Motivation and satisfaction among community health workers in Morogoro Region, Tanzania: nuanced needs and varied ambitions
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BACKGROUND: In 2012, the Ministry of Health and Social Welfare (MOHSW), Tanzania, approved national guidelines and training materials for community health workers (CHWs) in integrated maternal, newborn and child health (Integrated MNCH), with CHWs trained and deployed across five districts of Morogoro Region soon after. To inform future scale up, this study assessed motivation and satisfaction among these CHWs. METHODS: A survey of all CHWs trained by the Integrated MNCH Programme was conducted in the last quarter of 2013. Motivation and satisfaction were assessed using a five-point Likert scale with 29 and 27 items based on a literature review and discussions with CHW programme stakeholders. Exploratory factor analysis was conducted to identify motivation and satisfaction determinants. RESULTS: Out of 238 eligible CHWs, 96 % were included in the study. Findings showed that respondents were motivated to become CHWs due to altruism (work on MNCH, desire to serve God, work hard) and intrinsic needs (help community, improve health, pride) than due to external stimuli (monetary incentives, skill utilization, community respect or hope for employment). CHWs were satisfied by relationships with health workers and communities, job aids and the capacity to provide services. CHWs were dissatisfied with the lack of transportation, communication devices and financial incentives for carrying out their tasks. Factors influencing motivation and satisfaction did not differ across CHW socio-demographic characteristics. Nonetheless, older and less educated CHWs were more likely to be motivated by altruism, intrinsic needs and skill utilization, community respect and hope for employment. Less educated CHWs were more satisfied with service and quality factors and more wealthy CHWs satisfied with job aids. CONCLUSION AND RECOMMENDATIONS: A combination of financial and non-financial incentives is required to support motivation and satisfaction among CHWs. Although CHWs joined mainly due to their altruistic nature, they became discontented with the lack of monetary compensation, transportation and communication support received. With the planned rollout of the national CHW cadre, improved understanding of CHWs as a heterogeneous group with nuanced needs and varied ambitions is vital for ensuring sustainability.
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In 2012 the Tanzania Ministry of Health & Social Welfare approved an integrated Maternal Newborn and Child Health (iMNCH) training program for CHW to standardize CHW duties and expectations across the country.
“In 2012 the Tanzania Ministry of Health & Social Welfare approved an integrated Maternal Newborn and Child Health (iMNCH) training program for CHW [36] to standardize CHW duties and expectations across the country.”
From Impact of smartphone-assisted prenatal home visits on women’s use of facility delivery: Results from a cluster-randomized trial in rural Tanzania (2018) · cites this paper as [36]
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- [15]Rumishaeli S, Mzige A. Review of community health worker cadres training programs in Tanzania, published evidence, their impact and way forward. Dares Salaam, Tanzania; 2011
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- Authors
- Mpembeni, R. N. M., Bhatnagar, A., LeFevre, A., Chitama, D., Urassa, D. P., Kilewo, C., Mdee, R. M., Semu, H., Winch, P. J., Killewo, J., Baqui, A. H., & George, A.
- Affiliations
- Muhimbili University of Health and Allied Sciences (TZ)
- Johns Hopkins University (US)
- Jhpiego (US)
- Ministry of Health and Social Welfare (TZ)
- Corresponding author
- Mpembeni, Rose N M
- ORCID
- Venue
- Human Resources for Health
- Published
- 2015-06-05
- Volume
- 13
- Issue
- 1
- Pages
- 44-44
- ISSN
- 1478-4491 (ISSN-L)
- PMC
- PMC4458000
- OpenAlex
- W1862174058
- Cited by
- 113
- References
- 41
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 3 · 2023: 14 · 2022: 16 · 2021: 15 · 2020: 13 · 2019: 15 · 2018: 11 · 2017: 9 · 2016: 3 · 2015: 2
- FWCI
- 14.37
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Human Resources for Health (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- IHI Repository (acceptedVersion)
- Funders
- United States Agency for International Development (GHSA-00-09-00004-00, GHS-A-00-09-00004)
- Muhimbili University of Health and Allied Sciences
- Johns Hopkins Bloomberg School of Public Health
- Topics
- Health Sciences › Health Professions › Emergency Medical Services › Global Health Workforce Issues
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Social Sciences › Human Factors and Ergonomics › Employee Performance and Management
- Keywords
- community health workers, motivation, job satisfaction, altruism, intrinsic motivation, financial incentives, non-monetary incentives, Morogoro region
- MeSH terms
- Adult, Age Factors, Altruism, Attitude of Health Personnel, Career Choice, Community Health Workers, Educational Status, Female, Humans, Job Satisfaction, Male, Middle Aged, Motivation, Personal Satisfaction, Residence Characteristics, Salaries and Fringe Benefits, Tanzania
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