EFFECT OF EMPLOYEE MOTIVATION ON JOB PERFORMANCE: IN CASE OF FICHE GENERAL HOSPITAL

Motivation is significant issues affecting human behavior and it is not only affecting other cognitive factor like perception and learning but also affects total performance of an individual in organization setting. Hence this study was focused on investigate the effect of employee motivation on their job performance in Fiche General hospital. It also intended to evaluate employee level of motivational and their level of job performance. In order to meet this objective, the researcher has used simple random sampling techniques; in collected from 179 employees out of 287, using Likert scale questionnaires. Data was analyzed using descriptive statistics (mean, and standard deviation) and inferential statistics (correlation and regression). The result of the descriptive statistics finding indicated that the employee job performance has been under practiced in Fiche General Hospital. The results of inferential statistics have revealed that all motivational factors under study are positively related to employee job performance. According to this finding the employee empowerment practices is more significantly associated and has impacts on employee job performance than all motivational factors under study. Hence, managers of Fiche General Hospital as advised to more empower their employee in the work place as motivational tool in order to enhance their job performance.

. Motivating employees for improved performance includes these serious aspects: member of staff engagement, organizational vision and values, management acknowledgment and gratitude of effort done as per standard, and overall acceptability of leadership. Performance assessment i is one of the greatest vital human resource practices by which supervisors evaluate the performance of subordinates and the focus of the performance assessment i is measuring and improving the actual performance of the employee and aims to evaluate what an employee does. Performance evaluation is generally viewed as unique of the utmost dynamic human resource management roles (Judge and Ferris 2013), moreover; an accomplished performance evaluation and management arrangement is a vital portion of an organizations human resource management capabilities. Worker reactions to assessment in standings of perceived worker justice, correctness, and fulfillment are vital basics of assessment effectiveness because these perceived employee reactions can motivate employees to improve their performance. Performance assessment i helps as a means for providing feedback that can result in enhanced performance. Researches in performance assessment i has demonstrated that performance assessment i features (such as assessment i purpose and source) can provoke constructive employee reactions to performance assessment i and, which in turn, can encourage employees to improve their performance. Therefore, performance assessment is going to the core of personnel management and sets out dissimilar aims which are straight accountable for the profession advance of employees and continual development of the organizations. Employee turnover is a communal encounter that all organizations everywhere the world face (Stanley, 2012). Among the aspects which stated to high employee turnover is demonization. There is an increasing agreement among managers and leaders about the worth of merging actual motivation encouragements to good performance (Cole and Kelly, 2011). For organizations to see their aims, they essential have a staff that is stimulated and works towards achieving the aims (Steers and Porter, 2011). Motivating employees is an encounter and care employees inspired bigger challenge. currently, organizations are under dynamic burden to recognize and implement plans that will verify actual in improving employee efficiency (Deci, 2013). It is not at all extensive adequate to rise salaries and expect improved efficency; it is more multifaceted than Employee motivation disturbs efficiency and a low motivated work force will be expensive to the organization in terms of decrease efficiency and performance, high work turnover, add costs, common absence adverse effect on the self-esteem of workers. It is a well-known fact that the success of an organization largely depends on the quality of its human resource, nonetheless of the Hospital within which it functions (Deci, 2013). It is with this in attention that leaders and managers must struggle to confirm that their workforce is motivated and therefore creative. Motivation is seen as one of the most vital issues related to human resources management (HRM) and organizational behavior management (Nelson, 2013) Philosophies of job performance offer that motivation is a crucial element of performance The role of motivation in the work setting has been considered to understand what causes employees to try work hard, or more specifically what causes the stimulation, direction, and persistence of voluntary actions that are goal directed (Mitchell and Linden, 2012). It is therefore imperative that managers understand what motivates employees and by what means to motivate them effectively (Deci, 2013).

