Job Motivation and Income Satisfaction Among Governmental and Private Hospitals in Tigray, Ethiopia

Health care services can be provided via Governmental and Nongovernmental providers. A cross-sectional sample survey involving 379 human resource employees of the Governmental and Private Hospitals found in Tigray regional was carried out from January to March 2019. The findings show that there were Job motivation and income satisfaction among Governmental and Private Hospitals in the Tigray region, Ethiopia.

INTRODUCTION

Background to the study

Public health can be defined as the science of safeguarding the well-being and improving or restoring the health of communities by using the tools of education, policy-making and research for disease and injury prevention. Private healthcare is healthcare and medicine provided by entities other than the government. "Private healthcare" is more common and is used to describe medical services that are not possible to accomplish the government. Private health care can be given through “profit-making hospitals, self-employed practitioners and not profit-making non-government health providers”. (FMOH, 2005).

Inspired health care workers are in the first place to achieve both domestics and international health goals. At the center of each health system, the workforce is crucial to advancing health. There should be an optimum number and professional mix of human resources for the effective treatment and worth of the intended services (Ozcan S, et.al, 1995). Health services are labor-intensive and personal in nature. As funds become accessible from different initiatives like Global Fund against HIV/AIDS, Tuberculosis and Malaria, more obliged low-income Countries Initiative and other processes, the ability to suck up them will be constrained without appropriate human resources (Martinez J, Martineau T, 1998).

The researcher would want to make an assessment of the Job motivation and income satisfaction of workers to realize national and global health goals and understand those motives that can prompt health workers to put in their best at all times in both governmental and private Hospitals in Tigray region, Ethiopia.

STATEMENT OF THE RESEARCH PROBLEM

Global economic depression has put major constraints on government budgets recently. The demand for covering health care expense for both private and public health care facilities from multiple funders are becoming increasing and this dependency might be by the encouragement of International Monetary Fund (IMF), that countries increase the scope of private sector provision in health care as part of loan conditions to reduce government debt. However, The complaints of the private health area think that public healthcare delivery is of most helpful to unfortunate people and is a single way to accomplish general and fair access to health care.

For example, an earlier analysis of health care providers sharing using facility data from three developing countries accredited that the shortage of a homogeneous occupational coding system to recognize provider type resulted in difficulties in conducting cross-national comparisons (Amin S, Das J, Goldstein M, 2008).

Research Question

Is there a difference in Job motivation and income satisfaction among governmental and private hospitals?

Objective of the Study

General objective: The general objective of this study is to assess Job motivation and income satisfaction among governmental and private hospitals in Tigray Region, Ethiopia.

Specific objectives: To identify   the health provider’s income satisfaction level and Job motivation between governmental and private Hospital

DATA ANALYSIS

Introduction

The study tried to assess Job motivation and income satisfaction among governmental and private hospitals in Tigray region, Ethiopia. For this study, 379 questionnaires were distributed to the employees currently working in 42 public and private general and primary hospitals in the region.  All distributed questionnaires were filled up and returned with a response rate of 100%.

Data were cleaned, edited, coded after it was entered into Epi Info version 3.4.3 and exported to SPSS version 25. Using SPSS version 25, descriptive statistics were used to determine indices. Factor analysis was done to identify factors that explained most of the variance observed in the population with regard to each scale.

The analysis of variance to comparing responses from the public and private hospital respondents and multiple linear regressions for identifying determinants of employee satisfaction and management at public and private hospitals were done. A significance level of 0.05 was used in all cases.

Table: 1 Job motivation and income satisfaction frequency

Variables	S. Agree	Percent	Agree	Percent	Not Sure	Percent	S. Disagree	Percent	Disagree	Percent	Total (%)
The training programs are designed to fill performance gaps	31	8.2	143	37.7	64	16.9	59	15.6	82	21.6	100
applicants qualifications are given the highest priority	38	10.0	123	32.5	98	25.9	33	8.7	87	23.0	100
Employees are encouraged to participate in problem solving matters	31	8.2	146	38.5	58	15.3	53	14.0	91	24.0	100
Employees feel happy by the results of  appraising    their Performance	29	7.7	93	24.5	81	21.4	77	20.3	99	26.1	100
My Salary in this institution is enough for me	24	6.3	81	21.4	21	5.5	131	34.6	122	32.2	100
My organization gives competence or skill-based pay increment	17	4.5	63	16.6	65	17.2	121	31.9	113	29.8	100
our organization, salary and other benefits are comparable to the market	15	4.0	46	12.1	51	13.5	164	43.3	103	27.2	100
compensation for all employees is directly linked to his/her performance	23	6.1	88	23.2	55	14.5	109	28.8	109	28.8	100

Source: Own computation (2019)
 

1. The training programs are designed to fill performance gaps

In the findings in table1, the training programs designed to fill performance gaps revealed that 174 (45.9%) which is around half of the employees respondents agree and 64(16.9%) respondents are not sure the training programs are designed to fill performance gaps, whereas 141(37.2%) respondents disagree that the organization training programs are designed to fill performance gaps.

