Migration of workers
Human resource management. Human Resources in the Health Sectors. Concepts of motivation. An overview of migration and its impact on healthcare. Motivation indicators, migration in the Ghana health sector. Pull and push factors. Features of methodology.
| Рубрика | Международные отношения и мировая экономика |
| Вид | дипломная работа |
| Язык | английский |
| Дата добавления | 17.06.2017 |
| Размер файла | 748,4 K |
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On the other hand, salary, cooperation with/from colleagues and pay increments have insignificant effects on emigration. A possible reason could be that since the health workers in Ghana and Africa, in general, have a believe that there are better payment systems in Europe and America, irrespective of the salaries and allowances paid to them and the consistency of pay increments, they still strive to emigrate overseas and hence the insignificance of the relationship between emigration and salary contentment and pay increments (Lee, 1966). Moreover, according to this research, it could be noticed that job motivation and resource sufficiency have negative and insignificant relationships with emigration. It is probable that when the health workers in the Ghana health sector are duly motivated and have enough resources such as budget, equipment, and enough workers on board, it will help to boost their job satisfaction and as well cause a decrease in the occurrences of emigration among the health workers. From the table above, a unit change in job motivation and resource sufficiency will discourage emigration among the health workers in Ghana.
From the research, 68% of the surveyed health workers said they would like to emigrate and this is a huge number which if care is not taken and measures implemented to thwart such plans, the Ghana health sector will suffer a huge blow of low staffing and immense health worker ratios. The research sought to find out the reasons behind the desire for emigration and 44.3% said they wanted to emigrate because of their desire for a more conducive working environment, 42% said they believe they will get better salaries overseas, 38.4% said they intend to emigrate for the reason of getting exposed to modern healthcare systems, 25.1% argued that they intend to emigrate to continue their education or training while 9.4% said they intend to emigrate due to certain reasons which could be better living conditions abroad, family ties overseas, among other reasons. The research work by Teye et. al (2015) confirm the statistics of this research that majority of health workers in Ghana desire to emigrate (Kofi Teye et. al, 2015). The 38% that declined to emigrate could be as a result of their love for the country and the welfare of the sick, fear of emigrating, family issues, perceived integration problems among other reasons. The loss of health professionals through emigration can compromise health system capacity to deliver adequate care because those who emigrate are always the more experienced workers whose expertise are needed most. Staff shortages increase workloads and stress levels and it subsequently leads to demotivation of the few remaining health professionals, most especially in the rural areas. When this happens, there is the likelihood of many patients to die because the few health workers will be overburdened with the workload and there will be excessive nightshifts. According to the World Health Organization, many patients die during surgical operations at night than during daytime because health workers are worn-out at such times.
4.4.4 Hypothesis Testing
|
Tested Indicators |
Based on Descriptive Statistics |
Based on Multivariate Analysis |
|
|
H1 |
Supported |
||
|
Supported |
|||
|
i. ii. |
Rejected Rejected |
||
|
Supported |
|||
|
i. ii. |
Supported Supported |
||
|
Supported |
|||
|
H2 |
Supported |
||
|
i. ii. |
Supported Supported |
||
|
b. |
Supported |
||
|
c. i. ii. |
Supported Supported |
From the findings of this research, the majority of health workers in Ghana are overburdened with the workload. Out of the 203 surveyed health workers, 103 representing 50.7 indicated that they were overburdened with the workload due to low human resources leading to high health worker ratios. According to the multivariate analysis, job satisfaction was seen to have a negative and slightly insignificant relationship with burnouts or workload. Moreover, job motivation was seen to have positive relationships with salary contentment and pay increment at.08 and.02 respectively, while maintaining a negative relationship with the workload. This research predicted a negative relationship between job motivation, salary contentment and pay increments, however, the relationship was seen to be positive. This means that when the salaries of health workers are taken into consideration, raised and increased from time to time, their motivation towards work will be increased. Also, it was realized that when there is an increase in the workload of the health workers, their motivation to work will decrease by - .09 and it is slightly insignificant at.11.
On the other hand, rural-urban migration has negative and highly insignificant relationships with resource sufficiency and job satisfaction, while maintaining an insignificant yet positive relationship with the workload. Moreover, from the descriptive statistics, a majority of the workers in the Ghana health sector expressed their desire to emigrate overseas. Out of the 203 surveyed health professionals, 138 of them representing 68.0% expressed their intentions to emigrate. From the multivariate analysis, emigration intentions were seen to have negative and insignificant relationships with job motivation, satisfaction with management of the healthcare system, and resource sufficiency. However, prospective emigration had positive and highly significant relationships with sex (. 20***) and age (.60***).
Conclusions and recommendations
Conclusion
Job motivation and satisfaction have been identified as strong and working tools in ensuring the availability, access to and provision of quality healthcare in Ghana. As it was said by the president of the Ghana Medical Association, successive governments must make it their primary aim to motivate health practitioners in Ghana so that the health practitioners will, in return, be fully dedicated to their work and do best what is expected of them. When good policies are implemented that seek to motivate health practitioners in Ghana, it will boost the satisfaction for the current active labor force in the health sector and as well help to bring more health practitioners on board to reduce the current high health worker ratios, and also ensure sustainability and provision of quality healthcare in the country. Job safety, resource sufficiency, and management styles also have great effects on the output of health workers in the Ghana health sector. According to this research, when health workers realize that there are good safety precautionary measures available at the workplace, they feel more secured and they maximize their input on the job knowing that their safety is ensured. Moreover, resource sufficiency such as increasing the labor force and making available the necessary modern equipment for work ensures a reduction in the workload, promotes job motivation and satisfaction, and ensures increments in work output. Again, the management prowess of the management of the healthcare system has a direct effect on the health workers and work input and an indirect effect on the quality healthcare provision in the country. As a result of that, it is very prudent that the management of the healthcare systems employ good management skills while maintaining a friendly relationship with the health workers so as to encourage and lure the health workers to put in their maximum effort on their job.
