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Perceived Unfairness in Working Conditions: The case of Public Health Services in Tanzania.

机译：工作条件中的不公平现象：坦桑尼亚的公共卫生服务。

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The focus on the determinants of the quality of health services in low-income countries is increasing. Health workers' motivation has emerged as a topic of substantial interest in this context. The main objective of this article is to explore health workers' experience of working conditions, linked to motivation to work. Working conditions have been pointed out as a key factor in ensuring a motivated and well performing staff. The empirical focus is on rural public health services in Tanzania. The study aims to situate the results in a broader historical context in order to enhance our understanding of the health worker discourse on working conditions. The study has a qualitative study design to elicit detailed information on health workers' experience of their working conditions. The data comprise focus group discussions (FGDs) and in-depth interviews (IDIs) with administrators, clinicians and nursing staff in the public health services in a rural district in Tanzania. The study has an ethnographic backdrop based on earlier long-term fieldwork in the same part of Tanzania. The article provides insights into health workers' understanding and assessment of their working conditions. An experience of unsatisfactory working conditions as well as a perceived lack of fundamental fairness dominated the FGDs and IDIs. Informants reported unfairness with reference to factors such as salary, promotion, recognition of work experience, allocation of allowances and access to training as well as to human resource management. The study also revealed that many health workers lack information or knowledge about factors that influence their working conditions. The article calls for attention to the importance of locating the discourse of unfairness related to working conditions in a broader historical/political context. Tanzanian history has been characterised by an ambiguous and shifting landscape of state regulation, economic reforms, decentralisation and emerging democratic sentiments. Such a historic contextualisation enhances our understanding of the strong sentiments of unfairness revealed in this study and assists us in considering potential ways forward.
机译：低收入国家越来越关注决定卫生服务质量的因素。在这种情况下，卫生工作者的动机已成为人们非常感兴趣的话题。本文的主要目的是探索卫生工作者的工作条件经验，并将其与工作动机联系起来。有人指出工作条件是确保有动力和表现良好的员工的关键因素。实证重点是坦桑尼亚的农村公共卫生服务。该研究旨在将结果置于更广阔的历史背景中，以增进我们对卫生工作者关于工作条件的论述的理解。该研究采用定性研究设计，以获取有关卫生工作者工作条件经验的详细信息。数据包括焦点小组讨论（FGD）和对坦桑尼亚农村地区公共卫生服务的管理人员，临床医生和护理人员的深入访谈（IDI）。这项研究的民族志背景基于坦桑尼亚同一地区的早期长期田野调查。本文提供了有关卫生工作者对工作条件的理解和评估的见识。工作环境不令人满意的经验以及人们认为缺乏基本公平性的现象主导了烟气脱硫设备和IDI。线人报告说，工资，晋升，工作经验认可，津贴分配，培训机会以及人力资源管理等方面的不公平。该研究还显示，许多卫生工作者缺乏有关影响其工作条件的因素的信息或知识。这篇文章呼吁注意在更广泛的历史/政治背景下找到与工作条件有关的不公平话语的重要性。坦桑尼亚历史的特征是国家法规，经济改革，权力下放和新兴民主情绪的模棱两可和多变。这种具有历史意义的语境化可以增进我们对本研究中揭示的强烈的不公平情绪的理解，并帮助我们考虑潜在的前进方向。

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