Framework of Motivations
for Community Health Workers

JOHN LEE, ARIJIT SARKAR

Motivational Theory (Page 2 of 2)

Application to management theory

Theory X Theory Y

Maslow’s Hierarchy of Needs defines needs in a context that does not include situational factors. The needs theory describes human motivations in a vacuum. Maslow’s framework can be applied to existing management models in corporate settings.

In the 1960s, Douglas McGregor proposed a management theory called Theory X and Y, which drew many parallels to Maslow. McGregor proposes two extremes to management styles: Theory X and Theory Y.

Theory X reflects a view that individuals inherently dislike work, that workers must be goaded to perform well (Economist). Theory X-based management focuses on performance-based rewards, outputs, and extrinsic motivation. In application to Maslow’s theory, Theory X managers are catering to the lowest, most basic needs of individuals, the physiological needs. Managers view their workers as having physiologically unsatisfied needs only, and therefore they attempt to provide motivation by extrinsic rewards like money. At most, Theory X managers view their workers as having their safety needs unsatisfied. Therefore, job security can be used as a motivator.

Theory Y Managers believe that their workers are intrinsically motivated and that management practices should revolve around organizing self-directed, self-controlled workers (Economist). The goal is that workers become fundamentally committed to the goals of the organization. Managers are required to create an environment where workers feel safe, secure, essential, and worthy. McGregor’s Theory Y environment strongly corresponds with Maslow’s safety, love, and esteem needs. Theory Y was created as a management style that would maximize intrinsic motivation. McGregor felt that management closer to Theory Y would motivate its employees to the highest levels of performance (Economist). As a result, McGregor proposed practical management model of Maslow’s Needs Hierarchy.

Japanese management culture

Known as one of the most effective management practices, Japanese Management Culture employs multiple practices to create a committed, high-achieving workforce. Manufacturing firms using these practices are able to attain unbelievably high defect rates, lower than 1 per cent, and average job tenures of nearly 13.5 years (Keys & Miller). The management structure agrees with Maslow’s Hierarchy of Needs, placing great emphasis on achieving the levels beyond simple physiological need. Japanese Management Culture satisfies safety needs of individuals by providing lifetime employment. Rather than worrying about job security, workers have the opportunity to invest in long term efforts to train and develop into a better performer (Keys & Miller). Not only does this satisfy a safety need, but it also accomplishes the love need. Workers are brought into a mutual awareness with their employers of the commitment to each other. Upon acceptance into a firm, workers are socialized to feel like they have entered a family. Therefore, not only is a sense of belongingness achieved in the worker, but also a strong sense of loyalty (Keys & Miller). Organizational leadership in these firms is organized to encourage employee wishes and concerns, and to foster long term relationships. As a result, most major decisions are consensus driven by those that will be affected by the outcome (Keys & Miller). Japanese workers are given an authority and respect to satisfy Maslow’s esteem needs. Workers form a collective responsibility for the company, being intrinsically motivated to perform well in order to boost the efficiency and performance of the company. Japanese Management Culture stands as a testament to the ability of management strategies to instil intrinsic motivation into
their workforce.

One criticism of Japanese Management Culture is the possibility of fostering complacency from life-time tenure. Without the risk of losing their job, it is thought that workers will have little motivation to perform well. On the contrary, Japanese firms often employ different goal strategies than other Western firms. Without high attrition rates, firms are able to create long-term goals for workers. This alleviates immediate pressure, but allows workers to stay focused on a longer, more developed task (Keys & Miller). Also, tenure allows for career training and development. Workers are encouraged to participate in rotations in training in order to explore other positions (Keys & Williams). Therefore, Japanese firms create an environment where workers can explore and develop their own track, making self-actualization more possible.

The application of Maslow’s theory into corporate management shows how the Hierarchy of Needs can be put into practice. The Needs Hierarchy can be used as a framework to identify which needs a management structure satisfies and which it doesn’t. The literature review suggests that a focus on satisfying all levels of the Needs Hierarchy leads to better efficiency and performance from workers. Consequently, employers should strive to satisfy all needs in order to maximize motivation and performance.

