Provider behaviour
Pay and non-pay incentives, performance and motivation
The effects of incentives aimed at one groups of health workers impacts on the effectiveness of the entire health system
Authors:
V. Hicks; O. Adams
Publisher:
Prince Leopold Institute of Tropical Medicine, Antwerp, 2003
This chapter in the book ‘Towards a Global Health Workforce Strategy’ provides an overview of the current evidence on the effect of pay and non-pay incentives on health workers’ performance and motivation. The review is organised into three sections: the first presents the range of both pay and non-pay incentives; the second presents a review of evidence about the impact that incentives have on provider behaviour; the third section outlines some of the key factors in making incentives more effective.
The paper shows that non-financial incentives play a role in retaining sufficient numbers of personnel and the right mix of skills in the health workforce. It argues that to incentives more effective it is important to extend the scope of research and evaluation to include a range of professions including nurses, primary health care workers and managers of health facilities. The paper concludes that human resources for health must be seen as an interrelated system involving staff with a complex mix of skills and motivations. The effects of incentives aimed at one group of professionals will reverberate through the entire system. Policy makers need to know if specific incentives will reinforce health system goals or upset a delectate balance between workers.
