Effect of Motivation on Health Workers’ Job Performance at a Teaching Hospital, Ghana

Annie Adazewah Buabeng

Surgical Department, Korle-Bu Teaching Hospital, P.O. Box KB77, Korle-Bu, Accra, Ghana.

Augustine Adomah-Afari *

Department of Health Policy, Planning & Management, School of Public Health, College of Health Sciences, University of Ghana, P.O. Box LG13, Legon- Accra, Ghana.

*Author to whom correspondence should be addressed.


Aim: To determine the effect of intrinsic and extrinsic motivation on health workers’ performance among clinical health personnel.

Study Design: An exploratory cross-sectional design was applied.

Place and Duration of Study: Korle-Bu Teaching Hospital in the Greater Accra Region of Ghana in June 2016.

Methodology: Quantitative methods were employed and 324 clinical health personnel responded to a self-administered structured questionnaire. Stata version 13 was used for the statistical analysis. An ANOVA test was conducted to compare the effect of motivation on job performance. Simple and multiple linear regression models were used to estimate the overall effect of the independent variables on the outcome variable. The level of significance was a probability less than 5% (P<0.05).

Results: The study identified achievement and personal satisfaction, and incentive packages as intrinsic motivation factors that could influence the performance of health workers. All the extrinsic motivation factors (availability of equipment, job security, good interpersonal relationships with co-workers, recognition and promotion, improved salary, and workload or feeling burned out and emotionally drained after work) could significantly affect job performance. The overall multiple regression model showed that both intrinsic (F (4, 319) = 8.66, P=.001) and extrinsic (F (6, 317) = 23.97, P=.001) motivation factors were significantly associated with job performance. 

Conclusion: Generally, the study concludes that providing an enabling environment and motivation could have a positive effect on health workers’ job performance.

Keywords: Career development, extrinsic motivation, intrinsic motivation, job performance, motivation, public health

How to Cite

Buabeng , Annie Adazewah, and Augustine Adomah-Afari. 2023. “Effect of Motivation on Health Workers’ Job Performance at a Teaching Hospital, Ghana”. Asian Journal of Research in Nursing and Health 6 (1):389-405. https://journalajrnh.com/index.php/AJRNH/article/view/139.


Download data is not yet available.


Mathauer I, Imhoff I. Health worker motivation in Africa: The role of non-financial incentives and human resource management tools. Hum. Resour. Health. 2006;4(1):1-7. DOI: https://doi.org/10.1186/1478-4491-4-24.

Sallis E. Total quality management in education. London: Routledge; 2014.

Aguinis H, Gottfredson RK, Joo H. Avoiding a “me” versus “we” dilemma: Using performance management to turn teams into a source of competitive advantage. Bus. Horiz. 2013;56(4):503-512. DOI:https://doi.org/10.1016/j.bushor.2013.02.004

Platis C, Reklitis P, Zimeras S. Relation between job satisfaction and job performance in healthcare services. Procedia Soc. Behav. Sci. 2015; 175(2015):480-487. DOI: https://doi.org/10.1016/j.sbspro.2015.01.1226.

Gould-Williams JS, Mohammed A. Linking HRM systems with public sector employees' performance. Managing for public service performance: How people and values make a difference. UK: Oxford University Press. 2021;161.

Chhea C, Warren N, Manderson L. Health worker effectiveness and retention in rural Cambodia. Rural. Remote. Health. 2010; 10(3):1-4. Available:www.rrh.org.au/journal/article/1391

Alhassan RK, Spieker N, van Ostenberg P, Ogink A, Nketiah-Amponsah E, de Wit TF. Association between health worker motivation and healthcare quality efforts in Ghana. Hum. Resour. Health. 2013; 11(1):1-12. DOI: https://doi.org/10.1186/1478-4491-11-37

Henderson LN, Tulloch J. Incentives for retaining and motivating health workers in Pacific and Asian countries. Hum. Resour. Health. 2008;6(18):1-20. DOI: https://doi.org/10.1186/1478-4491-6-18

Afful-Broni A. Relationship between motivation and job performance at the University of Mines and Technology, Tarkwa, Ghana: Leadership lessons. Creat. Educ. 2012;3(03):309-314. DOI: https://doi.org/org/10.4236/ce.2012.33049.

World Health Organization (WHO). The world health report: 2006: Working together for health. World Health Organisation, Geneva; 2006.

Bonenberger M, Aikins M, Akweongo P, Wyss K. The effects of health worker motivation and job satisfaction on turnover intention in Ghana: a cross-sectional study. Hum. Resour. Health. 2014;12(43):1-12. DOI: https://doi.org/10.1186/1478-4491-12-43

Lutwama GW, Roos JH, Dolamo BL. A descriptive study on health workforce performance after decentralisation of health services in Uganda. Hum. Resour. Health. 2012;10(41):1-10. DOI: https://doi.org/10.1186/1478-4491-10-41

Muogbo US. The impact of strategic management on organisational growth and development (A study of selected manufacturing firms in Anambra state). J. Bus. Manag. 2013;7(1):24-32. Available:www.iosrjournals.org.

