Study On Incentive Factors Of Health Workers In Township Health Centres After Health System Reform

BackgroundTownship Health Centres (THCs) play key roles in primary health system in rural China. The amount of health service providers, who are generally regarded as principal part in providing health services, has been proved to have a close relationship with people’s health status. China, however, has been facing the shortage of health service provider in rural areas in the past decades. Since it seems impossible to solve the shortage within a short term, how to retain health workers and improve their performance and therefore to enable their initiative with the greatest degree became very necessary and significant.Aims and objectivesThe study aims to describe current situations of THCs workers’preference and satisfaction for incentive factors as well as their work attitudes and turnover intentions using the sample from THCs in Junan, Pingying and Liangshan, Shandong Province in2012. Effects of THCs workers’satisfaction for incentive factors on their work attitudes and turnover intentions will also be explored in this study.Data source and methodThe data of THCs workers collected in Junan, Pingyin and Liangshan in July2012come from Health Equity and Financial Protection in Asia,funded by EU. Microsoft Access2007was used for data entry and SPSS16.0was used for statistical analysis. For current situations of THC workers’preference and satisfaction for incentive factors and their work attitudes and turnover intentions, descriptive statistical analysis was used; for differences among objectives with different demographic characteristics in THC workers’preference and satisfaction for incentive factors and their work attitudes and turnover intentions, statistical inference was used; factor analysis was used to explore inner structure of THC workers’ satisfaction for incentives; and Ordinal regression was used to find out factors affecting work attitudes and turnover intentions of THC workers.Main resultsIn general, economic incentive and material incentive are preferred by THC workers in Shandong province, and preference for social and respective requirements, in contrast, are relative lower. However, economic incentive is the lowest satisfaction among THC workers while the satisfaction of interpersonal relationship is the highest.5independent factors were extracted through factor analysis, and they are: management system, material environment, respect and self-esteem, career development and interpersonal relationship. Preferences and satisfactions for incentive factors differed among objectives with different demographic characters.The fact was found by the Ordinal analysis that people with administrative duty, higher satisfaction for respect and self-esteem, or higher satisfaction for interpersonal relationship are more likely to consider themselves work hard. Satisfaction for incentive factors is a protective factor for health work staff remaining stable while education background and administrative duty are risk factors.Conclusion and policy implicationsEconomic incentives are still the most effective factors to THC workers after health system reform, however, THC workers’ satisfaction for them is not very high. Higher satisfaction is helpful for THC workers having positive attitudes to work as well as can reduce the possibilities of them having turnover intentions. Accordingly, the following suggestions for policy-making are therefore offered:Continue increasing the financial input by the government to THC; improve relevant systems and thereby improving satisfaction of THC workers; improve communication between THC managers and staff and consequently enhance staff’s identify to organizations; and take specific incentive measures to THC workers with different characters.