Statement of the Problem
Motivation is the foremost core of employee job behavior field in the work environment (Masydzulhak, Ali, & Anggraeni, 2016). Motivation is an important factor that supports employer to advance employee job performance (Sandhya & Kumar, 2011). Motivation and performances of the employees are essential tools for the success of organization in the long time (Dobre, 2013). According to (Muogbo, 2013), the effect of motivation on employee job performance has been the attention of thorough research effort in recent times to identify how well an organization inspires its workers. There is positive association between employee motivation and employee job effectiveness (Dobre, 2013). The motivation of public service workers in developing and industrialized countries differ as workers earning low income are more extrinsically motivated and receive inducements in order to make ends meet (UNDP, 2014). Employee motivational factors will rest on, not only on country level investigation, but also at regional, local and sector level (Devadass, 2011). Low motivation in any organization has led to high turnover of employees, inefficiency, fraud, corruption, indiscipline at work (Muze, 2014). As per these scholars, (Matsie, 2008, Temesgen, 2012, Tizazu, 2015and Farooq & Shafique, 2016, have found gap on these identified four basic variables of motivational factors on employee job performance. The study by (Muralidharan & Sundararaman, 2009 shows payment is associated with output of employees and serves as incentive to enhance workers' performance. Developing and implementing employee training motivate workers (Dobre, 2013), increases productivity, improves the services and brings positive change in organization (Shaheen, Naqvi, & Khan, 2013). The study by Harrison & Novak, 2006 reveals that efforts by management to establish promotion opportunities contributes to employee's job satisfaction and turns as a stimulus for job performance. The study by Manzoor, 2012 shows a positive association between employee empowerment and employee job effectiveness as the more the employees are purpose to tasks accomplishment higher will the employee job performance. Few researches have been done on motivational issues and job performance in service organization particularly to Ethiopia. Some of them were conducted at federal level administered organization such as Factories (Ambo Mineral Water Factory etc.), Telecom, Banks (CBE) & higher Educational institution etc. To the extent of my knowledge I have not seen studies at Fiche General Hospital regarding to effect of motivational factors on job performance. Thus, empirical and practical gaps support the importance of undertaking study on the effect of motivational factors on job performance at Fiche General Hospital

Objectives of the study 1.3.1 General Objective
The general objective of the study was to examine effect of employee motivation on job performance FGH.

Specific Objectives
The Specific Objectives of the studs includes; 1. To identify the main motivational factors practiced in FGH. 2. To examine the relationship between each motivational factors and employee motivation in FGH. 3. To investigate the cumulative effect of motivational factors on employee performance in FGH. 4. To find which motivational factor is more important.

Hypotheses of the Study
Hypotheses 1 H1: There is a significant association between working condition and job performance. H0: There is no significant association between working condition and job performance Hypotheses 2: H1: There is a significant association between Benefits and job performance H0: There is no significant association between Benefits and job performance Hypotheses 3: H1: There is a significant association between Empowerment and job performance H0: There is no significant association between Empowerment and job performance Hypotheses 4: H1: There is a significant association between Recognition and job performance H0: There is no significant association between Recognition and job performance 2. Literature Review

Types of Motivation 2.1.1. Intrinsic Motivation
Intrinsic motivation refers to individual motivation stimuli that are coming from inside. A want to perform a specific task because its results are in accord with his trust system or fulfill a want and our deep-rooted desires have highest motivation power (Prasad, 2005). There three forms of intrinsic motivation: In the first form people engage in activity for its own interest since they find the activity the aforementioned as a source of enjoyment and satisfaction. Example: can be hobbies that one selects to pursue in the work context fulfilling an exciting task. The second form is activities which are tedious and unexciting but their accomplishment is a source of pressure. For instance, meeting a deadline at work brings a sense of achievement. Third form is about compliance it states that it is a matter of compliance with standard for their own sake that propels people to act. These standards may be ethical standards, commitment to group members, and desire to act according values of material or fairness procedure (Frey and Osterloh, 2002).

Extrinsic Motivation
According to Ryan & Deci, 2000 extrinsic motivation is when people act because of external aspects that prompt them to take action. Extrinsic motivation is concerned with whatever activity that is done to attain a result that is distinguishable from the activity itself. In a career context extrinsic motivation means the desire to satisfy the need or goals that are not related to the work itself. Extrinsic motivational is external in the nature. The most famous and the most discussed motivational is money. Other examples of extrinsic motivation include employee of the month award, benefit package, bonus and organized activities (Armstrong 2012).

