Salary Enhancement and Perceived Service Delivery Among Health Sector Employees in Sheema District

Abstract

This study examined the effect of salary enhancement on perceived service delivery among health sector employees in Sheema District Local Government, Uganda. Despite government interventions to improve salaries, challenges such as limited resources, inadequate infrastructure, and workforce constraints continued to affect service delivery. The study aimed to assess the influence of current salary, salary fairness perception, and salary increment frequency on employees’ perceptions of service delivery. A quantitative research design was employed, using structured questionnaires administered to 385 respondents, including medical officers, nurses, midwives, clinical officers, pharmacists, laboratory technicians, public health officers, health information officers, health educators, support staff, and community beneficiaries. Key informant interviews and document reviews of salary records and service delivery reports were also conducted to enrich the findings. The results indicated that current salary had a moderate positive effect on perceived service delivery (r = 0.444, p = 0.02), though its relationship with salary fairness perception was weak and not statistically significant. Salary fairness perception was positively associated with perceived service delivery (r = 0.45, p = 0.025), suggesting that employees who considered their salaries fair were more likely to hold positive views about service quality. Salary increment frequency exhibited the strongest positive correlation with perceived service delivery (r = 0.97, p = 0.015), indicating that regular and predictable increments strongly influenced employees’ perceptions. Overall, the study demonstrated that salary enhancement, particularly frequent increments, contributed significantly to improving perceived service delivery. The study concluded that while higher salaries and fairness perceptions moderately enhanced service delivery, structured and regular salary increments were the most influential motivating factor. Recommendations included prioritizing frequent salary reviews, ensuring fair compensation structures across all health worker cadres, promoting professional ethics among employees, and encouraging collaboration between the government and NGOs to support incentive programs that complement salary enhancement.