Abstract
Background and ObjectivesThis paper analyses why and how conflicts occur and their influence on doctors and nurse-anaesthetists' motivation in the provision of maternal and neonatal health care in a specialist hospital.MethodologyThe study used ethnographic methods including participant observation, conversation and in-depth interviews over eleven months in a specialist referral hospital in Ghana. Qualitative analysis software Nvivo 8 was used for coding and analysis of data. Main themes identified in the analysis form the basis for interpreting and reporting study findings.Ethics StatementEthical clearance was obtained from the Ghana Health Service Ethics Review board (approval number GHS-ERC:06/01/12) and from the University of Wageningen. Written consent was obtained from interview participants, while verbal consent was obtained for conversations. To protect the identity of the hospital and research participants pseudonyms are used in the article and the part of Ghana in which the study was conducted is not mentioned.ResultsIndividual characteristics, interpersonal and organisational factors contributed to conflicts. Unequal power relations and distrust relations among doctors and nurse-anaesthetists affected how they responded to conflicts. Responses to conflicts including forcing, avoiding, accommodating and compromising contributed to persistent conflicts, which frustrated and demotivated doctors and nurse-anaesthetists. Demotivated workers exhibited poor attitudes in collaborating with co-workers in the provision of maternal and neonatal care, which sometimes led to poor health worker response to client care, consequently compromising the hospital's goal of providing quality health care to clients.ConclusionTo improve health care delivery in health facilities in Ghana, health managers and supervisors need to identify conflicts as an important phenomenon that should be addressed whenever they occur. Effective mechanisms including training managers and health workers on conflict management should be put in place. Additionally promoting communication and interaction among health workers can foster team spirit. Also resolving conflicts using the collaborating response may help to create a conducive work environment that will promote healthy work relations, which can facilitate the delivery of quality maternal and neonatal health care. However, such an approach requires that unequal power relations, which is a root cause of the conflicts is addressed.
Highlights
Introduction and Analytical ConceptsHealth workers’ motivation can be defined as individuals’ ‘degree of willingness to exert and maintain an effort towards organizational goals’ [1]
Effective mechanisms including training managers and health workers on conflict management should be put in place
Resolving conflicts using the collaborating response may help to create a conducive work environment that will promote healthy work relations, which can facilitate the delivery of quality maternal and neonatal health care
Summary
Health workers’ motivation can be defined as individuals’ ‘degree of willingness to exert and maintain an effort towards organizational goals’ [1]. Individual workers’ motivation can be affected by conflicts between collaborating workers. Individual, interpersonal and organisational factors contribute to conflicts and unequal power relations and relations of distrust among workers can affect how workers respond to conflicts [2,3,4,5]. Poor responses to conflicts can lead to persistent conflicts, which can frustrate efforts towards achieving organisational goals. Conflicts can be devastating where care provision is dependent on cooperation, understanding and interdependence between different professional groups. This paper analyses why and how conflicts occur and their influence on doctors and nurseanaesthetists' motivation in the provision of maternal and neonatal health care in a specialist hospital
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