Motivation or demotivation of health workers providing maternal health services in rural areas in Vietnam: findings from a mixed-methods study

Nguyen, Thi Hoai Thu, Wilson, Andrew, & McDonald, Fiona (2015) Motivation or demotivation of health workers providing maternal health services in rural areas in Vietnam: findings from a mixed-methods study. Human Resources for Health, 13(91).

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Motivation is an important driver for health professionals to maintain professional competencies, continue in a workforce and contribute to work tasks. While there is some research about motivation in health workers in low to middle income countries, maternal morbidity and mortality remains high in many low and middle income countries and this can be improved by improving the quality of maternal services and the training and skills maintenance of maternal health workers. This study examines the impact of motivation on maintenance of professional competence among maternal health workers in Vietnam using mixed methods.


The study consisted of a survey using a self-administered questionnaire of 240 health workers in 5 districts across two Vietnamese provinces and in-depth interviews with 43 health workers and health managers at the commune, district and provincial level to explore external factors that influenced motivation. The questionnaire includes a 23 item motivation instrument based on Kenyan health context, modified for Vietnamese language and culture.


The 240 responses represented an estimated 95% of the target sample. Multivariate analysis showed that three factors contributed to the motivation of health workers: access to training (β = -0.14, p=0.03), ability to perform key tasks (β = 0.22, p=0.001), and shift schedule (β = -0.13, p=0.05). Motivation was higher in health workers self-identifying as competent or enabled to provide more care activities. Motivation was lower in those who worked more frequent night shifts and those who had received training in the last 12 months. The interviews identified that the latter was because they felt the training was irrelevant to them, and in some cases, they do not have opportunity to practice their learnt skills. The qualitative data also showed other factors relating to service context and organisational management practices contributed to motivation.


The study demonstrates the importance of understanding the motivations of health workers and the factors that contribute to this and may contribute to more effective management of the health workforce in low and middle income countries.

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ID Code: 90978
Item Type: Journal Article
Refereed: Yes
Keywords: Motivation,, maternal health services,, Vietnam, human resources for health in low and middle income countries.
DOI: 10.1186/s12960-015-0092-5
ISSN: 1478-4491
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PUBLIC HEALTH AND HEALTH SERVICES (111700) > Health Care Administration (111709)
Australian and New Zealand Standard Research Classification > STUDIES IN HUMAN SOCIETY (160000) > POLICY AND ADMINISTRATION (160500) > Health Policy (160508)
Australian and New Zealand Standard Research Classification > LAW AND LEGAL STUDIES (180000) > OTHER LAW AND LEGAL STUDIES (189900)
Divisions: Current > QUT Faculties and Divisions > Faculty of Law
Current > Research Centres > Australian Centre for Health Law Research
Current > Schools > School of Law
Copyright Owner: Copyright 2015 Nguyen Thi Hoai Thu et al.
Copyright Statement: Open Access This article is distributed under the terms of the Creative Commons
Attribution 4.0 International License (, which permits unrestricted use, distribution,
and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link
to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication
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Deposited On: 03 Dec 2015 00:22
Last Modified: 03 Dec 2015 23:59

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