Comm Eye Health Vol. 18 No. 56 2005 pp 122 - 124. Published online 01 December 2005.

Creating motivation, identifying incentives and enablers, and encouraging staff development

Helen Roberts

Coordinator, Kwale District Eye Care, PO Box 90142, Mombasa, Kenya.

Related content

Creating motivation

Motivating staff so that they perform at their best is an integral part of running a project. People usually need to work in order to make money. But, although this may be the strongest incentive, it is not the only one.

Staff share the patient’s delight after the bandages are removed. KENYA. © Helen Roberts
Staff share the patient’s delight after the bandages are removed. KENYA. © Helen Roberts

People will enjoy their job and gain satisfaction from doing it well if they know that they are achieving results. If you are running a project you should be making sure that this is happening. The first step is to recruit the right people for the right job, the next step is to clearly define their roles and responsibilities and the third step is to enable them to do the job well. This article focuses on the third step.

Celebrate results

We are fortunate in eye care that our work can be very rewarding on an immediate basis. It is important, for example, that people who may not be directly involved with experiencing the patient’s delight at having their sight restored, get to witness this or to hear about it.

The whole team came in on a Saturday to paint the perimeter wall. Activities outside work help build team spirit. KENYA. © Helen Roberts
The whole team came in on a Saturday to paint the perimeter wall. Activities outside work help build team spirit. KENYA. © Helen Roberts
Seif, the driver, is elected as staff of the month and receives a T-shirt. KENYA. © Helen Roberts
Seif, the driver, is elected as staff of the month and receives a T-shirt. KENYA. © Helen Roberts

Create a good working environment

A good practical working environment helps get the job done. Clean, comfortable conditions with functioning bathroom facilities, available food and water all help. There should be suitable equipment to do the job efficiently and that equipment should be regularly maintained to avoid frustrating breakdowns and interference with the schedule.

Establish a clear goal and ownership

Your staff must understand and work towards a common goal. The goal of most eye institutions is clear. All staff must understand the vision and mission of the place in which they work. Ideas should be encouraged from all levels of staff. You don’t have to be a senior to have good ideas. If it is your idea or you were involved in developing it, you will care more that the idea is successfully implemented.

Foster teamwork, communication and feedback

People want to feel that they are doing a good job as members of a team. The best way to promote teamwork is to treat all your staff as valued members of the team. Good communication, a clear understanding of each person’s role and a sense of close involvement are the most important ingredients in creating and maintaining teamwork. Communication occurs on a day-to-day, minute-to-minute basis informally and, more formally, in meetings. Meetings must be well-run with clear outcomes. Team members are motivated by getting things done and seeing things being done. Equally, if something has been agreed but is not then put into action this can be disheartening. Sometimes delays or difficulties are inevitable, in which case it is important to feed this back. Without feedback people become puzzled, then frustrated when they do not see changes that have been promised.

Incentives and enablers

Specific incentives: back to money

We agreed that money is the main reason that people come to work. Your staff must be paid appropriately for the job that they do. For formal roles, such as nursing, there are government pay scales that may be helpful for reference. For less formally recognised posts, such as community-based workers, one must look at what the project can afford and what the employee is happy to come to work for. The salary should be agreed upon at recruitment and there should be a clear, logical system for increments.

Cash incentives in addition to a regular salary have their place. These must be thought out very carefully as they often create their own problems. For example when the team performed over 40 cataract operations in one day on outreach, the donor, who was not present at the outreach, made an accusation that the figure was false because the staff were paid per cataract operation. Fortunately, we were able to prove the figure and I was very grateful that a per cataract cash reward was not in place!

Some organisations use an overnight allowance as a cash incentive to go on outreach. One was faced with staff refusing to go to work away from the base for a day because there was no overnight stay and therefore no extra cash involved. We use a staff bonus system at the end of each year. This should be discretionary and awarded depending on that person’s performance. Again, this can be misinterpreted as being the right of each member to get this and therefore a cause of negative feeling if not received. Whenever making cash allowances or incentives, it is vital to consider all aspects before introducing them.

Other incentives can be helpful, such as a health care scheme for the employee that can then be extended to their family with a contribution from the employee. Legally one must cover health care for each employee, but at the foremost of peoples’ minds is their family’s health. These schemes tend to be financially worthwhile only if the institution employs over 60 people.

Team outings

These enable staff to meet outside work and enjoy themselves. If your staff have worked hard and achieved their targets this is a good way to show them your gratitude and appreciation.

Other team-building exercises, although involving hard work rather than relaxation, can be fun and contribute to teamwork, such as spending time improving the work environment.

Awards or recognitions

Staff member of the month is one way to do this. The member can be elected (by other staff or by a management board) or, more easily, awarded on results, such as the community-based worker of the month is the person who brings in the most people with eye disease. Without clear criteria this can be full of pitfalls such as favouritism and rigged voting. More important than the actual (usually cash) reward should be the recognition that these staff receive from their peers.

Group awards are even more encouraging. If your project is recognised by the eye community or praised by a donor organisation, this is excellent for morale. Staff need to be made aware if you are lucky enough for this to occur!

