Managing and Motivating Figure 1. Age profile of staff surveyed in health facilities of changing either their personal or professional standing (Bradley & McAuliffe, 2009). The cur- rent system forces them to either stagnate or leave clinical practice. Clinical officers themselves reported their lack of motivation, and staff who are trapped are unlikely to provide the best ser- vice (Martineau, Lehmann, Matwa, Kathyola & Fagin, 1997; Gleason-Scott, Sochalski, & Aiken, 1999; Upenieks, 2002) burnout (Aiken & Sloane, 1997), retention and recruitment (Kramner & Hafner, 1989; Slater & McCormack, 2007), decreased mortality and healthier staff (Aiken et al., 1997). Little is known about the predictive value of these same organisational traits in low-