Excessive workload is seen to be major the contributor to demotivation, lack of job satisfaction, and rural-urban migration. The excessive workload results in demotivation and creates burnouts and causes some of the health workers to inwardly resign, while it prompts others to embark on rural-urban migration and emigration in search of a better working condition. It must be noted that several reasons such as ethnocentrism, tribalism, lack of social amenities among others are the very contributing factors of demotivation of the few health workers left in the rural areas. That notwithstanding, the rural areas in Ghana are the areas that are constantly hit by water and airborne diseases. In view of that, the limited number of health workers left in the rural areas are always burdened by the workload. The research work of Karima Selah (2013) confirms the finding of this research that health worker ratios in Ghana is relatively high especially in the rural areas and has reduced job satisfaction and motivation among the health workers. As noted earlier, demotivation as a result of burnouts is seen as a great predictor of migration of health workers in Ghana, and according to the findings of this research, majority of the health workers in the Ghana health sector are found in the urban areas and the few in the rural areas always yearn to migrate to the urban centers. The 2008 and 2014 Ghana Demographic and Health Surveys (GDHS) confirm the finding of this research. In 2007, the national doctor-patient ratio was 10, 452 while each nurse took care of 1, 251 patients. In the Upper East and Upper West region, the doctor-patient ratio was 40, 502 in 2012 and 39, 697 in 2014. According to the 2014 GDHS, the number of midwives reduced marginally from 4, 032 to 3, 863 in 2012 which predicts a negative consequence for maternal and child health.
Though salary and pay increments have been identified as least extrinsic influential factors of job motivation, this research, however, proves that salary is a key contributing factor to emigration of health workers from Ghana. According to this research, the majority of the surveyed health workers (90%) have the desire to emigrate for reasons such as better salary, exposure to quality healthcare systems among others. Though rural-urban migration of health workers predominates in a circular form, however, other research works confirm this research that majority of highly skilled health workers in the Ghana health sector desire to emigrate. A report by a popular newspaper in Ghana, The Ghanaian Times, in 2002 estimated that about 1800 Ghanaian doctors were working outside Ghana which actually was even more than the number of doctors we had working in Ghana as at that time. A research work by Kofi et. al. (2015) also confirms the finding of this research that majority of health workers in the Ghana health sector have intentions of emigrating (Kofi Teye et. al, 2015).
Recommendation
Considering the findings of this research, this research urges the government of Ghana and its policy makers to come up with good policies that will seek to address the numerous complaints and problems facing the health sector and its employees regarding quality healthcare accessibility and provision in the country. The government should design attractive pension schemes for health practitioners with good salaries so that the health practitioners would be lured by those policies and benefits and put in their maximum efforts on their jobs. When this is done, it will also influence other people to pursue health-related programs in universities and health colleges and join the working force in the health sector which will, in the long run, increase the working force in the sector and subsequently reduce the high health worker ratios. In view of that, this research applauds the reinstatement of the nursing trainee allowances in the various nursing training colleges in Ghana by the current government of Ghana under President Nana Addo Danqua Akufo-Addo as it is in the right order since it will lure other people to enroll in the nursing training colleges which will help increase the workforce and then decrease high health worker ratios and burnouts.
With regards to the issue of rural-urban migration and emigration, this research holds that if the government of Ghana is able to extend social development projects to the rural areas in Ghana, health workers who are already there and those who will be posted to such areas will not feel left out in terms of infrastructure and social amenities and they will feel satisfied and motivated to work on their jobs in the rural areas. By infrastructure, it will be a great idea if more durable and beautiful nursing cottages and apartments are built in the rural areas where the health workers and their families can stay. If this is done, it will draw many health workers from the urban areas to the rural areas to health increase the workforce in the rural areas and hence the provision of quality healthcare will be ensured in the rural areas. It will also be a good idea if policy makers are able to design certain policies that would seek to discourage emigration and if possible, put some sort of restriction on health workers who received their training in Ghana from emigrating. There can also be bilateral agreements between the government of Ghana and those in the UK and US to help prevent the emigration of health workers from Ghana.
To sum it up, there should be a good motivation of the health workers in the Ghana health sector which will also lure other people to enroll in health-related programs in the universities and colleges so that there will be an increase in the health sector workforce. The government must also try to supply the health facilities with modern materials and other important resources to aid the work of the health workers while either reducing the income tax on the salaries of the health workers or by increasing the salaries of the health workers from time to time. In-service training is a critical part of every human resource management team if they desire to achieve maximum output. It is therefore advisable that the human resource management of the Ghana health service try their maximum best to organize in-service training and seminars to the health workers on new drugs and machines so that the health workers will be abreast with the technological know-how of modern healthcare systems, which will, in the long run, boost their confidence and satisfaction. It is no doubt that there are lack of good management skills in the Ghana health sector which has led to a great loophole in the motivation mechanisms in the Ghana health sector and if the government is able to recruit well-informed and selfless management personnel who are proactive and have the requisite management skills, there will dawn a new era of maximum job motivation and job satisfaction of majority of workers in the Ghana health sector, and a decrease in migration and turnovers. When these are done, availability, accessibility, and provision of quality healthcare will be for all Ghanaians.
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