Motivator factors
Motivator aspects are intrinsic to the job, such as the content of the work itself and the availability of opportunities for duty, improvement and appreciation for accomplishment (Santrock, 2009). Hygiene aspects are extrinsic to the job and relay to the situation in which the job is performed. Such factors include the organization's policy and administration, working conditions, salary, supervision and interpersonal relations. Herzberg argued that the extrinsic aspects of work (the hygiene factors) could not provide a source of motivation for employees but could, if 'bad', provide a source of disappointment and thus undermine employees. Hygiene factors should be seen as the precondition to allow the motivating aspects to influence employee's motivation. In a situation where there were 'good' hygiene factors, the employee would be in a state of 'no dissatisfaction'. The motivator factors, which Herzberg (1959) described as complex factors leading to this sense of personal growth and self-actualization, would reflect employee inspiration as a result rise job satisfaction and efficiency. As a consequence, in order to motivate workers in the direction of advanced productivity, while it is important to ensure that the hygiene aspects are accurate, the manager essential manipulate the motivators by attending to job-content matters for example jobenrichment (Sisk, 2009). Even though a lot has been written on motivation, this subject is not visibly understood and more often than unwell practiced. For instance, one salesperson may be motivated by the commission received on sales, while the other may be more concerned about attaining sales goals. This creates a fine distinction in the subject matter because motivation to enhance performance varies from person to person and from organization to organization (Daft, 2009)

Employee Performance
An effective performance management action is a significant instrument for employee inspiration for best performance. Though, it is not an adequate state for effective performance management. Furthermost vital issue with any performance management structure is how vital it is taken and how devotedly it is practiced by managers and employees. (Pulakos ,2009) Performance management is all about rightness, coordinating, progression to create value for and from customer with the result of economic value making to stockholders and owners. The expansion of performance management is clearly very huge, which is why performance management requirement be viewed within an enterprise as a instrument to improve on employee motivation for in height performance. (Cokins 2009, 9) Efficient management of performance requires a strong worry of the performance domain. That is, capturing the requirement and projects that are part of the job description within a firm. Once you have full skills of what the work involves, you have the foundation for evaluating and increasing performance. This is the foundation for assessing and enlightening performance within organization. Once this is no present, the significance is a mislaid connection in measuring employee performance and the likelihood of increasing employee performance within organization. Besides, there is also the misplaced connection in evaluating workers performance in association to other workers in the same job status (Robert, 2003).

Job satisfaction
In general job satisfaction as the singular assertiveness concerning the numerous characteristics of their works. Job satisfaction as the emotive happiness that outcomes from the evaluation ones work as attaining or simplifying the accomplishments of one's job importance (Lock, 1969). The observed work happiness produces progressive sentiment amongst individuals which in casual signify optimistic emotive reply in the direction of want for authority. The author additional discuss that satisfaction is attained as ones understands the importance of work standards to achieve one's elementary requirements. For the individuals working life skill job satisfaction is one of the important factors. Job satisfaction significance is connected to an individual getting enough extrinsic and intrinsic benefits to inspire the workers to stay and continue to expend a huge extent of period and accomplishing their responsibilities. Many scholars agree that job satisfaction is a direct on employee performance at numerous levels in an organization. It is one of the most important broadly debated topics in organizational manners, organizational management, staffs and human capital management. In simple word job satisfaction is sensation decent the job performed, combine with the organization mission and vision and a state of awareness Lewis et al. (2002). According to Steijn, B (2002) job satisfaction is an enjoyable sensitivity that outcomes from the insight that one's job permit or achieve of one's personal work standards. Persons want to accomplish their quantifiable capital through the work completed intentionally or unintentionally. Job satisfaction is the amount to which employees think significantly about their work (Pool, S.W,1997). Job satisfaction is an emotional response to ones work as well as the social and physical situation of the job environment. It is expected to be greater for workers who observe incentive involvement steadiness in their connection with engaging organization. In sum up job satisfaction is the results of numerous egotisms inclined by personnel on the road to his or her work. These job satisfaction attitudes may be connected to work aspects such as job safety, atmosphere of work, pays, and quick abstraction of grievances, job surroundings, and chance for development, and chances for participation in decision making and other choice of marginal payments. Any type of industry or enterprise the job satisfaction of whole labour force plays a key role and with a collection of pleased employee organization can effectively implement their policy. Numerous observed investigations have revealed that job satisfaction has direct effect on the employees' job performance at many levels in an organization. Job satisfaction is connected to worker performance and motivation (Kiviniemi et al, 2002). According to Meyer et al. (2002) clarified that job satisfaction is an approach originated from worker compassions of their works or job setting and indications to the degree to which an individual loves his or her work. It is an attitude very delicate to the features of the setting in which its culture.

