Perceived unfairness in working conditions: The case of public health services in Tanzania
Nils Gunnar Songstad, Ole Bjørn Rekdal, Deodatus A. Massay, Astrid Blystad, BMC Health Services Research, Feb 2011
Health workers’ motivation is one of the determining factors of the quality of health services. WHO points out this connection in its 2006 World Health Report Working together for health. The report indicates a shift from understanding poor health worker performance as caused by lack of knowledge and skills, to a focus on health workers’ motivation and on management of the workforce.
Health workers’ experience with their working conditions is one approach to address the issue of motivation. The focus in this paper is on rural public health services in Tanzania and the study aims to situate the findings in a broader historical context. In this paper six domains of perceived unfairness in the working conditions are identified: unfair allocation of allowances; limited access to training and further education; little recognition of long work experience; delayed promotions; low salary level and lack of transparency in human resource management.
The perception of unfairness related to working conditions has to be understood in the broader historical and political context. Tanzania has been characterised by an ambiguous and shifting landscape of state regulation, economic reforms, decentralisation and emerging democratic perspectives. The paper argues that the democratic reforms have given the health workers the possibility of expressing dissatisfaction with the working conditions. The perceived unfairness creates problems in running the public health services, but at the same time it may assist in establishing better practices for human resource management.
Read the full article at BioMed Central