Burkina Faso, Ghana, India, Kenya, & Tanzania: Service Availability & Readiness

Motivation and satisfaction can be challenging to measure because they are often influenced by local values, resources, and practices. While there are many tools that can be used to measure motivation in developed settings, they may not be applicable in developing countries, and few have been extensively tested.1 The absence of these measures has been particularly evident in the context of interventions designed to improve provider motivation, such as the Quality of Prenatal and Maternal Care: Bridging the Know-Do Gap (QUALMAT) project in Burkina Faso, Ghana, and Tanzania. A primary objective of this project was the development of a clinical decision support system for pregnancy care to improve competence and motivation.2 In an effort to evaluate this project, researchers developed a tool to measure provider motivation in these countries.1 The initial tool was developed through consideration of the QUALMAT conceptual framework, qualitative research, and a literature review. Experts and senior health staff reviewed measures for validity. The final instrument includes measures related to four areas: demographics, management, performance, and individual factors. The instrument can be found in this paper. When the evaluators compared results across contexts, they found that some internal consistency was lost, and they attributed this to the culturally-specific nature of motivation.1

Similar strategies have been used to develop instruments to measure provider motivation in Kenya and India. These instruments may be a valuable resource for implementers seeking to evaluate provider motivation in other low and middle-income settings; however, extensive time must be planned to adapt the instrument to the local context.


  1. Prytherch H, Leshabari MT, Wiskow C, Aninanya GA, Kakoko DC V, Kagoné M, et al. The challenges of developing an instrument to assess health provider motivation at primary care level in rural Burkina Faso, Ghana and Tanzania. Glob Health Action [Internet]. 2012 Jan [cited 2015 Aug 18];5:1–18. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3464065&tool=pmcentrez&rendertype=abstract
  2. Blank A, Prytherch H, Kaltschmidt J, Krings A, Sukums F, Mensah N, et al. “quality of prenatal and maternal care: Bridging the know-do gap” (QUALMAT study): An electronic clinical decision support system for rural Sub-Saharan Africa. BMC Med Inform Decis Mak. 2013;13(1).