Motivation is an important driver for health professionals to maintain their professional competencies, continue in the workforce and make a positive contribution to their workplace.
While there is some research about the motivation of health workers in low- to middle-income countries, maternal morbidity and mortality remain high and this can be lowered by improving the quality of maternal health services and the training and maintenance of the skills of maternal health workers.
In the work context, motivation can be defined as an individual’s degree of willingness to exert and maintain an effort towards organizational goals.
Work demotivation breeds a lot of negative energy among health workers and this goes beyond into other fields of life. Jane narrates her encounter with who she believes was a demotivated health worker
“I was passing through the corridors of a certain government-owned Ugandan hospital, I was in a hurry to go and be there for my sister who was due. As soon as I enter the ward the nurse came and told her to go into the observation room for injections to prepare her for the cesarean operation.” She narrated
I supported her and we walked to the observation room, to my surprise, the nurse was so rude telling her to bend forcefully and throwing insults that weren’t called for. I felt so sorry for my sister, she added.
When you hear this what comes to your mind? First, ask yourself if this health worker was given enough time off to rest, not overworked, appreciated as an important partner, and has good remuneration why would she be rude?
A dispirited health worker will choose any way to treat a patient, and when it gets to expectant mothers there is a very big communication gap in that mothers don’t get enough information about how to take care of themselves while pregnant and during the postnatal period.
Be it normal or cesarean delivery in most cases you find health workers not giving these mothers all the necessary information about the care of mother and child thus complications arise which in most cases leads to death.
The Ministry of Health Uganda reports on maternal health show that the current maternal mortality ratio in Uganda is 336 maternal deaths per 100,000 live births. Infant mortality is 43 deaths per 1000 live births, with 42% of the mortality occurring during the neonatal period.
A number of studies reveal poor maternal and newborn practices throughout the continuum of care, from ANC and skilled birth attendance to newborn care during childbirth.
With such poor results, it is not surprising that there are still high numbers of deaths due to maternal mortality in Uganda
Maternal and infant mortality might be related to the demotivation of the health system which greatly affects work performance and outcomes.
According to Bandura’s reciprocal determinism which postulates that people’s actions are determined by goals, self-efficacy, outcome expectations, perceived facilitators, and social and structural impediments.
However, it is important to understand the motivations of health workers and the factors that contribute to this and may contribute to more effective management of the health workforce in low- and middle-income countries.
The hospital management needs to improve the motivation of health workers by holding regular meetings to improve interpersonal relationships and giving stimulus for health professionals, career programs so that they will be motivated to improve their competence which will affect their performance hence improving maternal health.