2. Outline
• Objective of the session
• Introductory Concept of MCC
• Major MCC interventions
• Strategies to optimize HWF motivation
and retention
• Identified Indicators
• Staff satisfaction assessment tool 2
3. Is that possible to achieve WT & HSTP_II objectives?
3
With
Demotivated staff?
Incompetent stafWith
– Demotivated staff?
– Incompetent staff?
– Unethical staff ?
f?
Unethical staff ?
Client satisfaction 46% -75%
– Model house holds
– High performing PHCU
– Capacity of leaders
– Data use habit
– Financial protection
– Multisectoral
collaboration
4. Objective of the session
After this session participants will be able to:-
• Identify motivational factors of Health workforce
• Explain strategies for lifelong learning
• Recognize compassion as a foundation for person
centered care
• Recognize HWF motivation schemes for contextual
implementation to achieve WT
4
5. Introduction
Ethiopia brought visible change in implementing
compassionate and respectful care (CRC) HSTP –I
transformational agenda .
Through:
Strengthening collaboration and partnership among
various implementer stakeholders
E. Volunteerism, satisfaction, recognition, professionalism
5
6. Why Motivated Competent & Compassionate
(MCC) Theory of Change introduced in HSTP_II?
–To tackle the existing challenges and initiate a new way
of looking into the existing system.
–MOH in collaboration with WHO came up with a Theory
of Change (TOC) for CRC
–As a result MoH developed Motivated, Competent and
Compassionate (MCC) health service strategy as a
transformational agenda of HSTP-II 6
7. The MCC has 4 intervention strategies
1.Strengthening Ethics and Professionalism in Pre-service
and In-service education/training
2.Strengthening Health Systems for Compassionate Health
Service
3.Introduction of Person Centered Care (acceptability,
CBHI, statisfaction)
4. Community and Stockholders Engagement :-
To reduce morbidity and mortality
To increase client and staff satisfaction in the system
7
8. Motivation of Health Workforce
•Motivation in the work context is typically defined as the
willingness to exert and maintain an effort towards
organizational goals. (HSTP_II, WT)
•Motivation causes goal directed behavior
•Motivation is both a driver and a consequence of health worker
performance.
•Motivated health workers are likely to attend to their clients and
provide better care, (client & staff satisfaction)
•The relationship between motivation and performance is
influenced by the organizational climate (work environment)
8
10. Types of Motivation
Intrinsic Motivation Extrinsic Motivation
• You are motivated to do the
activities b/c it is internally
rewarding for you
• You choose to do it b/c it is
enjoyable, fun and satisfying
• The goal comes within and
the outcome satisfy basic
psychological needs,
competence and relatedness
• You are motivated to do the
activity in order to gain
external reward returns
• External gains such as
money, power, fame and
avoiding consequences
• WT? 10
11. Factors affecting motivation of Health
sector workers
Individual Determinants
Organizational and System level Determinants
Socio-cultural, Environment, and Reform context
Discuss and identify each determinant factors?
11
12. How we know if someone or yourself is
self-motivated?
Three questions you can use to determine whether you or
someone is self-motivated:
– Can you do it? - Self efficacy
– Will it work? Response efficacy
– Is it worth? – Consequence Vs Cost
12
13. Self-efficacy
Self-efficacy judgments are not necessarily related to
an individual’s actual ability to perform a task; rather,
they are based on the person’s beliefs about that ability.
Self–Efficacy Affects;
• The choices we make
• The effort we put forth (how hard we try)
• Our perseverance (how long we persist when we
confront obstacles) (transformed W, HH,)
• Our resilience (how quickly we recover from failure or
setbacks
13
14. Improves Performance Level
Unsympathetic Attitudes can be Changed
Reduction in Resistance to Change
Reduction of Employee Turnover and Absenteeism
Healthy institutional Image built,
service utilization increase and Satisfaction increase
Importance of self-motivation
15. MOH-ETH
The interaction of the three motivation
factors
Management Action Internal state Workplace Result
Incentives Motivation Improved Performance
(high performing
PHCU)
Workplace Climate Job Satisfaction Retention (high
performing PHCU),
satisfaction
18. Strategies to Lifelong Learning
Step 1: Recognize personal desire and goals
Step 2: Identify what should be learned or performed
Step 3: Identify how the goal and objectives will be
achieved
Step 4: Incorporate the learning objectives and activities
into the daily routine
Step 5: Make a commitment
18
19. Benefits of Lifelong Learning
• Improves self-motivation
• Recognize personal goals and ambitions
• Enhances other professional and personal
attributes(team sprit)
• Increases self-confidence
• Meet regulators expectations for relicensing or
recertification 19
20. Compassionate as a foundation of person
centered care
• Compassion is a feeling and character that promote
warmth, sympathy, empathy, love and belongingness,
between individuals, service providers and community and
• it is exceptionally imperative for the provision of quality
and morally acceptable health care service
20
21. The six attributes of compassion
Attributes
of
compassio
n
Motivat
ion Non-
conde
mning
and
non-
judgin
g:
Sympa
thy
Empat
hy
Distres
s
toleran
ce
Sensiti
vity
21
22. Person centered care
• Person-centered care is a way of thinking and doing
things to the people fairly and respectfully in
• planning, developing and monitoring care to make
sure meet their needs by engaging them.
