2. Motivation – to move – the psychological force that enables action.
Health worker motivation – what drives health workers to do their best at work
Should expect health worker motivation to be a central focus of PBF studies
It is not
Measuring motivation
5. PBF
More
motivation
Changed
behavior
Better
service del.
Better health
outcomes
Three reasons for examining PBF and health worker motivation (all based on the
fact that there is a multitude of motivations that drive work behavior):
• understand heterogeneity in the impact of PBF on service delivery
• check if PBF interacts with other work motivations (short term – long term)
• help us design better PBF
Measuring motivation
6. A Fact: research in psychology and behavioral economics has documented that
we are driven by many desires, many motivations.
Measuring motivation
Intrinsic (rewarding in itself; process) Extrinsic (for a reward; goal oriented)
enjoy an activity or see it as an
opportunity to explore, learn, and
actualize our potentials
• Financial (performance pay, promotion)
• Non-Financial
- self-regarding: respect, avoid guilt, self esteem
- other-regarding: helping patients, altruism
Motivations at work:
8. e0
Power
of financial
incentives
e0
Work effort
Financial and non-financial incentives
Observation 2: Financial-incentives may crowd out or in (not shown) non-financial motivation
Observation 3: The degree of crowding out or in depends on how incentives are designed
Supply curve if (counterfactually)
non-financial motivation was
unaltered
9. Measuring motivation is important to understand the impact of PBF and to
design well functioning financial incentives
Measuring motivation
• Indirectly
o experiments (dictator games)
o psychological tests: (memory tests: goal-related concepts are accessible
in memory; Implicit Association Tests
Question: How do we measure motivation (and how PBF affect motivation)?
• Directly
o survey health workers about their financial and non-financial motivation
(before and after PBF) - (social desirability bias)
