Employee Motivation and Healthcare Quality in the Post-COVID-19 Pandemic: A South African Public Health Sector Perspective

Employee Motivation and Healthcare Quality in the Post-COVID-19 Pandemic: A South African Public Health Sector Perspective

Main Article Content

Simon Matome Nkgapele

Abstract

Motivating employees is key to the effectiveness and quality of healthcare services, particularly in the public health sector of South Africa. Despite its significant contribution to national health achievements, this sector frequently encounters obstacles that impede the provision of high-quality health services. This article made use of a qualitative method and used secondary data to explore the key elements that affect employee motivation, examine its impact on healthcare service quality, and identify strategies to boost motivation. The findings show that healthcare providers who lack motivation often face burnout, diminished morale, and disengagement, leading to inefficiencies and inadequate patient care. To tackle these issues, the article recommended enhancing the work environment, offering increased remuneration, establishing opportunities for career advancement, improving leadership approaches, and promoting the well-being of employees. Putting these strategies into practice is vital for cultivating a motivated workforce capable of delivering high-quality healthcare and achieving the broader objectives of equitable and sustainable healthcare in South Africa.

References

Abbah, M.T. (2014). Employee motivation: The key to effective organizational management in Nigeria. IOSR Journal of Business and

Management, 16(4), pp.01-08. https://www.iosrjournals.org/iosr-jbm/papers/Vol16-issue4/Version-1/A016410108.pdf

Abrahams, G.L., Thani, X.C. & Kahn, S.B. (2022). South African public primary healthcare services and challenges: considerations during the Covid-19 pandemic. Administration Publica, 30(2), pp.63-85.

Adebanjo, A. T. (2024). Impact of COVID-19 on healthcare providers in Africa. In COVID-19 and the Right to Health in Africa (pp. 271-300).

Routledge. https://www.taylorfrancis.com/chapters/edit/10.4324/9781032671437-15/impact-covid19healthcareprovidersafricaadetoun-adebanjo

Afolabi, A., Fernando, S. & Bottiglieri, T. (2018). The effect of organisational factors in motivating healthcare employees: a systematic review. British Journal of Healthcare Management, 24(12), pp.603-610. https://doi.org/10.12968/bjhc.2018.24.12.603

Akintola, O. & Chikoko, G. (2016). Factors influencing motivation and job satisfaction among supervisors of community health workers in marginalized communities in South Africa. Human resources for health, 14, pp.1-15. https://doi.org/10.1186/s12960-016-0151-6

Alrawahi, S., Sellgren, S.F., Altouby, S., Alwahaibi, N. & Brommels, M. (2020). The application of Herzberg’s two-factor theory of motivation to job satisfaction in clinical laboratories in Omani hospitals. Heliyon, 6(9). https://doi.org/10.1016/j.heliyon.2020.e04829

Baartman, Z. (2024). Perceptions of Primary Healthcare Nurses About the Effectiveness of Their Working Environment for Integrated

Primary Healthcare Service Delivery in Nelson Mandela Bay Health District. https://scholar.sun.ac.za/server/api/core/bitstreams/93ab0b7b-432f-4f1e-9da4-9e2a255fbcb9/content

Billings, J., Ching, B.C.F., Gkofa, V., Greene, T. & Bloomfield, M. (2021). Experiences of frontline healthcare workers and their views

about support during COVID-19 and previous pandemics: a systematic review and qualitative meta-synthesis. BMC health services research, 21, pp.1-17. https://link.springer.com/article/10.1186/s12913-021-06917-z

Cabral, A. B. A. C. R., Clavell, E., Coitiño, A., De Lombaerde, P., Giler, G., Faria, M., ... & Ueleres, J. (2015). MEASURING THE PROGRESS AND SUCCESS OF REGIONAL HEALTH POLICIES.

Celestin, M., & Vanitha, N. (2023). FromnBurnout to Balance: Rethinking Employee Well-Being in A Post-Pandemic World. Age, 18(25), 20.