22
24. Benefits of Patient-Centered Care
Improves individual health outcomes and population health outcomes
Providers and health care systems also benefited through:
– Improves satisfaction scores among patients and their families.
– Enhances reputation of providers among health care consumers.
– Better morale and productivity among Health workforce ((high
performing PHCU).
– Improves resource allocation.
– Reduces expenses and increased financial margins throughout the
continuum of care.
24
25. Major MCC interventions
Establish peer learning platforms to build capacity, improve knowledge and
skills
Deploy adequate number and professional mix of HRH at PHC facilities
including comprehensive HP
Multi-disciplinary team-based support and care for better quality of care
Create conducive working environment (housing, friendly working
environment, CPD, licensing for all professionals )
Implement retention and motivation incentives to improve performance of
staffs (career pathways, capacity building, transfer, locally available
incentives)
Enhance capacity of staffs through coaching, mentorship, and supportive
supervision
Implement HRIS and Provide integrated refresher training for HP staffs
25
26. Strategies to Optimize HWF motivation
and retention in the health system
1. Redesign and implement locally available innovative
non- financial and financial motivation package at all
level.
Includes:- land supply for house building, supply of houses,
cash loans, from banks for house and car with smaller
interest, transportation supplies, duty free supply, direct
construction supply from the manufacturers for house
building, tax free duty payment and salary, risk allowance,
transport allowance….
26
27. Strategies to Optimize HWF motivation
and retention in the health system..
2. Ensure conducive work environment to enhance efficiency
and productivity at all level.
Includes:-
Ensure medical, equipment’s, drugs, laboratory supplies,
uninterrupted utilities, utility backups , renovating duty
rooms, refreshment corners, physical exercise areas, waiting
areas, greenery areas
• Positive Work place culture (leadership, staff, team sprit,..)
27
28. Strategies to Optimize HWF motivation and
retention in the health system..
3. Re-design and implement professional career development
at all level.
Includes:- implement need based HWF career development
opportunities, Link the career opportunity with hard to
reach area services & performance appraisal, Implement
strong mentorship, coaching and supervision at all level, and
twining teaching institutions for HWF capacity building
28
29. Strategies to Optimize HWF motivation and
retention in the health system..
4. Promote and employ periodic evidence generation on
motivation, competency, retention and productivity.
will be in placed by conducting research assessment to
address HWF motivation, competency, retention and
productivity factors and regular review of the improvement
mechanisms.
29
30. Strategies to Optimize HWF motivation and
retention in the health system..
5. Ensure occupational health and safety preventive
measures to enhance and promote the safety and protection
of HWF.
design protocols on HWF occupational health and safety
preventive measures, establish & implement preventive
(clinical) ethics committee at health facilities, work on
prevention of ethical breaches, advocate the deployment of
Lawyer professionals at health facilities.
30
31. Strategies to Optimize HWF motivation
and retention in the health system..
6. Re-design and implement health workforce performance
based recognition mechanism at all level
Implement recognition and rewarding guideline, conduct
public promotion of best performers
7. HWF distribution standard based and flexibly as cotext
31
32. HWF by WHO standards , CSC
Accessibility
Availability
Acceptability
32
33. Indicators
1. Staff satisfaction rate
2. Client satisfaction score
3. HWF attrition rate
4. Percentage of health professionals with an active
professional license
5. # of health facilities implementing non-financial
incentive schemes
WorkStaff satisfaction survey.docx
33
