Motivating peripheral health personnel of the Ministry of Health: a comparative study between the Sunyani Jaaman and Asunafo Districts of the Brong Ahafo Region of Ghana

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Ghana’s vision of becoming a middle income country is captured in the GHANA VISION 2020 document The expected contribution of the MOH is to improve the health status of all peoples living in Ghana. The MOH has drawn up a programme of work with specific objectives one of which is to increase the overall resources in the health sector and ensure their equitable and efficient distribution. The most important resource in the health sector is the human resource. There is the general observation that health personnel of the MOH tend to refuse or resist postings to the less well-endowed ‘periphery’. Most of them who accept posting there look for every possible opportunity to return to the big urban ‘centres’. There is no policy in place to attract MOH personnel to move to the periphery, remain there and work effectively and efficiently. The MOH / GHS has however, drawn up policy proposals aimed at ensuring the latter. This non-experimental, descriptive cross sectional study carried out in the Brong Ahafo Region of Ghana, focuses on the professional health service providers in Sunyarn, the regional capital on the one hand and those in the Asunafo and Jaaman districts (two relatively less well endowed districts on the other hand). It employed structured and unstructured interviews, questionnaire, focus group discussion, personal observation and review of official documents to assess the factors that would attract professional health service providers to the periphery as well as motivate them to remain and work there for an appreciable length of time. The responses to questionnaire administered to 138 (one hundred and thirty eight) professional health service providers and 33 (thirty three) health service managers (including managers at the headquarters) were analyzed using EPI-INFO 6 computer programme. A comparison between the responses from Sunyani on one hand and those from Astmafo-Jaaman on the other was made to elicit the major factors of motivation of professional health service providers at the periphery and also to rank them in order of importance from the perspective of the service providers. These factors were then compared to those put forward in the MOH /GHS policy proposals mentioned earlier. The research identified the following major factors of motivation of professional health service providers at the peripheral areas: • Fringe benefits in the form of salary differentials in favour of staff in the peripheral areas • Preferential allocation of awards / opportunities for further training to be in favour of staff in the peripheral areas. • Decent accommodation, subsidized or free, provided at peripheral areas • Good communication between the staff at the periphery’ and the MOH/GHS top hierarchy at the ‘centre& (District capitals, Regional Capitals and Headquarters). The above factors have been listed and ranked in decreasing order of importance to the service providers and should be buttressed by: • Good induction programme for the staff. These factors of motivation are in consonant with those in the policy proposals the MOH/GHS has drawn up aimed at attracting their health staffs to the peripheral areas It is recommended that steps should be taken to ensure ratification and implementation of the MOH/GHS policy proposals for motivation of peripheral health personnel.
A thesis submitted to the Department of Community Health, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, in partial fulfilment of the requirements for the award of in Health Services Planning and Management, 2001