Public Sector Health Worker Motivation and Health Sector Reform: a Conceptual Framework

This paper offers a conceptual framework for considering the many layers of influences upon health worker motivation. It suggests that worker motivation is influenced not only by specific incentive schemes targeted at workers, but also by the whole range of health sector reforms which potentially affect organizational culture, reporting structures, channels of accountability, etc. In addition, the impact of such organizational reforms will be further mediated by the social and cultural context. By drawing attention to the broad range of influences, the paper aims to help policymakers develop and implement health sector reform policies that promote worker motivation and understand better the potential of specific incentives to induce higher worker motivation. [from abstract]