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. 2017 May 22;15(1):33.
doi: 10.1186/s12960-017-0208-1.

Measuring health workers' motivation composition: validation of a scale based on Self-Determination Theory in Burkina Faso

Julia Lohmann  1 , Aurélia Souares  2 , Justin Tiendrebéogo  3 , Nathalie Houlfort  4 , Paul Jacob Robyn  5 , Serge M A Somda  6 , Manuela De Allegri  2
Affiliations
Free PMC article

Measuring health workers' motivation composition: validation of a scale based on Self-Determination Theory in Burkina Faso

Julia Lohmann et al. Hum Resour Health. .
Free PMC article

Abstract
in English, French

Background: Although motivation of health workers in low- and middle-income countries (LMICs) has become a topic of increasing interest by policy makers and researchers in recent years, many aspects are not well understood to date. This is partly due to a lack of appropriate measurement instruments. This article presents evidence on the construct validity of a psychometric scale developed to measure motivation composition, i.e., the extent to which motivation of different origin within and outside of a person contributes to their overall work motivation. It is theoretically grounded in Self-Determination Theory (SDT).

Methods: We conducted a cross-sectional survey of 1142 nurses in 522 government health facilities in 24 districts of Burkina Faso. We assessed the scale's validity in a confirmatory factor analysis framework, investigating whether the scale measures what it was intended to measure (content, structural, and convergent/discriminant validity) and whether it does so equally well across health worker subgroups (measurement invariance).

Results: Our results show that the scale measures a slightly modified version of the SDT continuum of motivation well. Measurements were overall comparable between subgroups, but results indicate that caution is warranted if a comparison of motivation scores between groups is the focus of analysis.

Conclusions: The scale is a valuable addition to the repository of measurement tools for health worker motivation in LMICs. We expect it to prove useful in the quest for a more comprehensive understanding of motivation as well as of the effects and potential side effects of interventions intended to enhance motivation.

Contexte: La motivation des agents de santé dans les pays à revenu faible et intermédiaire est devenue un sujet de grand intérêt pour les décideurs et les chercheurs au cours des dernières années. Pourtant, de nombreux aspects de la motivation des agents de santé ne sont pas encore bien compris. Ceci est dû en particulier à l’absence d’outils de mesure appropriés. Cet article présente une preuve de la validité conceptuelle d’une échelle psychométrique développée pour mesurer la composition de la motivation, c’est-à-dire le degré auquel des types de motivation d’origine différente à l’intérieur et à l’extérieur d’une personne contribuent à leur motivation globale au travail. L’échelle est fondée sur la théorie de l’auto-détermination (Self-Determination Theory).

Méthodes: Une enquête transversale a été mise en place auprès de 1 142 infirmières dans 522 formations sanitaires gouvernementales de 24 districts du Burkina Faso. Par analyse factorielle confirmatoire, nous avons examiné si l’échelle mesure ce qu’elle était supposée mesurer (validité structurelle et convergente/discriminante) et si ses propriétés de mesures sont comparables dans différentes sous-groupes d’agents de santé (invariance de la mesure).

Résultats: Les résultats montrent que l’échelle mesure une version légèrement modifiée du continuum de motivation proposée par la théorie de l’auto-détermination. Les propriétés de mesure étaient globalement comparables entre les sous-groupes, mais une certaine prudence est indiquée si une comparaison des moyennes entre les groupes est l’objectif principal de l’analyse.

Conclusion: L’échelle est une un apport important au référentiel des outils de mesure de la motivation des agents de santé dans les pays à revenu faible et modérés. Elle sera utile pour une meilleure compréhension de la motivation des prestataires, ainsi que des effets positifs et potentiellement secondaires des interventions visant à renforcer la motivation.

Electronic supplementary material: The online version of this article (doi:10.1186/s12960-017-0208-1) contains supplementary material, which is available to authorized users.

Keywords: Health worker motivation; Measurement; Motivation composition; Self-Determination Theory; Validation.

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Figures

Fig. 1
Fig. 1
The self-determination continuum of motivation. Legend: adapted from [15, 16]
Fig. 2
Fig. 2
The modified SDT taxonomy of motivation as measured by the scale
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