Frontline staff motivation levels and health care quality in rural and urban primary health facilities: a baseline study in the Greater Accra and Western regions of Ghana
Date
2016
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Springer Open
Abstract
Background: The population of Ghana is increasingly becoming urbanized with about 70 % of the estimated 26.9 million
people living in urban and peri-urban areas. Nonetheless, eight out of the ten regions in Ghana remain predominantly rural
where only 32.1 % of the national health sector workforce works. Doctor-patient ratio in a predominantly rural region is
about 1:18,257 compared to 1:4,099 in an urban region. These rural–urban inequities significantly account for the inability of
Ghana to attain the health related Millennium Development Goals (MDGs) before the end of 2015.
Purpose: To ascertain whether or not rural-urban differences exist in health worker motivation levels and quality of health
care in health facilities accredited by the National Health Insurance Authority in Ghana.
Methods: This is a baseline quantitative study conducted in 2012 among 324 health workers in 64 accredited
clinics located in 9 rural and 7 urban districts in Ghana. Ordered logistic regression was performed to determine
the relationship between facility geographic location (rural/urban) and staff motivation levels, and quality health
care standards.
Results: Quality health care and patient safety standards were averagely low in the sampled health facilities. Even though
health workers in rural facilities were more de-motivated by poor availability of resources and drugs than their counterparts
in urban facilities (p < 0.05), quality of health care and patient safety standards were relatively better in rural facilities.
Conclusion: For Ghana to attain the newly formulated sustainable development goals on health, there is the need for
health authorities to address the existing rural–urban imbalances in health worker motivation and quality health care
standards in primary healthcare facilities. Future studies should compare staff motivation levels and quality standards in
accredited and non-accredited health facilities since the current study was limited to health facilities accredited by the
National Health Insurance Authority.
Description
Research Article
Keywords
Rural–urban, Health worker motivation, Quality health care, Health facilities, Ghana
Citation
Alhassan, RK., Nketiah-Amponsah E. (2016) Frontline staff motivation levels and health care quality in rural and urban primary health facilities: a baseline study in the Greater Accra and Western regions of Ghana. Health Economics Review 6:39