system. At the national policy level this included poor conditions of service. At the hospital level, it included perceived inequity in distribution of incentives, lack of protection and respect for workers. These influenced frontline worker motivation negatively and sometimes led to poor response to client needs. However, intrinsically motivated workers overcame these challenges and responded positively to clients' health care needs. It is important to recognize and conceptualize frontline workers in health systems as internal clients of the facilities and organizations within which they work. Their quality needs must be adequately met if they are to be highly motivated and supported to provide quality and responsive care to their clients. Meeting these quality needs of internal clients and creating a sense of fairness in governance arrangements between frontline workers, facilities and health system managers is crucial. Consequently, intervention measures such as creating more open door policies, involving frontline workers in decision making, recognizing their needs and challenges and working together to address them are critical. en_US
dc.language.iso en en_US
dc.publisher Health Policy and Planning en_US
dc.subject Attitude en_US
dc.subject Frontline health workers en_US
dc.subject Ghana en_US
dc.subject Justice en_US
dc.subject Motivation en_US
dc.subject People-centred health systems en_US
dc.title Your health our concern, our health whose concern?': Perceptions of injustice in organizational relationships and processes and frontline health worker motivation in Ghana en_US
dc.type Article en_US


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  • Epidemiology Department [254]
    The Epidemiology Department contributes to the mission of the institute through basic and applied epidemiological research on, but not limited to, malaria and other diseases of public health importance. It is also home to the Social Science Unit of the Institute, including the Health Support Centre for HIV/AIDS and other communicable and noncommunicable health problems.

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