Determining the Financial Rewards that Influence Medical Doctor’s Retention in the Public Health Sector: A Case of Ghana

Seth Fenyi; Solomon Keelson

doi:10.51867/ajernet.6.1.73

Authors

Seth Fenyi Accra Institute of Technology, Ghana https://orcid.org/0000-0001-6243-0645
Solomon Keelson Takoradi Technical University, Ghana https://orcid.org/0000-0003-0562-486X

DOI:

https://doi.org/10.51867/ajernet.6.1.73

Keywords:

Financial Bonuses, Financial Incentives, Healthcare Sector, Medical Doctors’ Retention, Public, Salary Remunerations

Abstract

Retention of medical doctors within the public healthcare sector has remained a pressing challenge in Ghana. This study is guided by the Equity theory (1965). The study employed the use of a cross-sectional hospital-based study conducted in three public-based hospitals in Accra, Ghana namely: Greater Accra Regional Hospital, Korle Bu Teaching Hospital in Accra, and University of Ghana Medical Center, Accra. Using a random sampling method, a tagret study population of 370 medical doctors was obtained and a sample size of 192 was obtained using the Yamane formula. The instrument of data collection was a structured questionnaire. A total of 200 questionnaires were distributed with 193 returned representing a 96.5% response rate. The study evaluated the collected using descriptive statistics using: tables, mean, frequencies, and percentages and also established the research objectives employing inferential statistics where a linear regression model was employed. The dependent variable was retention (RETM), while the independent variable was salary remuneration (SRM), financial bonuses (FBM), and the prompt payment of financial entitlements (PPM). The result of the regression analysis shows that the R-square is 0.445, the relationship between RETM and SRM was statistically significant at P-value<0.05, while the coefficient is positively related at 0.242. The relationship between RETM and FBM was also positive and statistically significant at a p-value<0.05 and a coefficient of 0.589. There was a p-value>0.05 between RETM and PPM showing a non-significant relationship. The study concludes that salary remuneration and financial bonuses are the most influential financial factors in retaining medical doctors in public hospitals. The study recommends increasing the salaries of medical doctors and introducing performance-based financial bonuses to retain medical doctors.

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References

Adams, J. S. (1965). Inequity in social exchange. Advances in Experimental Social Psychology, 2(C), 267-299. https://doi.org/10.1016/S0065-2601(08)60108-2

Adesola, R. O., Opuni, E., Idris, I., Okesanya, O. J., Igwe, O., Abdulazeez, M. D., & Lucero-Prisno, D. E. (2024). Navigating Nigeria's health landscape: Population growth and its health implications. Environmental Health Insights, 18, 1-8. https://doi.org/10.1177/11786302241250211

Adjei-Mensah, S. (2023). Factors influencing brain drain among health workers in Ghana. European Journal of Human Resource, 7(1), 17-30. https://doi.org/10.47672/EJH.1349

Adzei, F. A., & Atinga, R. A. (2012). Motivation and retention of health workers in Ghana's district hospitals: Addressing the critical issues. Journal of Health Organization and Management, 26(4), 467-485.

https://doi.org/10.1108/14777261211251535

Ahmad, F., Meyer, E., & Higgs, M. (2024). Financial incentives and prosocial motivation among physicians in a faith-based society. Public Performance & Management Review, 47(5), 1302-1325. https://doi.org/10.1080/15309576.2024.2369331

Akinto, A. (2021). Critical review of the use of financial incentives in solving health professionals' brain drain. International Journal of Research in Business and Social Science, 10(4), 446-454. https://doi.org/10.20525/IJRBS.V10I4.1202

Anson, B. A. (2019). Effect of incentive package on the performance of health workers at the Greater Accra Regional Hospital-Accra (Doctoral dissertation, University of Cape Coast).

Antwi, J., & Phillips, D. C. (2012). Wages and health worker retention: Evidence from public sector wage reforms in Ghana. Journal of Development Economics, 102, 101-115. https://doi.org/10.1016/j.jdeveco.2012.10.004

Arnold, M., Fernando, D., Wickramanayake, K., Karunapema, P., Wickramatilake, S., Fernando, Y., Denawaka, C., Mahesh, P. K. B., & Pandithrathna, S. (2022). Work-related factors affecting the retention of medical officers in the preventive health sector in Sri Lanka. Human Resources for Health, 20(1), 56. https://doi.org/10.1186/S12960-022-00753-W

Chukwu, O. A., & Essue, B. (2024). Addressing health workforce shortages as a precursor to attaining universal health coverage: A comparative policy analysis of Nigeria and Ghana. Social Science & Medicine, 355(10350), 117095. https://doi.org/10.1016/j.socscimed.2024.117095

