Healthworkers’ motivation in low- and middle-income countries: A systematic review of the literature

Healthcare systems in low- and middle-income countries (LMICs) face a double burden of workforce challenges: low availability of healthworkers, and poor performance of many in post. Knowledge of what motivates healthworkers in their work may help address both challenges. To understand developments in this area, a systematic review of f literature was conducted. From an initial 4341 papers, 73 met the review’s inclusion criteria, encompassing a mix of focuses, methodologies, and geographical areas. Five themes are identified by healthworkers in the studies reviewed as influencing their motivation: working conditions (54 studies), financial incentives (46 studies), social incentives (37 studies), career development (31 studies) and living conditions (28 studies). As in previous reviews, there is a lack of evidence on the effectiveness of interventions for improving the availability, performance and motivation of healthworkers. A number of areas for further research are highlighted such as: developing effective interventions, understanding the role of context, and analysing the cost-effectiveness of different approaches to attracting and motivating healthworkers.