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Physicians' Motivation in the Ministry of Health and Population - Egypt: Challenges and Opportunities

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Physicians' Motivation in the Ministry of Health and Population - Egypt: Challenges and Opportunities American University in Cairo AUC Knowledge Fountain Theses and Dissertations 6-1-2019 Physicians' motivation in the Ministry of Health and Population - Egypt: challenges and opportunities. Heba AlSawahli Follow this and additional works at: https://fount.aucegypt.edu/etds Recommended Citation APA Citation AlSawahli, H. (2019).Physicians' motivation in the Ministry of Health and Population - Egypt: challenges and opportunities. [Master’s thesis, the American University in Cairo]. AUC Knowledge Fountain. https://fount.aucegypt.edu/etds/761 MLA Citation AlSawahli, Heba. Physicians' motivation in the Ministry of Health and Population - Egypt: challenges and opportunities.. 2019. American University in Cairo, Master's thesis. AUC Knowledge Fountain. https://fount.aucegypt.edu/etds/761 This Thesis is brought to you for free and open access by AUC Knowledge Fountain. It has been accepted for inclusion in Theses and Dissertations by an authorized administrator of AUC Knowledge Fountain. For more information, please contact [email protected]. The American University in Cairo School of Global Affairs and Public Policy PHYSICIANS’ MOTIVATION IN THE MINISTRY OF HEALTH AND POPULATION- EGYPT: CHALLENGES AND OPPORTUNITIES A Thesis Submitted to the Public Policy and Administration Department In partial fulfillment of the requirements for the degree of Master of public policy By Heba AlSawahli Supervised by Prof.Laila ElBaradei Spring 19 1 CONTENTS List of tables .................................................................................................................................................. 5 List of figures ................................................................................................................................................ 6 List of abbreviations ..................................................................................................................................... 7 Acknowledgment .......................................................................................................................................... 8 1 Chapter one: Introductory discussions ................................................................................................ 10 1.1 Introduction ................................................................................................................................. 10 1.2 Problem statement ....................................................................................................................... 11 1.3 Policy relevance: ......................................................................................................................... 20 1.4 Research objectives and questions: ............................................................................................. 20 2 Chapter Three: Literature Review: ..................................................................................................... 22 2.1 Motivation of HRH and why it is relevant to health reform ....................................................... 23 2.2 Definition of motivation.............................................................................................................. 24 2.3 Intersection with other definitions: ............................................................................................. 25 2.4 Theories of motivation ................................................................................................................ 25 2.5 Determinants of motivation ........................................................................................................ 28 2.6 Consequences of demotivation ................................................................................................... 34 2.7 International approaches to address health workforce motivation and consequent shortages .... 36 3 Chapter Two: Methodology and Conceptual Framework ................................................................... 43 3.1 Conceptual framework ................................................................................................................ 43 2 3.2 Methodology ............................................................................................................................... 44 3.3 Ethical considerations ................................................................................................................. 48 3.4 Limitations .................................................................................................................................. 48 3.5 Research motivation/ role of researcher ...................................................................................... 49 4 Chapter Four: Egypt Health Care System ........................................................................................... 50 4.1 Egypt health system: physicians, supply, and attempts to reform .............................................. 50 4.2 Work environment for physicians ............................................................................................... 51 4.3 Role of private sector for physicians and patients ...................................................................... 52 4.4 Physicians in the reform plans .................................................................................................... 53 4.5 Medical Education and preparedness to market needs ............................................................... 55 4.6 Role of medical Syndicate: ......................................................................................................... 57 4.7 Motivation of Egyptian medical doctors ..................................................................................... 57 4.8 Response to the problem ............................................................................................................. 60 4.9 Migration of Egyptian doctors .................................................................................................... 62 5 Chapter Five: Study results ................................................................................................................. 64 5.1 ANALYSIS OF FINDINGS ....................................................................................................... 64 5.1.1 Individual factors of motivation .......................................................................................... 64 5.1.2 Organizational factors ........................................................................................................ 66 5.1.3 Cultural factors ................................................................................................................... 75 5.1.4 Response to the problem ..................................................................................................... 78 3 5.1.5 Consequences of demotivation and dis-satisfaction ........................................................... 79 5.1.6 Medical syndicate perspective ............................................................................................ 84 5.2 Conclusion .................................................................................................................................. 86 5.3 Discussion ................................................................................................................................... 88 6 Chapter Six: Policy conclusions and Implications .............................................................................. 90 6.1 Addressing demand ..................................................................................................................... 91 6.1.1 Medical education ............................................................................................................... 91 6.1.2 Medical training .................................................................................................................. 91 6.2 Addressing supply ....................................................................................................................... 92 6.2.1 Performance-based health finance ..................................................................................... 92 6.2.2 Technology and telehealth .................................................................................................. 93 6.2.3 Introducing assistant cadres and mid-level personnel ........................................................ 93 6.2.4 Public-private partnerships ................................................................................................ 94 6.3 Addressing retention ................................................................................................................... 95 6.3.1 Government expenditure on health ..................................................................................... 95 6.3.2 Steering instead of rowing .................................................................................................. 96 6.3.3 Sound legislations and objective standards ........................................................................ 97 6.3.4 Investment in primary healthcare ....................................................................................... 97 7 References ........................................................................................................................................... 99 4 LIST OF TABLES Table 1 Physician, nurses and midwifery personnel density per 1000 population in Egypt and other middle-income
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