Cohen, L., Manion, L., & Morrison, K. (2018). Surveys, longitudinal, cross-sectional and trend studies. Research Methods in Education, 334-360. https://doi.org/10.4324/9781315456539-17

Darkwa, E. K., Newman, M. S., Kawkab, M., & Chowdhury, M. E. (2015). A qualitative study of factors influencing retention of doctors and nurses at rural healthcare facilities in Bangladesh. BMC Health Services Research, 15(1), 1-12. https://doi.org/10.1186/S12913-015-1012-Z

George, G., Rhodes, B., & Laptiste, C. (2019). What is the financial incentive to immigrate? An analysis of salary disparities between health workers working in the Caribbean and popular destination countries. BMC Health Services Research, 19(1), 109. https://doi.org/10.1186/S12913-019-3896-5

Herzer, K. R., & Pronovost, P. J. (2015). Physician motivation: Listening to what pay-for-performance programs and quality improvement collaboratives are telling us. Joint Commission Journal on Quality and Patient Safety, 41(11), 522-528. https://doi.org/10.1016/S1553-7250(15)41069-4

Hoxha, G., Simeli, I., Theocharis, D., Vasileiou, A., & Tsekouropoulos, G. (2024). Sustainable healthcare quality and job satisfaction through organizational culture: Approaches and outcomes. Sustainability, 16(9), 3603.

https://doi.org/10.3390/su16093603

Hoyler, M., Finlayson, S. R. G., McClain, C. D., Meara, J. G., & Hagander, L. (2014). Shortage of doctors, shortage of data: A review of the global surgery, obstetrics, and anesthesia workforce literature. World Journal of Surgery, 38(2), 269-280. https://doi.org/10.1007/S00268-013-2324-Y

Jinah, N., Sharin, I. A., Bakit, P., Adnan, I. K., & Lee, K. Y. (2024). Overview of retention strategies for medical doctors in low- and middle-income countries and their effectiveness: Protocol for a scoping review. JMIR Research Protocols, 13(1). https://doi.org/10.2196/52938

Kajungu, T., & Mugisha, J. (2015). Role of remuneration in retention of health workforce in a rural district setting in Uganda. International Journal of Public Health Research, 3(1), 94-100.

Liu, X., Dou, L., Zhang, H., Sun, Y., & Yuan, B. (2015). Analysis of context factors in compulsory and incentive strategies for improving attraction and retention of health workers in rural and remote areas: A systematic review. Human Resources for Health, 13(1). https://doi.org/10.1186/S12960-015-0059-6

Mohammadiaghdam, N., Doshmangir, L., Babaie, J., Khabiri, R., & Ponnet, K. (2020). Determining factors in the retention of physicians in rural and underdeveloped areas: A systematic review. BMC Family Practice, 21(1). https://doi.org/10.1186/S12875-020-01279-7

Ojakaa, D., Olango, S., & Jarvis, J. (2014). Factors affecting motivation and retention of primary health care workers in three disparate regions in Kenya. Human resources for health, 12, 33. https://doi.org/10.1186/1478-4491-12-33

Owusu-Ansah, J. (2015). Brain drain in Ghana's health sector: A case study of why doctors and nurses emigrate (Unpublished master's thesis). KDI School of Public Policy and Management.

Saluja, S., Rudolfson, N., Massenburg, B. B., Meara, J. G., & Shrime, M. G. (2020). The impact of physician migration on mortality in low and middle-income countries: An economic modelling study. BMJ Global Health, 5(1).

https://doi.org/10.1136/bmjgh-2019-001535

Samuel, A., & Haozhen, Z. (2024). An analysis of the compensation and benefits packages offered to healthcare professionals in Ghana: Are they competitive enough to retain talent? Preprints.

https://doi.org/10.20944/preprints202411.0701.v1

Snow, R. C., Asabir, K., Mutumba, M., Koomson, E., Gyan, K., Dzodzomenyo, M., Kruk, M., & Kwansah, J. (2011). Key factors leading to reduced recruitment and retention of health professionals in remote areas of Ghana: A qualitative study and proposed policy solutions. Human Resources for Health, 9, 13. https://doi.org/10.1186/1478-4491-9-13

Ukponahiusi, O., & Ahuru, R. R. (2024). A systematic review of the impact of incentives on job performance among healthcare workers in Africa. African Journal of Social and Behavioral Sciences, 14(8), 4709-4727.

WHO. (2000). The effects of economic and policy incentives on provider practice. https://iris.who.int/handle/10665/69778

Yamane, T. (1967). Statistics: An introductory analysis (2nd ed.). Harper & Row.