Performance in organization
Performance in organization can be categorized into organizational performance and job performance (Otley 1999, 363-382). According to Otley, the performance of organization is subjected to the performance of worker's job performance and other elements which can be environment of the organization. The difference between organizational and job performance is seeming; an organization that is performing best is the one that is effectively attainment its aims, in other words: one that is in effect carrying out an appropriate plan and job performance is the single result of an employee's work. Besides, high job performance is the ability of the employee himself. The employee must be able to give better results and also have a high productivity (Hunter, 1986, 72 -98).

Job performance
A good employee performance is essential for the organization, since an organization's achievement is reliant on upon the employee's creativity, innovation and commitment (Ramlall 2008, 128). Good job performance and efficiency progress are also vital in soothing our economy; by means of improved living situations, high wages, increase in the availability of goods for consumption, etc (Griffin et al 1981) Griffin et al. also reason that therefore research of individual employee performance is vital to society in universal. Employee invention and employee job performance looks to be associated; performance in some cases is evaluated as the number and value of goods produced. However, in overall, productivity is associated with production-oriented terms (e.g, profit and turnover) and performance is connected to efficiency or perception-oriented terms (Griffin et al 1981, 655-664).

Performance Improvement
It is a response to make services of an organization better, affordable and faster. It seeks to rectify any problems that exist and build upon those performance levels that are already good (Katz and Green, 1997). According to Katz andGreen (1997, pp.: 2000) performance improvement involves the resolution of performance problems and the exploitation of performance opportunities. Problems may be related to service, practice or governance. Performance opportunities consist of those occasions when, although the performance target is adequate, an opportunity exists to improve the outcome of the service or process by which the service is delivering.

Performance Assessment Methods
The most commonly used performance assessment approaches include: Essay assessment: This simply needs the rater to write a series of statements regarding an individual's strengths, weaknesses, previous performance and likely for promotion. Graphic rating scale: in which the rater measures an individual on issues such as initiative, dependability, cooperativeness, attitude and quantity of work. Checklist technique: in which the rater does not assess performance but simply records it on a sequence of questions concerning the employee's behavior, the rater checks yes or no answers. Critical occurrence: assessment in which the evaluator is requested to have a written record on actions that demonstrates both constructive and harmful conduct of the individual being evaluated. Ranking method: It develops essential to compare performance of two or more individuals. Management by objective (MBO): method or performance assessment in which is founded on adapting organizational goals and aims for individuals (Obserg, 1972 andMaiser, 1976) recommends that the performance assessment method might be communicated to the evaluated individuals using the following methods. Tel and sell technique: The assessor let the worker recognize in what way he or she is responsibility, gets worker's getting of the assessment, and has the employee agree to plan of enhancement. This method according to Maier is most likely to be actual with innovative, new workers and with workers who are in a new task. Individual in these situations are more likely to have lack of confidence that can result from inexperience and usually are more anxious to receive the helpful advice of a more knowledgeable individual. Tell and listen technique: The technique with tell and listen method is for the rater to communicate the evaluation and then wait for a reply from the employee. Principally, the assessment is takes place in two ways. During the first ways, the worker's strong and weak points are covered, during the second, the employee is stimulated to distress and express his or her feelings about the assessment. Problem solving technique: As per Maier, the first two techniques tell and sell and tell and listen techniques place the rater in the position of being a judge and force the individual being assessed into a defensive position. Though, the problem technique is to take the evaluator out of the role of a judge and make him or her helper and a friend. 360 0 assessment technique: this technique confirms that not only the greater that assesses the subordinate but also the subordinate also assesses the larger. Colleagues also assess colleagues and individuals who assess themselves and all the assessment is are used to reach at the final assessment result subsequently calculating the average.

Importance of Motivation
Motivation is necessary for employee performance. If people do not feel inclined to engage themselves in work behavior, they will not put necessary efforts to perform well. However, performance of an individual in the organization do not only depends on motivation instead their other factors besides the level of motivation which include abilities, sense of competence, role perception and resources. Motivation seems to be one of the most important tools for increases productivity and retaining employees. Organizations that design motivation systems are not only meant to encourage employees to perform in the most effective way but also to attract potential candidates. One of many ways to motivate and retain employees is by giving traditional rewards and monetary benefits, compensation incentives to reward good performance (Memmott and Growers, 2012).