2. Applicant’s qualifications are given the highest priority

As shown in Table 4, majority of the employees 38 (10.0%) and 123(32.5%) respondents strongly agreed with the recruitment and selection through the applicants qualification that gives highest priority while 98(25.9%) are not sure, whereas 33(8.7%) and 87(23%) respondent strongly disagree the recruitment and selection give the highest priority to qualification.

3. Employees are encouraged to participate in problem-solving matters

The encouragement of problem-solving matters participation of employees in the organization responses are as shown in table 4; Thus, 31(8.2%) and 146(38.5%) almost majority of the respondents replied strongly agree the organizations encourage the employees in problem-solving matters and 58 (15.3%) respondents responded not sure, whereas 53(14%) and 91 (24%) respondents responded strongly disagree.

4. Employees feel happy by the results of appraising their performance

As indicated above in table 1, Employees feel happy by the results of the appraising of their Performance. However, 12 (32.2%) of them showed their agreement that employees feel happy by the result of appraising their performance and while 81 (21.45) employees responded not sure. However, 176(46.4%) employees disagree that the employees do not feel happy with the results of appraising their Performance and the remaining respondents indicated that employees did not feel happy by appraising their performance.

5. Salary in this institution is enough for me

The frequency analysis revealed that 105 (27.7%) employees identified that salary in the institution is agreed to be enough, 21(5.5%) respondents were not sure, whereas, 253(66.8) employees disagree on the salary of the institution is not enough by showing their disagreement.

6. The organization gives competence or skill-based workers payment increment

As indicated above in Table 1, the organization gives competence or skill-based workers payment increment. However, 80(21.1%) of them agreed while 65 (17.2%) employees responded not sure and 234(57.8%) employees disagree that the organization gives competence or skill-based workers payment increment.
This implies that employees are not given any top-up allowance or competence skills based on payment in the process of work and this largely influences the performance of employees in the long run. The availability of such top-up allowances allows staff members in their organizations to work effectively which significantly contributes to the performance of the overall performance of the enterprise in the long run.

7. Our organization's salary and other benefits are comparable to the market

As indicated In table1, Frequency analysis was conducted to find the response. The finding revealed that 61(16.1%) the few employees agreed to respond that organization, salary and other benefits are comparable to the market, 51(13.5%) respondents were not sure, while the majority 267(70.5%) employees showed their disagreement.

8. Compensation for all employees is directly linked to his/her performance

Table1. clearly identified the responses of employees that is,111(29.3%) employees proved that the Compensation for all employees is directly linked to his/her performance, 55 (14.5%) employees said they are not sure, whereas, 218(57.6%) more than half of the respondent disagree with the idea.

Cross tabulation with Chi-square Data Analysis to measure relationship between the facility type and variables

An important consideration when cross tabulating the findings of the study is verifying to see whether the represented in the cross-tab is true or false.

