Abstract:
Healthcare workers are an essential element in the functionality of the health system.
However, the health workforce impact on health systems tends to be overlooked. Countries
within the Sub-Saharan region such as the six in the East African Community (EAC) have weak
and sub-optimally functioning health systems. As countries globally aim to attain Universal Health
Coverage and the Sustainable Development Goal 3, it is crucial that the significant role of the health
workforce in this achievement is recognized. In this systematic review, we aimed to synthesise
the determinants of motivation as reported by healthcare workers in the EAC between 2009 and 2019.
A systematic search was performed using four databases, namely Cochrane library, EBSCOhost,
ProQuest and PubMed. The eligible articles were selected and reviewed based on the authors’ selection
criteria. A total of 30 studies were eligible for review. All six countries that are part of the EAC were
represented in this systematic review. Determinants as reported by healthcare workers in six countries
were synthesised. Individual-level-, organizational/structural- and societal-level determinants were
reported, thus revealing the roles of the healthcare worker, health facilities and the government in
terms of health systems and the community or society at large in promoting healthcare workers’
motivation. Monetary and non-monetary determinants of healthcare workers’ motivation reported
are crucial for informing healthcare worker motivation policy and health workforce strengthening in
East Africa.
