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Table 1 Description of study design, interventions, and methods of outcome ascertainment for studies in the systematic literature review

From: Approaches to motivate physicians and nurses in low- and middle-income countries: a systematic literature review

Author Country Study design Respondents Intervention type Description of intervention Random allocation Motivation definition provided Instrument informed by motivation theory Items/instrument used
Alhassan et al. 2016 Ghana Randomized trial—group Heterogeneous: clinical and non-clinical staff Supervision The Systematic Community Engagement (SCE) intervention included a structured step-by-step and cyclical process of facilitators engaging community groups/associations to assess health service quality at their nearest health facility. Facilitators provided feedback to facility heads, gaps in quality were identified, and action plans were developed to address gaps. Facilitators followed up with service providers to monitor progress on action plan.a
Sixteen facilities were assigned to intervention, and sixteen served as controls.
Y Y2 Not described Not described
Aninanya et al. 2016 Ghana Non-randomized trial—group Heterogeneous: community health nurses; midwives; other-medical assistants and public health nurses Compensation; Supervision Performance-based intervention (PBI) with financial and non-financial awards provided to the best-performing health workers at biannual ceremonies. Awards included monthly allowances (~ US$20), small appliances (e.g., refrigerators, televisions, microwaves) or certificates of recognition.
Six facilities were allocated to the intervention group receiving PBI, and six facilities served as controls.
N Y2 Not described Mutale et al. 2013 & Mbindyo et al. 2009
Carasso et al. 2012 Zambia Cross-sectional Heterogeneous: nurses; doctors; midwives; pharmacy dispensers; classified daily employees Compensation Intervention facilities abolished a user fee, which authors theorize results in a loss of financial incentives to health worker and concurrent increase in utilization. The control group retained the user fee, theoretically improving financial incentives to health workers.
The six facilities that continued to collect user fees were the intervention, and the fourteen facilities where user fees were abolished were the control. As the reverse policy would serve as an incentive to providers, we consider the retention of user fees to be the intervention.
N N Y—Hertzberg two-factor motivation theory Not described
Hosseinabadi et al. 2013 Iran Randomized trial—group Heterogeneous: emergency medical service personnel (including emergency medical technicians, nurses, operating room attendants, and anesthetic technicians) Supervision Quality circles implemented as a participatory management technique to offer assistance to health workers dealing with work-related problems and led by a supervisor. The goal was to resolve work-related problems, improve performance and motivate employees.
One facility served as the intervention facility and one facility served as the control.
Y N Y—Hertzberg two-factor motivation theory Mohsenpour et al. 2002; Jafariayan, 2007
Liu et al. 2017 China Pretest–posttest Homogenous: registered nurses; registered professional nurses; nurse practitioners; assistant head nurse Supervision; Compensation; Lifelong learning A web-based communication platform used to document comments from nurses and psychological forum held twice a year to discuss these;
2nd component to provide continuing education and certificates for nurses; 3rd component to offer spiritual rewards to encourage internal motivation of nurses. Salary and benefits were raised based on the performance appraisals.
Study was conducted in one facility with historical control.
N N Not described 38-item Chinese version of the Practice Environment Scale (CPPE-38)
Shen et al. 2017 Zambia Randomized trial—group Heterogeneous: district community medical officer; clinical officer; registered nurse; enrolled midwife; enrolled nurse; environmental health technician; classified daily employee, lab technician, other (administrators, human resource officers) Compensation Performance-based financing (PBF) was one intervention group, with financing linked to performance; Enhanced financing (EF) was the first control group, where the same amount of financing was given but not linked to performance; the pure control facilities were the third group where no financing was given
Due to bottlenecks- the EF group only received about 56% of the financing amount as the PBF group- and therefore was dissimilar.
Thirty districts were triplet-matched on key health systems and outcome indicators and randomly allocated to one of three arms, ten to PBF, ten to Control-Enhanced Financing, ten to a pure control.
Y Y2 Not described Weiss et al. 1967: Minnesota Satisfaction Questionnaire
Spector et al. 1985: Job Satisfaction Survey
Vermandere et al. 2017 Mozambique Randomized trial—group Heterogeneous: health care providers Systems support The intervention consisted of ten monthly audits in 15 facilities to examine stock cards and stock-counts of six contraceptives. The first intervention group received only a monthly evaluation report, reflecting the quality of their supply management. The second intervention group received the monthly evaluation report as well as material incentives conditional on facility performance (note: incentives at facility, not individual, level). The third group served as a control group.
Fifteen health facilities in Maputo Province, Mozambique, were divided into 3 groups of five facilities: intervention group (monthly evaluation report), a second intervention group (monthly evaluation report and incentives), and finally a third group (control).
Y N Not described Mutale et al. 2013
  1. aAlhassanet al. (2013)
  2. bDefinition provided refers to "an individual’s degree of willingness to exert and maintain an effort towards organizational goals" (Franco et al. 2002)
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