Adopting a holistic sociotechnical perspective, healthcare systems do not merely exhibit complex structures and functionalities but are also affected by the differing expectations, claims, and concerns of the systems’ stakeholders (Guba & Lincoln, 1989; Haux, Winter, & Ammenwerth, 2004). Furthermore, the issues addressed at healthcare systems are not limited to the concerns and requirements of health service providers, whose primary and most fundamental concerns in general terms represent the assurance of their own economic well-being and ability to proactively operate as well as the development of sustainable strategies in order to realize their own interests whatever they may be (Carsten, Hankeln, & Lohmann, 2004; Kappler, 1994). Furthermore, the objectives of other health systems stakeholders such as hospital operators and financiers as well as (health) politicians, which may well be in contradiction to the objectives of mere health service providers, have to be incorporated when systematically analyzing healthcare systems (Horev & Babad, 2005; Peltier, Kleimenhagen, & Neidu, 1996; Staudinger, 2004a ).
Developing a tool to assess motivation among health service providers working with public health system in India
