Service Provider Competence, Motivation, and Resource Availability as Determinants of Quality Healthcare Delivery: A Cross-Sectional Study at Makeni Regional Hospital, Sierra Leone

Quality healthcare delivery in low- and middle-income countries remains constrained by workforce and resource limitations. This study assessed service provider competence, service provider motivation, and resource availability as determinants of quality healthcare delivery at Makeni Regional Hospital in Northern Sierra Leone, from the service providers' own perspective. A cross-sectional study, descriptive in type, was conducted among 155 service providers, with sample size determined using the Yamane formula. Structured questionnaires were administered and analyzed using STATA to assess the relationship between competence, motivation, resource availability, and quality healthcare delivery. Most service providers (74.8%) reported possessing the required professional skills, and 91.6% perceived that competent staff resulted in improved delivery of quality healthcare; 94.8% associated competent personnel with improved patient outcomes. Motivation levels were markedly lower: only 7.1% of respondents were highly motivated, 16.1% were motivated, and 40.65% were somewhat motivated, while all respondents (100%) agreed that motivation influences quality of care delivery. Resource availability showed the strongest association with quality outcomes, with 99.4% of respondents affirming that adequate resources affect quality healthcare delivery and 95.5% affirming that adequate resources result in improved delivery of quality healthcare; gaps were noted in bed capacity (45.8% reporting inadequacy) and equipment. Service provider competence, motivation, and resource availability were all found to significantly determine the delivery of quality healthcare at Makeni Regional Hospital, with motivation representing the weakest of the three despite high levels of provider competence. Continuous professional development, formal motivation policies, and improved resource allocation are recommended to strengthen quality healthcare delivery.