Aladwan K, Bhanugopan R, Fish A. Why do employees jump ship? Examining intent to quit employment in a non‐western cultural context. Empl. Relat. 2013; 35(4):408-422. DOI: https://doi.org/10.1108/ER-03-2012-0027

Okorley EN, Boohene R. Determinants of bank staff motivation in the Cape Coast Metropolis. Int. Bus. Manag. 2012; 4(1):121-125. DOI:https://doi.org/10.3968/j.ibm.1923842820120401.1120

Ampofo P. Motivational packages and their effects on employee performance in the Ghana Education Service: a case study of Asante Akyem Senior High School. Masters Thesis, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; 2011.

Attrams RA. Motivation and employee satisfaction: perceptions of workers in public and private health care facilities. MPhil Thesis, University of Ghana, Accra, Ghana; 2013.

Wukir A. Human resource management in school organization. Yogyakarta, Multi Presindo; 2013.

Sudiardhita KI, Mukhtar S, Hartono B, Sariwulan T, Nikensari SI. The effect of compensation, motivation of employee and work satisfaction to employee performance Pt. Bank Xyz (Persero) Tbk. Acad. Strateg. Manag. J. 2018;17(4):1-14.

Hafiza NS, Shah SS, Jamsheed H, Zaman K. Relationship between rewards and employee’s motivation in the non-profit organizations of Pakistan. Bus. Intell. J. 2011;4(2):327-334.

Ali JA, Howaidee M. The impact of service quality on tourist satisfaction in Jerash. Interdiscip. J. Contemp. Res. 2012;3(12): 164-187. Available:www.jcrb.webs.com.

Frederick-Recascino CM, Hall S. Pilot motivation and performance: Theoretical and empirical relationships. Int J Aviat Psychol. 2003;13(4):401-414. DOI:https://doi.org/10.1207/S15327108IJAP1304_05

Korle-Bu Teaching Hospital (KBTH). Annual Report: 2010-2012. Korle Bu Teaching Hospital, Accra: Ghana; 2013.

Damanka S, Adiku TK, Armah GE, Rodrigues O, Donkor ES, Nortey D, Asmah R. Rotavirus infection in children with diarrhea at Korle-Bu teaching hospital, Ghana. J. Infect. Dis. 2016;69(4): 331-334. DOI:https://doi.org/10.7883/yoken.JJID.2014.407

Korle-Bu Teaching Hospital (KBTH). Annual Report 2012-2014. Korle Bu Teaching Hospital, Accra: Ghana; 2015.

Watt JD, Hargis MB. Boredom proneness: Its relationship with subjective underemployment, perceived organizational support, and job performance. J Bus Psychol. 2010;25(1): 163-174. DOI: https://doi.org/10.1007/s10869-009-9138-9

Agyepong IA, Anafi P, Asiamah E, Ansah EK, Ashon DA, Narh‐Dometey C. Health worker (internal customer) satisfaction and motivation in the public sector in Ghana. Int J Health Plann Manage. 2004;19(4):319-336. DOI: https://doi.org/10.1002/hpm.770

Blaauw D, Ditlopo P, Maseko F, Chirwa M, Mwisongo A, Bidwell P, Thomas S, Normand C. Comparing the job satisfaction and intention to leave of different categories of health workers in Tanzania, Malawi, and South Africa. Glob. Health Action. 2013;6(1):127-137.

Schat AC, Frone MR. Exposure to psychological aggression at work and job performance: The mediating role of job attitudes and personal health. Work Stress. 2011;25(1):23-40. DOI:https://doi.org/10.1080/02678373.2011.563133

Mbindyo P, Gilson L, Blaauw D, English M. Contextual influences on health worker motivation in district hospitals in Kenya. Implement. Sci. 2009;4(43):1-10. DOI: https://doi.org/10.1186/1748-5908-4-43

Maslow AH. A theory of human motivation. Psychol. Rev. 1943;50(4):370-396. Available:https://laymn.com/a-theory-of-human-motivation/

Nawab S, Bhatti KK, Shafi K. Effect of motivation on employees performance. Interdiscip. J. Contemp. Res. 2011; 3(3):1209-1216.

Cerasoli CP, Nicklin JM, Ford MT. Intrinsic motivation and extrinsic incentives jointly predict performance: a 40-year meta-analysis. Psychol. Bull. 2014;140(4):980-1008. DOI. https://doi.org/org/10.1037/a0035661

McClelland DC. N achievement and entrepreneurship: A longitudinal study. J Pers Soc Psychol. 1965;1(4):389-392.

