Motivating rural health workers in north Viet Nam

The performance of public health sector staff is affected by a variety of factors that can either motivate or discourage them in their work. Increasing the performance of health sector staff depends, among other things, upon the response of policy-makers and managers to these factors. In rural north Viet Nam, financial incentives play a considerable part in staff performance, but are not alone. Recognition from management, colleagues and the community, as well as training, are also key.

Most of Viet Nam’s public health sector is in rural areas. Here staff receive extremely low pay and are often forced to have second jobs in order to survive. This makes it very difficult to attract staff and to retain them once in post. As a result, it is very important that appropriate human resource management (HRM) tools are used to motivate and keep staff in post.

Research carried out by the Royal Tropical Institute of the Netherlands and the Hanoi School of Public Health in Viet Nam studied the major motivating factors of public health staff working in rural areas. Following a theory of motivation that distinguishes between motivating factors and factors that lead to unhappiness in the job, researchers conducted interviews with policy-makers and managers, health workers and members of the community. Interviewers explored perceptions of the factors that motivate and discourage health workers, their perception on the value of HRM tools and the community’s perceptions of what constitutes good care and effective staff.

The study found that:

• Health workers are motivated by recognition and respect from managers and colleagues and by the community.
• There is a mismatch between the motivational needs of health workers and the HRM tools used by managers. For example, the supervision of staff by managers is widely perceived as a method of control.
• The appreciation of the community is an important motivational factor for health workers. Therefore, there is a need for feedback mechanisms from the community to health workers.
• Poor salaries and working conditions are important factors that can discourage staff. It is accepted that, because of low pay, public health staff have to gain additional income in order to earn a living. This may have a negative impact on the quality of care provided in the public health sector.

The study showed that to improve staff motivation, policy-makers and managers should consider non-financial as well as financial incentives and improve the implementation of performance management systems. Good working relationships and performance management appraisals can help improve staff morale.

Source(s):
'Identifying factors for job motivation of rural health workers in north Viet Nam', Human Resources for Health 1: 10, by M. Dieleman et al, 2003

id21 Research Highlight: 28 April 2004

Further Information:
Marjolein Dieleman
Area Education
KIT Development, Policy and Practice
Royal Tropical Institute
Amsterdam
The Netherlands

Tel: +31 20 568 8658
Fax: +31 20 568 8677
Contact the contributor: m.dieleman@kit.nl

Royal Tropical Institute (KIT), Netherlands

Hanoi School of Public Health, Viet Nam

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