Chrest, K.T. (2020). Employee motivation related to leadership behaviors in rural outpatient healthcare settings. Franklin University. https://www.proquest.com/openview/09d4bb4604aaeb6b3a9d2dd277be5e15/1?pq-origsite=gscholar&cbl=18750&diss=y

Coovadia, H., Jewkes, R., Barron, P., Sanders, D., & McIntyre, D. (2009). The health and health system of South Africa: historical roots of current public health challenges. The lancet, 374(9692), 817-834. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60951-X/abstract?rss=yes&TB_iframe=true&width=850&keepThis=true&height=650

Dawood, B., Tomita, A., & Ramlall, S. (2022).‘Unheard,’‘uncared for’and ‘unsupported’: The mental health impact of Covid-19 on healthcare workers in KwaZulu-Natal Province, South Africa. PLoS One, 17(5), e0266008. https://doi.org/10.1371/journal.pone.0266008

De Beer, J.N. (2019). The recruitment and retention of medical practitioners and specialists in rural areas: the case of the North West Department of Health (Doctoral dissertation, North-West University (South Africa)). https://repository.nwu.ac.za/handle/10394/33813

De Villiers, C., Cerbone, D., & Van Zijl, W. (2020). The South African government’s response to COVID-19. Journal of Public Budgeting,

Accounting & Financial Management, 32(5), 797-811. https://doi.org/10.1108/JPBAFM-07-2020-0120

De Walque, D., Kandpal, E., Wagstaff, A., Friedman, J., Piatti-Fünfkirchen, M., Sautmann, A., Shapira, G. & Van de Poel, E. (2022). Improving effective coverage in health: do financial incentives work?. World Bank Publications.

Deonarain, M. (2024). The quality of work life of frontline healthcare workers that affect service delivery at selected hospitals in South Africa (Doctoral dissertation, Cape Peninsula University of Technology).

Dramowski, A., Zunza, M., Dube, K., Parker, M., & Slogrove, A. (2020). South African healthcare workers and COVID-19: A shared responsibility to protect a precious and limited resource. South African Medical Journal, 110(7), 567-568. https://hdl.handle.net/10520/EJC1e4e33a499

Ebi, E.A.O. (2016). Enforcing the right of access to healthcare services in South Africa. LLM unpublished. University of South. Feldacker, C., Pintye, J., Jacob, S., Chung, M. H., Middleton, L., Iliffe, J., & Kim, H. N. (2017). Continuing professional development for medical, nursing, and midwifery cadres in Malawi, Tanzania and South Africa: A qualitative evaluation. PloS one, 12(10), e0186074. https://doi.org/10.1371/journal.pone.0186074

Fugar, F.D. (2007). Frederick Herzberg’s motivation-hygiene theory revisited: The concept and its applicability to clergy (A study of fulltime stipendiary clergy of the global evangelical church, Ghana. Journal of Science and Technology (Ghana), 27(1), pp.119-130. https://doi.org/10.4314/just.v27i1.33031

Gagné, M., Parker, S.K., Griffin, M.A., Dunlop, P.D., Knight, C., Klonek, F.E. & Parent-Rocheleau, X. (2022). Understanding and shaping the future of work with self-determination theory. Nature Reviews Psychology, 1(7), pp.378-392. https://doi.org/10.1038/s44159-022-00056w

Ghimire, J., Kumal, A.B., Mahato, R.K. & Gupta, R.P. (2013). Factors associated with the motivation and de-motivation of health workforce in Nepal. Journal of Nepal Health Research Council. https://doi.org/10.33314/jnhrc.v0i0.374

Goenaga, R.R. (2024). Employee Perceptions of Effective Leadership Styles in Promoting Employee Motivation in a Governmental Academic Workplace (Doctoral dissertation, Walden University). https://www.proquest.com/openview/ac2e795a05ab9990a0755a95798bf160/1?pq-origsite=gscholar&cbl=18750&-diss=y

Govender, S., Gerwel Proches, C.N. & Kader, A. (2018). Examining leadership as a strategy to enhance health care service delivery in regional hospitals in South Africa. Journal of multidisciplinary healthcare, pp.157-166. https://doi.org/10.2147/JMDH.S151534

Jaeger, F.N., Bechir, M., Harouna, M., Moto, D.D. & Utzinger, J. (2018). Challenges and opportunities for healthcare workers in a rural district of Chad. BMC health services research, 18, pp.1-11. https://doi.org/10.1186/s12913-017-2799-6