Theoretical Review
Numerous scholars have developed several motivation theories approaching motivational problem but all stressing on comparable set of associations which comprise individual, his desires, his perception on how to satisfy his needs, and weather his needs satisfaction is equitable. All theories are not combined thus may work only in a particular situation. In this study Maslow's hierarch of needs, Herzberg's Motivation theory, McGregor's Theory X and Y will be discussed to find out importance and suggestions in inspiring workers.

Maslow Hierarchy of Needs
The most popular theory of motivation which is considered as base for this study is Abraham Maslow's motivation theory. Abraham Harold Maslow (1908Maslow ( -1970 is an American psychologist who is famous for his theory of Hierarchy of Needs. The theory demonstrates five different phases of human needs in a hierarchic order, starting from the most basic to the most complex ones (Haggbloom, Warnick, Warnick, Jones, Yarbrough, Russell, Borecky, McGahhey 2002). There are some needs that are essential to human beings, and lacking their presence nothing else matters. We living person consider needs as a motivator. We always start with the lowest level of needs (Skemp-Arlt & Toupence 2007) and strive for satisfaction fulfillment; once achieved, we are then looking to satisfy higher needs. In other words, "a person cannot move to the next level of needs without satisfying the preceding level" (Maslow 1954) Maslow's Hierarchy of Wants is frequently defined in a pyramid shape with the biggest and supreme elementary levels of need at the bottom, and the need for self-actualization at the top (Steere 1988). "Maslow used the terms 'physiological', 'safety', 'belongings' and 'love', 'esteem', and 'self-actualization' to describe the pattern that human motivations generally move through. The goal of Maslow's theory is to attain the highest level offstage: self-actualization needs" (McEwen & Wills 2014). The most basic and crucial four layers of Maslow's Hierarchy of Needs pyramid are called "deficiency needs" or "dneeds": physiology needs, safety needs, love and belongings, and esteem. If there is a absence on this level, an individual's all behaviors will be directed to content the deficits (Cherry 2015). Furthermore, if these "d-needs" are not met -with the exception of physiology needs: a fundamental level of need which must be fulfilled with satisfaction in the first place -the individual will feel nervous and scared. For example, if you have not slept well or eaten adequately, you will not be interested in your belonging's desires. It is suggested by Maslow that the most essential level of needs must be met and achieved before a person moving to satisfy higher levels of needs (Goble 1970). In addition, the "d-needs" itself classified into basic needs (including physiological and safety needs) and psychological needs (including love and belonging and esteem) (McLeod 2007(McLeod , 2016. The Hierarchy of Needs starts with the lowest level of need: physiology needs (Skemp-Arlt et al. 2007). Physiological needs comprising vital necessities for human life, such as; air, water, food, and other living needs. Physiological needs are considered to be the best important because without satisfying it first, the desire for other needs is not a matter of concern. Without food, a human body cannot function well; if you are hungry, all your activities will be oriented and forced to find food; "employers who pay at least a minimal living wage will meet these basic employee needs" (Silberstein 2017). Therefore, physiological needs should be met first. Once an individual's physiological needs are achieved and somewhat satisfied, the person drives the desire towards his or her safety needs (Skemp-Arlt et al. 2007). It includes, for instance, the personal security: of body, of health and wellbeing, of morality, and of family; the job security: of work opportunity, and of employment; and the financial security: of property, and of resources. In the world currently, it is a worry when the need for safety is day by day growing. It is not just about having a place to live, feeling certain and being free from the threat of danger and pain. People feel unsafely due to such reasons as normal disaster, war, violence, abuse, or economic instability. This level is more likely to be appeared in children as they normally need the feeling of being secured. In organization, "employers can meet these needs by ensuring employees are safe from physical, verbal or emotional hazards and have a sense of job security" (Silberstein 2017) The next level of needs is love and belonging (Skemp-Arlt et al. 2007), which belongs to human's psychological needs. "Humans need to love and be loved -both sexually and non-sexually -by others" (Goble 1970). According to Maslow, when an individual's basic needs are fulfilled, their need is interpersonal, involvement, and acceptance. This is the need to be social, to have friends, and relationships. It can be the involvement in a group of co-workers, clubs, student organization, hobbies group, or a person's own gang; or the connections with family, close friends, colleagues, and neighbors. We cannot deny the important role of love and belonging needs in human's life, as there are evidences of people experiencing from loneliness, anti-socialization, autism or even depression in the deficient of this element. Respectively, for employers in business aspect, being able to create a satisfactory reward system and implement organizational program in which employees are actively take part in can help fulfill and satisfy these needs of employees (Silberstein 2017). The fourth level mentioned by Maslow in the Hierarchy of Needs is esteem needs. "All people in our society have a need or desire for a stable, firmly based, usually high evaluation of themselves, for self-respect, and for the esteem of others" (Maslow 1954, Stephens 2000. Consequently, this level of needs is categorized into two types, which can be defined by the term "self-respect" and "esteem". Self-respect refers to "the desire for strength, for achievement, for adequacy, for mastery and competence for confidence in the face of the world, and for independence and freedom" (Maslow 1954). This level is achieved when a person feels satisfied and enjoyable with what they have completed, like merely by feeling positively, and living an expressive, valuable and on-purpose life. Likewise, esteem portrayed the desire to be accepted and valued by others. And only by satisfying the "desire for reputation or prestige, status, fame and glory, dominance, recognition, attention, importance, dignity, or appreciation" this esteem needs will be fully achieved (Maslow 1954, Brembeck 1991. Finally, self-actualization: that is classified as the "being needs" or "b-needs -is the highest level in Maslow's Hierarchy of Needs. "What a man can be, he must be" (Maslow 1954). This level demonstrates the need of "to become everything that one is accomplished of becoming" (Hagerty 1999): to be aware of and achieve a person's full potential. In other words, they will try to do everything to the best of their ability. When a person has reached the state of self-actualization, they tend to be characteristic, concentrating more on themselves and having a wish to broaden knowledge, obtain new skills, take on new tasks, knowledge more new encounters, and act in a way that will take them to achieve their wanted life aims. According to Maslow, in order to completely achieve this level of wants, an individual necessity not only achieves and satisfying the earlier needs, but also dominant them (Maslow 1954;McLeod 2007McLeod , 2016).