DOI: https://doi.org/10.1037/h0021956

Locke EA, Latham GP. A theory of goal setting and task performance. Upper Saddle River, NJ: Prentice Hall; 2005.

Lambrou P, Kontodimopoulos N, Niakas D. Motivation and job satisfaction among medical and nursing staff in a Cyprus public general hospital. Hum. Resour. Health. 2010;8(26):1-9.

DOI: https://doi.org/10.1186/1478-4491-8-26

Samuel A, Cervero RM, Durning SJ, Maggio LA. Effect of continuing professional development on health professionals’ performance and patient outcomes: A scoping review of knowledge syntheses. Acad. Med. 2021;96(6):913-923. DOI:https://doi.org/10.1097/ACM.0000000000003899

Manongi RN, Marchant TC, Bygbjerg IB. Improving motivation among primary health care workers in Tanzania: a health worker perspective. Hum. Resour. Health. 2006;4(1):1-7. DOI: https://doi.org/10.1186/1478-4491-4-6

Willis-Shattuck M, Bidwell P, Thomas S, Wyness L, Blaauw D, Ditlopo P. Motivation and retention of health workers in developing countries: A systematic review. BMC Health Serv. Res. 2008;8(247):1-8. DOI: https://doi.org/10.1186/1472-6963-8-247

Prabhakar GV, Brnia RW. Ambulatory health care staffs’ perception of the influence of training on performance. Eur. J. Train. Dev. 2016;3(3):17-36. Available:www.eajournals.org

Lee MC, Idris MA, Tuckey M. Supervisory coaching and performance feedback as mediators of the relationships between leadership styles, work engagement, and turnover intention. Hum. Resour. Dev. Int. 2019;22(3):257-282. DOI:https://doi.org/10.1080/13678868.2018.1530170

Miller G, Babiarz KS. Pay-for-performance incentives in low-and middle-income country health programs. NBER Working Paper Series, Working Paper 18932; 2014. Available:http://www.nber.org/papers/w18932

Jones GR, George JM. Contemporary management, 7th ed. New York, NY: McGraw-Hill/Irwin; 2011.

Herzberg F, Mausner B, Snyderman B. The motivation to work. New York,USA: Wiley; 1959.

Anitha J. Determinants of employee engagement and their impact on employee performance. Int. J. Product. Perform. 2014;63(3):308-323. DOI: https://doi.org/10.1108/IJPPM-01-2013-0008

Darvishmotevali M, Ali F. Job insecurity, subjective well-being and job performance: The moderating role of psychological capital. Int. J. Hosp. Manag. 2020;87(1): 102462. DOI:https://doi.org/10.1016/j.ijhm.2020.102462

Sageer A, Rafat S, Agarwal P. Identification of variables affecting employee satisfaction and their impact on the organization. J. Bus. Manag. 2012;5(1):32-39. Available:www.iosrjournals.org.

Paillé P, Chen Y, Boiral O, Jin J. The impact of human resource management on environmental performance: An employee-level study. J. Bus. Ethics. 2014;121(1):451-466. DOI: https://doi.org/10.1007/s10551-013-1732-0

Peters DH, Chakraborty S, Mahapatra P, Steinhardt L. Job satisfaction and motivation of health workers in public and private sectors: cross-sectional analysis from two Indian states. Hum. Resour. Health. 2010;8(27):1-11. DOI: https://doi.org/10.1186/1478-4491-8-27

Patterson M, Rick J, Wood SJ, Carroll C, Balain S, Booth A. Systematic review of the links between human resource management practices and performance. Health Technol Assess. 2010; 14(51):1-380. DOI: https://doi.org/10.3310/hta14510

Jenkins Jr GD, Mitra A, Gupta N, Shaw JD. Are financial incentives related to performance? A meta-analytic review of empirical research. J. Appl. Psychol. 1998;83(5):777-787. DOI:https://doi.org/10.1037/0021-9010.83.5.777

Glenton C, Colvin CJ, Carlsen B, Swartz A, Lewin S, Noyes J, Rashidian A. Barriers and facilitators to the implementation of lay health worker programmes to improve access to maternal and child health: A qualitative evidence synthesis. Cochrane Database Syst. Rev. 2013(10): 1-66. DOI:https://doi.org/10.1002/14651858.CD010414.pub2

Jaskiewicz W, Tulenko K. Increasing community health worker productivity and effectiveness: A review of the influence of the work environment. Hum. Resour. Health. 2012;10(38):1-9. DOI: https://doi.org/10.1186/1478-4491-10-38.

