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[Motivation and incentives: different perceptions of administrators and professionals. Evaluation Team of the Materno-Infantile Health Program].

OBJECTIVE
To find the views of Primary Care District managers and Health Centre (HC) professionals in Andalusia on systems of motivation and incentive in use in this autonomous community.


DESIGN
A descriptive study which uses qualitative and quantitative methodology.


SETTING
Primary Care districts and Health Centres in Andalusia.


PARTICIPANTS
Primary Care district managers (51) and HC professionals (91).


MATERIAL AND METHODS
Information-gathering: self-administered questionnaire (managers) and focus groups (professionals).


ANALYTICAL TECHNIQUES
Non-parametric tests to compare means and analysis of contents of discourse. Field-work. July 1994 and February 1995.


RESULTS
55% of the district managers thought that the incentive systems in use were inadequate and insufficient. Enabling professionals to be trained is the main motivating and incentive mechanism in place. Variable productivity was the next most common mechanism. However, variable productivity, in the view of the professionals, was the main demotivating factor of recent years. Professionals thought that the economic rewards of the incentives system were slight, the target variables were unsuitable, there were no objective evaluation mechanisms and the economic differences between the incentives earned by managers and professionals were too great.


CONCLUSIONS
The District managers indicated that improvements in the incentives systems used are needed. The HC professionals affirmed that the Andalusian incentives system has demotivated Primary Care teams and has had little effect on orienting professional practice.