Hygiene Theory (Herzberg 1968)
This is another motivational theory developed by Fredrick Herzberg who conducted intensive study on the experience and feelings of about 200 engineers and accountants in nine different companies in United State of America concerning their previous jobs. Theorist found that there were two categories of needs essentially independent of each other affecting behavior in different ways thus are maintenance or hygiene factor and motivational factors. Hygiene Factors these include several factors like company policy and administration, technical supervision, interpersonal relationship with peer and subordinates, salary, job security, personal life, working conditions and status. These are not intrinsic part of a job, but they are related to conditions under which a job is performed. They produce no growth in a worker output they only prevent losses in workers performance due to work relations. These maintenance factors are necessary to maintain reasonable level of satisfaction of employees, increase beyond this level will not provide any satisfaction while decrease below this level will dissatisfy employees. Motivational factors are capable of having positive effect on job satisfaction often resulting in an increase in one's total output. These include achievement, recognition, and advancement; work itself, possibility of growth and responsibility. Most of these factors are related to job contents. An increase in these factors will satisfy the employees; however, any decrease will not affect their level of satisfaction. Since these increase the level of satisfaction of employees may be used in motivating them for higher output. Implication of Herzberg model is based on the fact that most of the people are able to satisfy their lower order needs considerably. The model has been applied in the industry and has given several new insights. One of the insights is job enrichment which involves enrichment of jobs in such a way that they have more motivators than before, the idea behind job enrichment is to keep maintenance factor constant or higher while increasing motivational factors (Prasad, 2005). The theory alerts human resource managers that an employee cannot be motivated by a single motivation factor instead a combination of intrinsic motivation factors like promotion, career achievement, recognition as well extrinsic factors such as salary, medical benefits, transport benefits and working condition are required to achieve better performance.

McGregor's Theory X and Y
The theory involves assumptions such as generalization and hypotheses relating to human behavior and nature.
McGregor presented assumptions that could predict human behavior in two opposite point as follows; 2.13.1. Theory X Management is responsible for organizing the element of productive enterprise that is money. Material, equipment, people in the interest of economic ends, it also assume that without active intervention by management, people would be passive even resistant to organization needs, Furthermore this theory assume that an average man is by nature indolent, man lacks ambition, dislikes responsibility and prefer to be led, lastly the theory assume that a man is inherently self-centered, indifferent to organization needs and resistant to change by nature.

