Factors That Affect Staff Morale in Tertiary Hospitals in Malawi: A Case Study of Kamuzu Central Hospital

John Benson Chipeta

HIV/AIDS Section, UNICEF, Lilongwe, Malawi.

DOI: 10.4236/jhrss.2014.24024                

Abstract

Staff morale is low among medical and nursing staff in Malawi’s health facilities. This leads to voluntary attrition or unfavorable survival strategies among members of staff. This study sought to determine critical factors that affected staff morale at Kamuzu Central Hospital (KCH). This was a case study research design. Quantitative data were collected through structured questionnaires filled in by doctors, registered nurses and clinical officers. Qualitative data were collected through focus group discussions with the same cadres. An in-depth interview was done with one human resource officer. Key factors that affected staff morale at KCH were: inadequate resources for work, poor compensation, heavy workload, inadequate performance management, lack of career development and lack of training opportunities. Nurses further complained of inadequate management support. Thirty-one percent of the respondents were very dissatisfied with their jobs and 57% were intending to leave within 12 months. Job satisfaction was associated with management responsiveness (p-value 0.009).

Keywords

Human Resource Management, Staff Morale, Medical and Nursing Staff

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Ministry of Economic Planning and Development (2011) Malawi Growth and Development Strategy II: 2011-2016, Lilongwe.
[2]	Ministry of Health (2011) Health Sector Strategic Plan 2011-2016, Lilongwe.
[3]	Huddart, J. and Picazo, O.F. (2003) The Health Sector Human Resource Crisis in Africa. Academy for Educational Development. An Issue Paper, Washington DC.
[4]	Muula, A. and Maseko, F. (2005) Survival and Retention Strategies for Malawian Health Professionals. Regional Network for Equity in Health in Southern Africa. EQUINET Discussion Paper No. 32.
[5]	Palmer, D. (2006) Tackling Malawi’s Human Resources Crisis. Reproductive Health Matters, 14, 27-39. http://dx.doi.org/10.1016/S0968-8080(06)27244-6
[6]	McAuliffe, M.O., Bowie, C., Maseko, F., MacLachlan, M. and Normand, C. (2008) Maximising Human Resource Capacity in Rural District Health Systems in Malawi, Lilongwe.
[7]	United States of America’s Ministry of Health (2006) What Makes a Healthy Work Environment? http://www.health.gov.bc.ca/environments/workplace/healthyworkplace.html
[8]	Armstrong, M. (2006) A Hand Book of Human Resource Management Practice. Kogan Page, London.
[9]	Paradath, A., Chamberlain, C., McCoy, D., Ntuli, A., Rowson, M. and Loewenson R. (2003) Health Personnel in Southern Africa: Confronting Maldistribution and Brain Drain. EQUINET Discussion Paper No. 3.
[10]	Ministry of Health (2008) Malawi Health SWAp Mid-Term Review: NORAD Collected Reviews, Lilongwe.
[11]	GTZ/Malawi Health SWAp (2007) Human Resources/Capacity Development within the Health Sector. Needs Assessment Study, Lilongwe.
[12]	Noe, R., Hollenbeck, J., Gerhart, B. and Wright, P. (2010) Human Resource Management: Gaining a Competitive Advantage. McGraw Hill, New York.
[13]	Pearce, J.A. and Robinson, R.B. (2011) Strategic Management: Formulation, Implementation and Control. McGraw Hill, New York.
[14]	Mathauer, I. and Imhoff, I. (2006) Health Worker Motivation in Africa: The Role of Non-Financial Incentives and Human Resource Management Tools. Human Resources for Health, 4, 24. http://dx.doi.org/10.1186/1478-4491-4-24
[15]	Dambisya, Y. (2007) A Review of Non-Financial Incentives for Health Worker Retention in East and Southern Africa. Proceedings of Equinet Discussions, University of Limpopo, South Africa, Paper No. 44.
[16]	Carlson, C., Boivin, M., Chirwa, A., Chirwa, S., Chitalu, F., Hoare, G., Huelsmann, M., Ilunga, W., Maleta, K., Marsden, A., Martineau, T., Minett, C., Mlambala, A., Massow, F., Njie, N. and Olsen, I. (2008) Malawi Health SWAp Mid-Term Review. Norad Collected Reviews.
[17]	Department for International Development (2010) Evaluation of Malawi’s Emergency Human Resources Programme.
[18]	Mangham, L. (2007) Addressing the Human Resource Crisis in Malawi’s Health Sector: Employment Preferences of Public Sector Registered Nurses. ESAU Economic and Statistical Analysis Unit, London, March 2007, Working Paper 18.
[19]	Herzberg, F. (1964) The Motivation-Hygiene Concept and Problems of Manpower. Personnel Administration, 27, 3-7.
[20]	Grobler, P., Warnich, S., Carrell, M., Elbert, N. and Hatfield, R. (2006) Human Resource Management in South Africa. Thomson, Pat Bond, London.
[21]	Deloitte and Touch (2010) Compensation Strategies: How to Reward and Retain Employees on a Tight Comp Budget. http://www.deloitte.com/assets/dcom-global/local%20assets/documents/human%20capital/us_talent2020_september2012_09142012.pdf
[22]	Health Systems Strengthening for Equity (2008) Factors Affecting Job Satisfaction and Retention in Malawi, Mozambique and Tanzania: The Importance of Supervision.
[23]	McCord, C., Mbaruku, G., Pereira, C., Nzabuhakwa, C. and Bergstrom, S. (2009) The Quality of Emergency Obstetrical Surgery by Assistant Medical Officers in Tanzanian District Hospitals. Health Affairs, 28, 876-885.
[24]	Pereira, C., Cumbi, A., Malalane, R., Vaz, F., McCord, C., Bacci, A. and Bergström, S. (2007) Meeting the Need for Emergency Obstetric Care in Mozambique: Work Performance and Histories of Medical Doctors and Assistant Medical Officers Trained for Surgery. BJOG: An International Journal of Obstetrics and Gynaecology, 114, 1530-1533. http://dx.doi.org/10.1111/j.1471-0528.2007.01489.x
[25]	Ntuli, A. (2006) Regional Evidence and Perspectives on Migration of Health Workers. Proceedings of a Regional Planning Meeting: Retention and Migration of Health Personnel in Southern Africa, Lusaka.
[26]	Awases, M., Gbary, A., Nyoni, J. and Chatora, R. (2004) Migration of Health Professionals in Six Countries: A Synthesis Report. WHO-AFRO DHS, Brazaville.
[27]	Saunders, M., Lewis, P. and Thornhill, A. (2012) Research Methods for Business Students. Pearson Education Ltd., Harlow.
[28]	Morris, C. (2012) Quantitative Approaches in Business Studies. 8th Edition, Pearson Education Ltd., Harlow.
[29]	Alliance Capital Ltd. (2013) Business-Daily Market Data. The Daily Times, 13 August 2013, 10.