Jalili, M., Niroomand, M., Hadavand, F., Zeinali, K., & Fotouhi, A. (2021). Burnout among healthcare professionals during COVID-19

pandemic: a cross-sectional study. International archives of occupational and environmental health, 94, 1345-1352. https://link.springer.com/article/10.1007/s00420-021-01695-x

Jensen, N., Lund, C. & Abrahams, Z. (2022). Exploring effort–reward imbalance and professional quality of life among health workers

in Cape Town, South Africa: a mixed-methods study. Global Health Research and Policy, 7(1), p.7. https://doi.org/10.1186/s41256-022-00242-6

Jonas, L. (2022). Absenteeism in district rural hospitals in the Eastern Cape: the experiences of nurses (Doctoral dissertation, Stellenbosch: Stellenbosch University). https://scholar.sun.ac.za/handle/10019.1/126391

Kolawole, O. (2023). Medical negligence litigation as a mechanism for understanding gaps in health system responsiveness in the

South African public health system. (Doctoral dissertation, University of Cape Town). https://open.uct.ac.za/items/dfc63938-dbd1-

ac7-9f0b-db3a9fcc8710

Koncar, P., Santos, T., Strohmaier, M. & Helic, D. (2022). On the application of the Two-Factor Theory to online employer reviews. Journal of Data, Information and Management, 4(1), pp.1-23. https://doi.org/10.1007/s42488-021-00061-3

Kumar, R.D. & Khiljee, N. (2016). Leadership in healthcare. Anaesthesia & Intensive Care Medicine, 17(1), pp.63-65. https://doi.org/10.1016/j.mpaic.2015.10.012

Lee, H.F., Chiang, H.Y. & Kuo, H.T. (2019). Relationship between authentic leadership and nurses’ intent to leave: The mediating role of

work environment and burnout. Journal of nursing management, 27(1), pp.52-65. https://doi.org/10.1016/j.mpaic.2015.10.012

Mabena, S.Y. (2022). The dynamics of compliance with the national core standards for health establishments in South Africa: a case study of two tertiary hospitals in Gauteng province (Doctoral dissertation). https://wiredspace.wits.ac.za/server/api/core/bitstreams/897139aa-c036-4e7c-b7bb-10f7236229ff/content

Mafhungo, T.C. (2022). Challenges experienced by professional nurses at the rural primary health care facilities in Msukaligwa Sub-District of Mpumalanga Province, South Africa. (Doctoral dissertation, University of Venda). https://univendspace.univen.ac.za/server/api/core/bitstreams/17d992f7-17ec413b-adb4-6e8fcf55346a/content

Manyisa, Z.M. & van Aswegen, E.J. (2017). Factors affecting working conditions in public hospitals: A literature review. International

journal of Africa nursing sciences, 6, pp.28-38. https://doi.org/10.1016/j.ijans.2017.02.002

Maphumulo, W. T., & Bhengu, B. R. (2019). Challenges of quality improvement in the healthcare of South Africa post-apartheid: A critical review. Curationis, 42(1), 1-9. https://journals.co.za/doi/abs/10.4102/curationis.v42i1.1901

Maslow, A.H. (1943). Preface to motivation theory. Psychosomatic medicine, 5(1), pp.85-92. https://journals.lww.com/psychosomaticmedicine/abstract/1943/01000/Preface_to_Motivation_Theory.12.aspx

Mathevula, H. M., & Dhliwayo, S. (2022). A comparison of job satisfaction levels among south African public healthcare professionals. Academic Journal of Interdisciplinary Studies, 11(2), 163.

McLeod, S. (2007). Maslow’s hierarchy of needs. Simply psychology, 1(1-18). https://www.simplypsychology.org/maslow.html?ez_vid=2cae626a2fe896279da43d587baa3eb663083817

Mnisi, F. (2022). Assessment of job-related factors associated with stress and burnout amongst mental healthcare workers in Gauteng,

South Africa (Doctoral dissertation, University of Johannesburg). https://www.proquest.com/openview/821d0de7188e7d24d2c0ac348cf4fe0a/1?pq-origsite=gscholar&cbl=2026366&diss=y

Mokgolobotho, R., & Nkgapele, S. (2024). The Role of Alternative Service Delivery Models in Improving Access to Health Care, Education, and Water Services in the South African Public Service. International Journal of Social Science Research and Review, 7(10), 14-26. https://doi.org/10.47814/ijssrr.v7i10.2231

