Motivation and Demotivation: a Case Study of the Malawian Health Management Information System

Gro Alice Hamre, Jens Kaasbøll


This paper addresses the problems of utilisation of health management information systems (HMIS) in developing countries due to the critical shortage of qualified and motivated human resources. The study employed qualitative research methods in an interpretive in-depth case study, and the study was carried out in two districts in Malawi. Analyses are based on motivational theory and the six categories of good and bad critical motivational incidents defined by Machungwa and Schmitt. Gasser’s theory of integration of computing and routine work was applied to address the secondary, and supportive, nature of HMIS computing work. This research suggests that motivational items identified by Machungwa and Schmitt are chiefly relevant to the Malawian context, but since the HMIS work is of a secondary type compared to core health activities, the work motivation that comes from work itself has little motivating effects. Supervision visits and a recognition scheme were social arenas which motivated the health workers.


Health Information System; Developing Countries; Human Resources; Motivation; Secondary work

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