Masri NE, Abubakr SU. Talent management, employee recognition and performance in the research institutions. Stud. Bus. Econ. 2019;14(1):127-140. DOI: https://doi.org/10.2478/sbe-2019-0010

Awases MH, Bezuidenhout MC, Roos JH. Factors affecting the performance of professional nurses in Namibia. Curationis. 2013;36(1):1-8. DOI:https://hdl.handle.net/10520/EJC134855

Mafini C, Dlodlo N. The relationship between extrinsic motivation, job satisfaction and life satisfaction amongst employees in a public organisation. SA J. Ind. Psychol. 2014;40(1):1-13. DOI:https://hdl.handle.net/10520/EJC152849

Lavrakas PJ. Population. Encycl Surv. Res. Methods; 2008. DOI:https://dx.doi.org/10.4135/9781412963947.n383

Bennett S, Gzirishvili D, Kanfer R. An in-depth analysis of the determinants and consequences of worker motivation in two hospitals in Tbilisi. Major Applied Research 5, Working Paper 9:1-80. Bethesda, Georgia, USA: Partnerships for Health Reform, Abt Associates Inc; 2000.

Mutale W, Ayles H, Bond V, Mwanamwenge MT, Balabanova D. Measuring health workers’ motivation in rural health facilities: Baseline results from three study districts in Zambia. Hum. Resour. Health. 2013;11(8):1-8. DOI: https://doi.org/10.1186/1478-4491-11-8

Baljoon RA, Banjar HE, Banakhar MA. Nurses’ work motivation and the factors affecting It: A scoping review. International Journal of Nursing & Clinical Practices. 2018;5(1):277. Int J Nurs Clin Pract. 2018;5(277):1-10. DOI:https://doi.org/10.15344/2394-4978/2018/277

Wang H, Jin Y, Wang D, Zhao S, Sang X, Yuan B. Job satisfaction, burnout, and turnover intention among primary care providers in rural China: Results from structural equation modeling. BMC Fam. Pract. 2020;21(12):1-10.

DOI: https://doi.org/10.1186/s12875-020-1083-8

Davidescu AA, Apostu SA, Paul A, Casuneanu I. Work flexibility, job satisfaction, and job performance among Romanian employees—Implications for sustainable human resource management. Sustain. 2020;12(15):1-53. DOI: https://doi.org/10.3390/su12156086

Ormel H, Kok M, Kane S, Ahmed R, Chikaphupha K, Rashid SF, Gemechu D, Otiso L, Sidat M, Theobald S, Taegtmeyer M. Salaried and voluntary community health workers: exploring how incentives and expectation gaps influence motivation. Hum. Resour. Health. 2019;17(59): 1-12. DOI: https://doi.org/10.1186/s12960-019-0387-z

Ali BJ, Anwar G. An empirical study of employees’ motivation and its influence job satisfaction. Ali, BJ, & Anwar, G.(2021). An Empirical Study of Employees’ Motivation and its Influence Job Satisfaction. Int. J. Eng. Bus. Manag. 2021;5(2):21-30. DOI: https://dx.doi.org/10.22161/ijebm.5.2

Scott K, Beckham SW, Gross M, Pariyo G, Rao KD, Cometto G, Perry HB. What do we know about community-based health worker programs? A systematic review of existing reviews on community health workers. Hum. Resour. Health. 2018;16(39):1-17. DOI: https://doi.org/10.1186/s12960-018-0304-x

Liu J, Zhu B, Wu J, Mao Y. Job satisfaction, work stress, and turnover intentions among rural health workers: A cross-sectional study in 11 western provinces of China. BMC Fam. Pract. 2019;20(9):1-11. DOI: https://doi.org/10.1186/s12875-019-0904-0

Alrawashdeh HM, Al-Tammemi AA, Alzawahreh MK, Al-Tamimi A, Elkholy M, Al Sarireh F, Abusamak M, Elehamer NM, Malkawi A, Al-Dolat W, Abu-Ismail L. Occupational burnout and job satisfaction among physicians in times of COVID-19 crisis: a convergent parallel mixed-method study. BMC Public Health. 2021;21(811):1-18. DOI: https://doi.org/10.1186/s12889-021-10897-4

Musinguzi C, Namale L, Rutebemberwa E, Dahal A, Nahirya-Ntege P, Kekitiinwa A. The relationship between leadership style and health worker motivation, job satisfaction and teamwork in Uganda. J. Healthc. Leadersh. 2018:10(1):21-32. DOI: https://doi.org/10.2147/JHL.S147885

Munnangi S, Dupiton L, Boutin A, Angus LG. Burnout, perceived stress, and job satisfaction among trauma nurses at a level I safety-net trauma center. J. Trauma Nurs. 2018;25(1):4-13. DOI:https://doi.org/10.1097/JTN.0000000000000335

Grujičić M, Jovičić-Bata J, Rađen S, Novakovic B, Šipetić-Grujičić S. Work motivation and job satisfaction of health workers in urban and rural areas. Vojnosanit Pregl. 2016;73(8):735-743. DOI:https://doi.org/10.2298/VSP140715062G