Moore, N. (2007). (Re) using qualitative data?. Sociological Research Online, 12(3), pp.1-13. https://doi.org/10.5153/sro.1496

Mtimkulu, D.S., Naranjee, N. & Karodia, A.M. (2014). An evaluation of the leadership styles of managers and their impact on

human capital factors of motivation, performance and absenteeism of employees at selected hospitals in Eastern Free State, South

ةعجارم نم ةيمويلا ةيبرعلا لوصفلا نامع .Africa

لامعألا, 34 2597(, pp.1-30.

Mukwena, N.V. & Manyisa, Z.M. (2022). Factors influencing the preparedness for the implementation of the national health insurance scheme at a selected hospital in Gauteng Province, South Africa. BMC Health Services Research, 22(1), p.1006. https://doi.org/10.1186/s12913-022-08367-7

Muthuri, R.N.D.K., Senkubuge, F. & Hongoro, C. (2020, June). Determinants of motivation among healthcare workers in the East African community between 2009–2019: a systematic review. In Healthcare (Vol. 8, No. 2, p. 164). MDPI. https://doi.org/10.1186/s12913-022-08367-7

Naidoo, T., Tomita, A. & Paruk, S. (2020). Burnout, anxiety and depression risk in medical doctors working in KwaZulu-Natal Province, South Africa: Evidence from a multi-site study of resource-constrained government hospitals in a generalised HIV epidemic setting. PLoS one, 15(10), p.e0239753. https://doi.org/10.1371/journal.pone.0239753

NELAGO, S. (2024). An exploration of the challenges faced by hospital based social workers during the COVID-19 pandemic in the Omusati region, Namibia (Doctoral dissertation, University of Namibia).

Netshisaulu, K.G., Malelelo-Ndou, H. & Ramathuba, D.U. (2019). Challenges experienced by health care professionals working in resource-poor intensive care settings in the Limpopo province of South Africa. Curationis, 42(1), pp.1-8. https://hdl.handle.net/10520/EJC-14d00613f5

Nkgapele, S. M., & Mokgolobotho, R. M. (2024). Developing Transformational Strategies to Improve the Accessibility of E-Governmental Services in the South African Local Government. International Journal of Law, Social Science, and Humanities (IJLSH), 1(2),56-68. https://doi.org/10.70193/ijlsh.v1i2.147

Nkgapele, S. A., & Thusi, X. (2025). The Recruitment and Retention of Critical Healthcare Professionals: Focus at Polokwane Provincial Hospital. Journal of Management & Business Studies, 7(1), 1-19. https://doi.org/10.32457/jmabs.v7i1.2486

Parashakti, R.D., Fahlevi, M., Ekhsan, M. & Hadinata, A. (2020, April). The influence of work environment and competence on motivation and its impact on employee performance in health sector. In 3rd Asia Pacific International Conference of Management and Business Science (AICMBS 2019) (pp. 259-267). Atlantis Press. https://doi.org/10.2991/aebmr.k.200410.040

Pervez, S., Kousar, R. & Asghar, S. (2023). Effects of Absenteeism in Nursing Profession: Effects of Absenteeism in Nursing Profession. NURSEARCHER (Journal of Nursing & Midwifery Sciences), pp.11-14. https://doi.org/10.54393/nrs.v3i01.33

Rai, R., Thekkekara, J.V. & Kanhare, R. (2021). Herzberg’s two factor theory: A study on nurses’s motivation. RGUHS Journal of Allied Health Sciences, 1(1). https://doi.org/10.26463/rjahs.1_1_5

Rauf, A., Rook, L., Rajapakse, B., Lartey, J.K.S. & Almeida, S. (2024). Resource loss a significant issue for healthcare professionals: A

case study of an Australian regional hospital. Stress and Health, 40(5), p.e3461. https://doi.org/10.1002/smi.3461

Republic of South Africa. (1996). Constitution of the Republic of South Africa. Act 108 of 1996. Pretoria: Government Printers. Republic of South Africa. (2013). National Development Plan 2030: Our Future - make it work. National Planning Commission (NPC).

The Presidency. http://www.poa.gov.za/news/Documents/NPC%20National%20Development (Accessed: 25 November 2024).

