Factors associated with the motivation and de-motivation of health workforce in Nepal.

BACKGROUND: Health workforce plays an important role in improving the health of people but its shortage is a major problem facing Nepal. This is further compounded by prolonged absence, low motivation, and improper distribution. The objective of the study is to find out the factors determining motivation of health workforce in the public sector. METHODS: A cross sectional study was conducted during September, 2012 to February, 2013. The health facilities were selected proportionately representing all the Illakas and then a simple random sampling was done to select individual facilities. Data was collected using questionnaire. The collected data was entered and analyzed in SPSS. Ethical approval was taken from the Nepal Health Research Council. RESULTS: More than a half (55%) of the health workers were satisfied with their current jobs and the financial benefits they acquired. The results revealed that higher age, higher education (OR:2.6; CI:1.414-4.660) and lower service duration (OR:2.567; CI:1.193-3.306) were significant factors for the motivation of health workers along with financial rewards (OR:4.706; CI:2.961-7.478), working environment (OR:2.344; CI:1.507-3.648) and opportunity for capacity development (OR:5.437; CI:3.344-8.840). The major de-motivational factors were: low remuneration (OR:3.215; CI:2.049-5.045), limited capacity development opportunity (OR:4.269; CI:2.672-6.821), poor working environment (OR:4.062; CI:2.528-6.526), non-recognition of performance (OR: 2.157; CI:1.389-3.350), and political interferences (OR:2.752; CI:1.754-4.320). CONCLUSIONS: Motivation of health workers is an important factor for smooth functioning of health intuitions and increased access to quality services. The good working environment, salary and other financial benefits matter greatly for enhanced performance of health workers along with additional factors.

Human resource for health production capacity in Nepal: a glance.

BACKGROUND: Shortage of human resources for health is apparent in Nepal. The current HRH strategy has tried to address the demand for skilled birth attendants, MDGPs, gynecologists, anesthetists, radiologists and other health workforce. Despite the increased number of institutions, there is still shortage of health workforce due to ineffective monitoring. This study was undertaken to find out the situation of HRH production in Nepal. METHODS: This cross sectional study was conducted from September 2012 to February 2013. The primary focus was on the quantitative method by using the format for the data collection. The main study samples were the academic institutions of Nepal. The finding was analyzed and tabulated in the summary form. RESULTS: There were a total of 294 institutions to produce different cadres of health workforce in Nepal. Staff nurses (101) and CMAs (76) have been produced by the maximum number of institutions. The result revealed that the institutions were not producing the graduates upon their capacity, only 1,451 staff nurse graduated annually against the capacity of producing 4,017 per annum. Although Nepal has a capacity to produce 1,760 MBBS, 267 MD and 116 MS doctors, only 1,074 Nepali MBBS, 222 MD and 95 MS doctors graduated per year. CONCLUSIONS: The health institutions performance is lower in producing HRH compared to their capacity in the country. A long-term effort is now required to match demand and supply of the HRH in the country.

Health in Nepalese media.

BACKGROUND: Coverage of health in Nepali print media is quite a recent phenomenon despite readers' ample appetite for it. Dominated by politics, Nepal's print media has been marginally publishing news pieces, features, editorials and op-ed articles, photographs and cartoons on health, though marginally. But the media did not wake up to the issues of human resources for health until lately. METHODS: We content analysed the coverage of health issues including, human resources for health in select Nepali print media Kantipur, Nagarik and Annapurna Post of select three months in 2012 April, August and December. News pieces and their placements, Op-eds, editorials, features, letters to the editor, photos and cartoons were subjected to analysis. RESULTS: Over the study period, the papers covered 544 health news pieces, 44% of political news pieces. Health workforce news pieces contributed 24% to it. However, only 10% of the health news made to the front pages. Coverage of health in editorials, features, Op-eds, photographs, cartoons and letters to the editor is even more meager. For example, only 7% of the editorials are relating to health. CONCLUSIONS: Health is prioritized far less by the print media than politics despite the reader's appetite for it. Print media should give health a top priority, particularly in those areas that relate to health systems like human resources for health, for their massive impact on the lives of the people.