Table 2. Job motivation and income satisfaction Cross tabulation

Variables cross tabulation	Facility Type	Agree	Disagree	Not sure	Strongly agree	Strongly Disagree	Total	Pears on chi-square value	Degree of freedom	P-Value	90%Confidence interval		Interpretation
											Lower Bound	Upper Bound
Facility Type (Governmental and Private) Verses The training programs are designed to fill performance gaps	Governmental Count and Percent Private Count and Percent	119 36.0%	74 22.4%	57 17.2%	24 7.3%	57 17.2%	331 100%	7.55	4	.110	.110	.104	There is no evidence of a relationship between the facility type and The training programs are designed to fill performance gaps
		24 50.0%	10 20.8%	7 14.6%	5 10.4%	2 4.2%	48 100%
Facility Type Governmental and Private Verses   applicants qualifications  given the highest priority	Governmental Count and Percent Private Count and Percent	105 31.7%	78 23.6%	90 27.2%	26 7.9%	32 9.7%	331 100%	11.16	4	.025	.026	.023	There is no evidence of a relationship between the facility type and  applicants qualifications  given the highest priority
		17 35.4%	10 20.8%	10 20.8%	10 20.8%	1 2.1%	48 100%
Facility Type Governmental and Private Verses   Employees are encouraged to participate in problem solving matters	Governmental Count and Percent Private Count and percent	117 35.3%	86 26.0%	54 16.3%	21 6.3%	53 16.0%	331 100%	23.29	4	.000	.00	.00	There is very strong evidence of  relationship between the facility type and Employees are encouraged to participate in problem solving matters
		27 56.3%	5 10.4%	6 12.5%	9 18.8%	1 2.1%	48 100%
Facility Type Governmental And PrivateVerses   Employees feel happy by the results of  appraising    their Performance	Governmental Count and Percent Private Count and Percent	74 22.4%	92 27.8%	71 21.5%	22 6.6%	72 21.8%	331 100%	9.91	4	.042	.041	.037	There is slightly evidence of a relationship between the facility type and Employees feel happy by the results of  appraising    their Performance
		17 35.4%	11 22.9%	8 16.7%	7 14.6%	5 10.4%	48 100%
Facility Type Governmental and Private Verses   My organization gives competence or skill based pay increment	Governmental Count and Percent Private Count and Percent	51 15.4%	97 29.3%	54 16.3%	11 3.3%	118 35.6%	331 100%	23.41	4	.000	.000	.000	There is very strong  evidence of a relationship between the facility type and  My organization gives competence or skill based pay increment
		12 25.0%	15 31.3%	12 25.0%	6 12.5%	3 6.3%	48 100%
Facility Type Governmental And Private Verses   Our organization, salary and other benefits are comparable to the market	Governmental Count and Percent Private Count and Percent	33 10.0%	89 26.9%	40 12.1%	11 3.3%	158 47.7%	331 100%	30.69	4	.000	.000	.000	There is very strong evidence of a relationship between the facility type and our organization, salary and other benefits are comparable to the market
		16 33.3%	13 27.1%	9 18.8%	3 6.3%	7 14.6%	48 100%
Facility Type Governmental And Private Verses   Compensation for all employees is directly linked to his/her performance	Governmental Count and Percentprivatecount and Percent	67 20.2%	91 27.5%	49 14.8%	18 5.4%	106 32.0%	331 100%	16.92	4	.002	.002	.001	There is very strong evidence of a relationship between the facility type and compensation for all employees is directly linked to his/her performance
		19 39.6%	12 25%	8 16.75%	5 10.4%	4 8,3%	48 100%
Facility Type Governmental and Private Verses   My Salary in this institution is enough for me	Governmental Count and Percent Private Count and Percent	63 19.0%	109 32.9%	15 4.5%	17 5.1%	127 38.4%	331 100%	20.99	4	.000	.001	.000	There is very strong evidence of a relationship between the facility type and My Salary in this institution is enough for me
		15 31.3%	16 33.3%	6 12.5%	6 12.5%	5 10.4%	48 100%

 

DISCUSSION OF FINDINGS

Discussion on variables associated with family type

There was a difference in the training programs that are designed to fill performance gaps that favors an employee’s career future between governmental and private Hospitals.

The finding in table 2. revealed that Training needs to be identified, realistic, useful and is based on the service strategy of an organization that is statically associated (P= 0.012 (95% confidence interval). There is very strong evidence of a relationship between the facility type and Training needs identified based on the service strategy. This shows that there is a difference identified during training needs based on the service strategy between governmental and private Hospitals.

During the evaluation the applicant's qualifications are given the highest priority because, in the facility types, there is very strong evidence of a relationship between the facility types and Recruitment and Selection in the organization giving highest priority on the applicants' qualification, (P=025: 95% confidence interval). This means there is a difference in recruitment and selection activities in governmental and private health institutions.

The study conducted about Health Care Workforce Priority in America declared that private health care institutions gave more priority for qualification than experience. This research finding also identified that there is a significant difference in giving priority for qualification between public and private health facilities, Aiken (L. H., & Salmon, M. E. (1994). 

The result in table 2. showed that the Organization encourages performance in teams on different tasks statically associated (P= 0.019 (95% confidence interval). There is also strong evidence of a relationship between the facility type and encourage performance in teams on different tasks. This shows that there is a difference during performance encouragement between public and private health facilities.