Theory Y
The expenditure of physical and mental effort in work is natural as play or rest, second assumption states external control and threat of punishment are not the only means for bringing about effort towards organization objectives, thirdly commitment to objective is a function of the reward associated with achievement. Fourth assumption state that the average human being learns under the proper conditions not only to accept, but to seek responsibility. Furthermore, the capacity to exercise a relatively high degree of imagination, ingenuity, and creativity in the solution of organizational problem is widely, not narrow distributed in the population and lastly under the conditions of modern industrial life, the intellectual potentialities of the average human being are only partially utilized. Theory X and Y implies that management should greatly consider kind of people has in the organization especially when undertaking management functions such as planning, directing, apprising and controlling.

Vroom's Expectancy Theory
The first component in the equation is expectancy, which is well-defined as a person's trust that their effort will rose in wanted results, such as performance or achievement. It is also a person's assessment of what kind and how much energy should be put in order to attain better outcomes or higher performance. For example, an employee working in the customer services department believes that if he/she tries harder, the work performance will lead to customer satisfaction. When the employee has a strong emotion of it and is aware that he/she is able to achieve the aim, then he/she will be likely to put more energy to work. In this way, we say he/she has high expectancy. The second component -instrumentality -refers to a person's belief that his/her performance is connected to later results, such as reward or punishment. For instance, if a person believes that his/her hard-work will be recognized and resulted in rewards, he/she is likely to put more exertion to work. Finally, valence component shows a person's awareness about the amount of reward or punishment received as a result of performance. If a person feels that the reward or punishment is well-earned with his/her effort and performance, he/she will put more effort to achieving it (Skempt-Arlt et al 2007;Scholl 2002).Force, which indicates a person's motivation to perform a set of activities, is the result of the three components. "In general, people will work hard when they think that it is likely to lead to desired organizational rewards" (Skempt-Arlt et al 2007). "Vroom thought that people are motivated to work toward a aim if they believe the goal is worthwhile and if they perceived that their efforts will contribute to the attainment of that objective" (Moran 2013). In short, the theory suggests that when a person extents a high level of all constituents in the equation, he/she will be extremely motivated and put more effort into attaining the preferred results.

The Effects of Motivation on Employees' Performance
The motivation theorists such as Maslow (1946), Herzberg (1968), Alderfer (1972 and McClelland (1988) have suggested specific things that managers can do to help their subordinates become self-actualized, because such employees are likely to work at their maximum creative potential when their needs are met. These authors (Koch, 1990;Stuart, 1992) all stated that appreciation of a job well done or full appreciation for work done is often among the top motivators of employee performance and involves feedback. Positive feedback follows the principles advocated in Reinforcement Theory, which states that behavior is contingent on reinforcement. Examples of constructive support in this context may include workplace visits by top executives to high-performance employees, personal handwritten notes of thanks accompanying paychecks, and telephone calls by top executives to employees at home (Knippen and Green, 1990). Philosophies such as fairness has some imperative implications for ways of motivating people by not underpay, overpay and giving information about outcomes in a thorough and socially sensitive manner. It states that, companies that attempt to save money by reducing employees" salaries may find that employees respond in many different ways to even the score; those that overpay some employees as a useful motivational technique to increase performance may later realize that when you overpay one employee, you are underpaying all the others. Osei (2011), also agrees with the equity theory that, one of the fundamental issues that is sensitive and critical which can make or unmake any organization is wage or salary determination. Justice, fairness and equity in salary determination, to a great extent, put to rest all the traumas an individual or any organization may practice, and that is highly motivational enough to assess the optimal usage of time and energy. Also, theory such expectancy has several important implications for ways of motivating employees by clarify people's expectancies that their effort will lead to performance, that is by training employees to do their jobs more efficiently and so achieve higher levels of performance from their efforts and linking valued rewards and performance by specifying exactly what job behaviors will lead to what rewards. It is possible for employees to be paid in ways directly linked to their performance such as through piece-rate incentive systems, sales commission plans or bonuses. Locke (1968), goal setting theory believes that you can achieve effective performance goals by assigning specific goals; difficult but acceptable performance goals; and providing feedback concerning goal attainment. He further indicated that giving praises, Management by Objectives (MBO), and job-design increases employees" performance. Praise is motivator (not hygiene) because it meets employees" needs for esteem, self-actualization, growth and achievement. It is most powerful, less expensive, and simplest, yet the most underused motivational technique. To motivate people to high-levels of performance, objectives should be difficult but achievable, observable and measurable, specific, with a target date, anticipatively set when possible and accepted by employees. Employee who meet their objectives should be rewarded through recognition, praise, pay raises, promotions etc. Many organizations now link pay to meeting goals (Lussier, 2005) and the way the first step in organization design is job design -the process by which managers decide how to divide tasks into specific jobs, for example, McDonaldisation (Jones et al, 2000).