Encouraging staff development


Appraisals are the starting block for managing the individual’s performance and motivation. They are of paramount importance: they help the member of staff understand the role that they play and enhance communication between the manager and themselves.

At the appraisal you need to find out the person’s wishes and suggestions and encourage them in a direction that suits them, while fitting in with what is needed by the organisation or project. From the appraisal there should be a clear plan of development for that staff member. That usually involves training, but may, perhaps, address a weakness which that team member needs to work on. The importance of following this up cannot be overemphasised. If a need is identified but support and monitoring of progress is not done, that staff member will feel uncared for. Box 1 provides guidelines on how to conduct appraisals.


People love to learn and this is a very good way to motivate staff and enable them to do their job better. Training should have both an individual and a team approach and occur both in-house and externally.

It is important for staff to meet as a group and learn together regularly. Subjects addressed may be specific to their job category or may be about personal development and concerns, such as how to cope with stress or avoid contracting HIV.

Any training course should be selected carefully with the individual. You need the right person to learn the right things. On their return from training it is important that they are encouraged to implement what they have learnt. All too often people do not receive the backup to apply their new knowledge. This is very demotivating. The poor staff member feels that it has all been a waste of time.

Exposure to similar projects is less expensive than formal training courses and often more relevant. This may be done as an individual or a group.


The success or failure of a project depends heavily on the staff and how well they do their job. Motivating and enabling them to do this is an ongoing part of running a project.

Box 1
How to conduct a good appraisal

Who should be there?

The line manager needs to be present with the employee. The appraisal is an individual approach and is usually done one-to-one, but there may occasionally be some points for which you want another person to be involved.

Sometimes junior staff will personalise issues, blaming problems on their line manager. This may mean that the overall ‘boss’ as well as the line manager needs to be involved. It should be stressed that appraisals are not about telling people what they are doing wrong or disciplining them. If this is required it should be done at a separate meeting. Appraisals are about reviewing performance over the last 12 months and setting objectives for the next 12 months. Remember one cardinal rule: NEVER discuss another member of staff in a meeting when they are not present. If they need to be discussed, arrange to include them so that they can give their side of the story.

Before you start

The timing of the appraisal needs to be discussed and agreed with the member of staff involved. There is some preparation involved. If this is the first appraisal, the person should be given an idea of what will be addressed during the meeting. Most important, he or she must know that this is not a meeting to tell them off or be nasty. Many junior members are afraid of appraisals because of this. If you can gain the understanding that this exercise is intended to help both the employee and the organisation, staff members are more likely to open up so that you see the real person and get their input.

Appraisal forms

Before the date of the appraisal, the staff member and the person conducting the appraisal should be given a questionnaire to help them prepare. Box 2 provides some suggested forms that you can use. They are simply to give you an idea and can be modified to suit your needs.

At the appraisal

1. During the appraisal make sure that there are no disturbances.

2. Work through appraisal forms (see Box 2 over page) allowing enough time for discussion.

3. At the end, summarise what has been discussed and have clear objectives to achieve by certain times. As discussed before, the entire process is a waste of time if decisions and plans are not acted upon as agreed.

4. Finally, set a date for the next appraisal. Appraisals should be done for each staff member at least once per year. Sometimes, if an issue comes up, progress may need to be reviewed earlier

Box 2
Sample appraisal forms for manager and staff member

Manager’s preparation

Name ………………………………………………

Date ………………………………………………..

Job title ……………………………………………

1. Is the job description up to date? Any changes? Health checks, PIN numbers, etc.

2. Is this person in the right place on the organogram? Are the lines of reporting correct, open and clear?

3. Is this person:

  • punctual
  • cheerful
  • responsible
  • adhering to policies
  • meeting deadlines
  • willing to take on more responsibility
  • getting on well with fellow workers
  • treating patients with respect and caring• promoting teamwork by supporting colleagues
  • giving feedback
  • offering ideas
  • coming to work appropriately dressed?

4. Look at the last appraisal summary notes. How well are the objectives for the job now being met and, more specifically, have the objectives defined at the last appraisal been achieved? Is this person using their skills and talents to the best of their ability?

5. Regarding the job, what are this staff member’s main strengths/weaknesses? Are there any areas of the performance which could be improved?

6. What are their development needs? Training? Do they need anything to enable them to improve their performance at work?7 What are this staff member’s objectives for next year?

Post holder’s preparation

Name ………………………………………………

Job title ……………………………………………

1. Look at your job description. Are there any areas that should be included? Are there areas which should be removed? Is there anything that is not clear to you?

2. List the people who report to you. Name the person to whom you report. Is this actually happening? Do you exchange feedback with them? Is this feedback acted on by relevant parties?

3. What do you think your strengths in this job are?

4. What do you think your main achievements have been over the past year?

5. What do you like about your present role? What do you dislike about your present role? What might help you do your job better?

6. What do you see yourself doing in five year’s time? What would you like to be doing? What do you feel you need to learn more about to help you do your job?

7. What do you see as your main objectives for the coming year?

Summary notes


Strengths and successes

Weaknesses, challenges, difficulties, etc.

Plan to address these

Training requirements and timeline

Date of next appraisal

Read, understood and signed by employee


Read, understood and signed by person appraising