Commitment among state health officials & its implications for health sector reform: lessons from Gujarat.

Sunil Kumar Maheshwari · Ramesh Bhat · Somen Saha

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Employee Performance and Management Global Health Workforce Issues Healthcare Education and Workforce Issues

Abstract

BACKGROUND & OBJECTIVE: Commitment, competencies and skills of people working in the health sector can significantly impact the performance and its reform process. In this study we attempted to analyse the commitment of state health officials and its implications for human resource practices in Gujarat. METHODS: A self-administered questionnaire was used to measure commitment and its relationship with human resource (HR) variables. Employee's organizational commitment (OC) and professional commitment (PC) were measured using OC and PC scale. Fifty five medical officers from Gujarat participated in the study. RESULTS: Professional commitment of doctors (3.21 to 4.01) was found to be higher than their commitment to the organization (3.01 to 3.61). Doctors did not perceive greater fairness in the system on promotion (on the scale of 5, score: 2.55) and were of the view that the system still followed seniority based promotion (score: 3.42). Medical officers were upset about low autonomy in the department with regard to reward and recognition, accounting procedure, prioritization and synchronization of health programme and other administrative activities. INTERPRETATION & CONCLUSION: Our study provided some support for positive effects of progressive HR practices on OC, specifically on affective and normative OC. Following initiatives were identified to foster a development climate among the health officials: providing opportunities for training, professional competency development, developing healthy relationship between superiors and subordinates, providing useful performance feedback, and recognising and rewarding performance. For reform process in the health sector to succeed, there is a need to promote high involvement of medical officers. There is a need to invest in developing leadership quality, supervision skills and developing autonomy in its public health institutions.

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1990The measurement and antecedents of affective, continuance and normative commitment to the organization 1976Organizational commitment and managerial turnover: A longitudinal study 1974Unit performance, situational factors, and employee attitudes in spatially separated work units 1992Employee Commitment 1989Work commitment among salaried professionals 1999Towards a better understanding of the link between participation in decision‐making and organizational citizenship behaviour: A multilevel analysis 1993Professional and Organizational Commitment: Compatible or Incompatible?

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2014Evaluation of Capacity-Building Program of District Health Managers in India: A Contextualized Theoretical Framework 2016Organizational Commitment of Health Professionals and Associated Factors in Government Health Facilities of Gurage Zone, South Ethiopia

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