There was no difference in organization carrying out performance evaluation of each individual employee and organization that has a shared understanding or way of how to achieve what favors an employee’s career future between public and private health facilities.

The judgment in table 2 revealed that employees feel happy by the results of appraising which was statically associated as (P= 0.042 (95% confidence interval). There is strong evidence of a relationship between the facility type and employees feeling happy by the results of appraising. This shows that there is a difference during happiness by the results of appraising between public and private health facilities.

The finding in table 2. revealed that the organization's positive performance appraisal leads to rewards statically associated (P= 0.013 (95% confidence interval). There is strong evidence of a relationship between the facility type and positive performance appraisal which leads to rewards. This shows that there is a difference during positive performance appraisal which leads to a reward between public and private health facilities.

Variables asked the organization salary and other benefits comparable to the market were statically associated with (P=0 .000 (95% confidence interval). There is very strong evidence of a relationship between the facility type and the salary and benefits are comparable to the market. This shows that there is difference during the salary and benefits are comparable to the market.

The Variable asked whether facilities compensation for all employees directly linked to his/her performance was statically associated to (P= 0. 002(95% confidence interval). There is very strong evidence of a relationship between the facility type and compensation for all employees which is directly linked to his/her performance. This shows that there is difference during compensation for all employees which is directly linked to the performance.

When the current salary structure improving service delivery and Salary in this institution is enough for the employees is assessed, there is also both very strong evidence of a relationship between the facility type (P=0.000 : 95% confidence interval). That means there is difference during the assessment of salary structure improving service delivery and Salary in this institution is enough for the employees between public and private health facilities.

The finding in table 2. reveled that organization gives competence or skill based pay increment, cash bonus based on the surplus made per and usually organizes small non-cash awards to staff statically associated all with the (P= 0.000 - 95% confidence interval). There is strong evidence of a relationship between the facility type and organization which gives competence or skill based pay increment. Oorganization gives cash bonus based on the surplus made per and the organization usually organizes small non-cash awards to staff statically associated. This shows that there is difference during organization competence or skill based pay increment which gives cash bonus based made per and usually organizes small non-cash awards to staff between public and private health facilities.

The Variable asked whether organization Job performance is an important factor in determining the incentive compensation of employees statically associated to (P= 0. 012 - 95% confidence interval).There is strong evidence of a relationship between the facility type and organization Job performance as an important factor in determining the incentive compensation of employees. This shows that there is difference during Job performance.

The study showed that organization salary and other benefits are comparable to the market and compensation for all employees which is directly linked to his/her performance was statically associated (P= 0.00 and 0.002 - 95% confidence interval). There is strong evidence of relationship between the facility type and salary; benefits are comparable to the market, and compensation for all employees as directly linked to performance was statically associated. This shows that there is difference during salary and benefits that are comparable to the market and compensation for all employees is directly linked to performance between public and private health facilities

CONCLUSIONS

This study is conducted for the assessment of job motivation and income satisfaction among governmental and private hospitals. It encompasses recruitment and selection, training and development, performance appraisal, rewarding and compensation of human resource practice.

The finding of this research showed that employee recruitment and selection and application of employee’s qualifications during recruitment were different between governmental and private hospitals. In addition, the differences were identified by accepting suggestions for organization improvement and participation in problem-solving once employees were recruited. In Training and Development,  the activities that show difference from the governmental and private hospitals are a provision of the training programs which are designed to fill the performance gaps.

When performance appraisal section was also assessed; activities like employees feel happy due to results of appraising Performance. Compensation of all employees is directly linked to their performance and were different between governmental and private hospitals. The other section also seen was compensation/rewards management and in this section, there was a difference in activities like paying of reasonable salary and compensation between the governmental and private hospitals. 

When we saw the salary satisfaction, employees in private facilities were highly satisfied with the government health facility and similarly, employees in private health facilities were satisfied and motivated more on their employment.

Recommendation

Overall, this research showed that there is a difference in job motivation and income satisfaction activities like recruitment and selection, training and development, performance appraisal and rewarding and compensations. It also recommended that:

1. There should be an equilibrium human resource combination and professional’s competency between governmental and private health facilities.
2. Salaries and other compensation payments should be adjusted as per market value and other basic necessary needs. 
3. Further research should be conducted to strengthen the findings of this research

Source: This is a short version of an article by our students Atakilt H. Siyum and Umar Lawal Aliyu. Full version of this article can be found here.  It was supervised by our lecturer Umar Lawal Aliyu.