Application to volunteering

One of the most basic reasons for attaining a job is to create income in order to provide for food, shelter, clothing, etc. For this reason, volunteering differs from traditional jobs. Volunteering holds an assumption that it adds to an existing job or source of income, involving some form of a sacrifice from the volunteer, whether it is financial or non-financial. Therefore, it becomes essential for any management structure for volunteers to consider other levels than simple physiological needs to foster intrinsic motivation within volunteers.

James L. Perry, in developing Public Service Motivation model, found that those that served in public service were usually driven by values such as self-esteem, esteem within the community, and respect. These values were often tied to parental, religious, professional and political ideologies (Perry). These workers were motivated intrinsically, rather than by monetary incentives. Similar to employees in Japanese Management Culture, volunteers were more concerned with their value, worth, and respect in performing volunteer work than monetary or extrinsic rewards. In a study on volunteer incentives that Hugh Arnold conducted, he found that extrinsic rewards often had no consequence on intrinsic motivation. His data indicated that feedback on performance positively attributed to feelings of competency which had a positive effect on intrinsic motivation (Arnold). Arnold’s study suggests that external rewards, such as monetary incentives, do not increase the motivation of volunteers. In light of this, volunteer management models should attempt to develop strategies based on higher ideologies, rather than extrinsic rewards.

In Economic and Philosophical Manuscripts, Karl Marx provides a theory of why someone would choose to engage in volunteer work. He hypothesizes that volunteers seek to excel and achieve self-actualization in community service because they have not been able to do so in their career fields (Marx). These workers have been alienated from normal labor markets; therefore they have a number of unsatisfied needs. In relation to Maslow, while the physiological needs of these workers may be satisfied through their normal work, they lack a sense of security, love, esteem, and self-actualization (Thompson & Bono). Therefore, the motivation to engage in volunteer work is based on an urge to satisfy the needs that have not been satisfied by their jobs. In less developed regions of the world, Marx’s theory may be especially relevant because of the significant number of labor intensive blue collar work. Often selected from resource-poor communities, CHWs may volunteer because they are able to fulfil their needs for love, esteem, and self-actualization through their jobs.

In much of the same way that corporate management models try to satisfy higher order levels on Maslow’s pyramid, similar techniques and strategies can be implemented on volunteer management structures. Like Japanese Management Culture, volunteers can be given significant autonomy, good feedback, belongingness, identity, and other incentives that will satisfy their needs. The main difference in management style would have to be in addressing the non-paid aspect of volunteering. Without providing salaries, volunteer programs are under the assumption that volunteers can provide for their own physiological needs. While volunteer management structures cannot provide salaries, it can be set up so that the volunteer work does not affect the ability of workers in securing salaries in their respective jobs. Management should be focused on accommodating volunteers, to make their work as convenient as possible, while trying to satisfy upper level needs.

Similar to corporate business models, the failure of volunteer management and motivation often results from not addressing upper level needs (Mathauer). According to a study on health worker motivation in Africa, health workers often began their post with great motivation and drive to accomplish goals, but became frustrated (Mathauer). Frustration was often from a lack of professionalism, which lowered the esteem of workers, and recognition in the health community, which detracted from their sense of belonging in primary healthcare (Mathauer). Sustainability and effectiveness in volunteer programs can only be achieved by developing structures in which upper level needs are fulfilled.

For an effective management structure for volunteer worker to be created, the upper level needs of individuals must be identified. Maslow’s Hierarchy of Needs provides a firm basis in which to identify and distinguish unsatisfied and satisfied needs. Although Maslow’s framework does not account for situational factors, it provides a systematic method applicable to different management structures. Therefore, the Hierarchy of Needs can be implemented as a tool in creating incentive and management structures for volunteer health workers.

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