Richards, A. (2020). Exploring the benefits and limitations of transactional leadership in healthcare. Nursing Standard, 35(12), pp.46-50. https://doi.org/10.7748/ns.2020.e11593

Schoeb, V. (2016). Healthcare service in Hong Kong and its challenges. The role of health professionals within a social model of health. China Perspectives, 2016(2016/4), pp.51-58. https://doi.org/10.4000/chinaperspectives.7118

Selamu, M., Thornicroft, G., Fekadu, A. & Hanlon, C. (2017). Conceptualisation of job-related wellbeing, stress and burnout among healthcare workers in rural Ethiopia: a qualitative study. BMC health services research, 17, pp.1-11. https://doi.org/10.1186/s12913-017-2370-5

Shipalana, M.L. (2019). Recruitment and retention of healthcare professionals in the public health sector: focus at the Limpopo

Department of Health. http://ulspace.ul.ac.za/bitstream/handle/10386/2763/shipalana_recruitment_2019.pdf?sequence=1

Sikwela, S. (2016). Employee retention strategies for medical staff in public hospitals: The case of Potchefstroom hospital (Doctoral dissertation, North-West University, Potchefstroom Campus).

Sikwela, S. (2016). Employee retention strategies for medical staff in public hospitals: The case of Potchefstroom hospital (Doctoral dissertation, North-West University (South Africa), Potchefstroom Campus). https://repository.nwu.ac.za/handle/10394/25853

Sono-Setati, M. E., Mphekgwana, P. M., Mabila, L. N., Mbombi, M. O., Muthelo, L., Matlala, S. F., ... & Ramalivhana, N. J. (2022, July).

Health system-and patient-related factors associated with COVID-19 mortality among hospitalized patients in limpopo province of

South Africa’s public hospitals. In Healthcare (Vol. 10, No. 7, p. 1338). MDPI. https://doi.org/10.3390/healthcare10071338

Ștefan, S.C., Popa, Ș.C. & Albu, C.F. (2020). Implications of Maslow’s hierarchy of needs theory on healthcare employees’ performance. Transylvanian Review of Administrative Sciences, 16(59), pp.124-143. https://doi.org/10.24193/tras.59E.7

Thant, Z.M. & Chang, Y. (2021). Determinants of public employee job satisfaction in Myanmar: Focus on Herzberg’s two factor theory. Public Organization Review, 21(1), pp.157-175. https://doi.org/10.1007/s11115-020-00481-6

Thusi, X., & Nkgapele, S.M (2024). Sustainable Strategies for Enhancing the Recruitment and Retention of Health Professionals in Rural Areas in the Public Health Sector, South Africa. Asian Journal of Management, Entrepreneurship and Social Science, 4(04), 1751-1769.

https://www.ajmesc.com/index.php/ajmesc/article/view/1030

Umeh, I.E. (2022). Management Motivation Strategies and Their Impact on Motivating Healthcare Employees (Doctoral dissertation, Walden University). https://www.proquest.com/openview/7f39721ccfdb234915865a2bcacd5cc4/1?pqorigsite=gscholar&cbl=18750&diss=y

Van Rensburg, H.C. (2014). South Africa’s protracted struggle for equal distribution and equitable access–still not there. Human

resources for health, 12, pp.1-16. https://doi.org/10.1186/1478-4491-12-26

Van Wyk, S.N. (2023). The effect of nurse shortages on healthcare at a public hospital in KwaZulu-Natal (Doctoral dissertation, Cape Peninsula University of Technology). https://etd.cput.ac.za/bitstream/20.500.11838/3946/1/Sandhya_Nankoo_Van_Wyk_223231118.pdf

Vizzuso, J. (2015). Leadership strategies to influence employee engagement in health care. Walden University. https://www.proquest.com/openview/cd66304bfb4cd27f260c97581978a937/1?pq-origsite=gscholar&-cbl=18750

Wahome, C. (2022). What is Maslow’s hierarchy of needs.

Washeya, F.N. (2018). Factors influencing retention of professional nurses in a public health care facility in Windhoek, Namibia (Doctoral dissertation, Stellenbosch: Stellenbosch University). https://scholar.sun.ac.za/handle/10019.1/103478