Empirical Literature Review
Several researchers have examined factors that motivate workers and their subsequent impact their employee motivation. This section presents a review of some most recent empirical studies on employee motivation and in various organizations including Health. Aiyetan and Oltuah (2006) conducted a research on the relationship between job performance and employee motivation of workers in FGH purpose was to identify a number of motivational schemes that enhance the performance of two types of workers: professional Health workers and Administrative (supportive staff) workers. The study used two sets of questionnaires: one set was administered on management staff and the other on nonmanagement staff (operatives). The study revealed that salaries paid to all staffs in the study were below the stipulations of the employee motivation it further showed that all staffs are rarely promoted, and operatives prefer financial incentives to non-financial incentives. The study recommended that increases in salary via promotion, overtime allowances and holidays with pay should be used as motivators (financial incentives) for increase in performance of all workers in FGH. The three motivating factors were interpersonal relationship, workplace environment and interesting work, all of which have the potential to motivate employees at higher levels. For long-term motivation, job related factors such as meaningful work, flexible working hours, and friendly social gestures were found to be effective motivators, while monetary, social gathering, tangible items such as awards, certificates and gifts were most effective motivators for short-term. The purpose was to assess motivation to perform among healthcare workers in Hospital healthcare facilities. Its purpose was to examine factors that motivate employees in order to have increased performance within the Hospital. The study found that employees at Ultimate in FGH had an overall fair job satisfaction. The employees are not satisfied with their current salary situation at the Hospital which illustrate that financial motivation was important within a Hospital the findings equally showed that majority of the employees are motivated most to perform when they receive non-financial rewards. Also, majority of the employee showed a great intrinsic value for higher performance. Finally, the study recommended that the management at Ultimate companion limited should use multiple motivational strategies in order to achieve greater performance from the employees

Conceptual Frame Work
The model below illustrates some of the motivating factors which affect employees' motivation. These factors will form the independent variables of the study and will be manipulated to positively or negatively affect the dependent variable, which is employee motivation. These independent variables have been broadly covered in the literature review.

Independent Variable
Dependent variable

Research Design and Methodology
To conduct this research the researcher has employed explanatory research design. This research design has been used to explain the effect and relation that exist between the aspects of employee motivation and job performance of the employees. Moreover, it is used to explain the cause effect relations and used to generate many ideas. To reach on appropriate conclusion about the issue and in order to answer research hypothesis the necessary data has been collected through quantitative approaches. The quantitative approach would allow the researcher to measure and analyze statistical data. Fiche General Hospital permanent employees would be the main targets of this study. The Fiche General Hospital operating department are, Medical Department, Specialist/Clinical/, Midwifery, Nursing, Pharmacy, Mental Health, HRM and Finance Department. The total number of employees in Fiche General Hospital operating are 287 from which adequate samples would be selected using appropriate method of sample size determination. To determine representative sample from the Fiche General Hospital of the 287 employees, the researcher has used Yamane 1976 formula and the sample size was 187 employees. The type of data used for this was primary data. This data was collected through questionnaires from target respondent and interview was also used to collect primary data from authorized body of Fiche General Hospital. In order to know the effect of employee motivation on job performance in Fiche General Hospital, the researcher use the multiple regression models as follows = 1 1 + 2 2 + 3 3 + 4 4 + 5 5 + 6 6 + 7 7 + 8 8 + 9 9 Where; Y -Job performance  The mean score of employee benefit package sub factors are range between 3.69 and 2.13, as presented in table 4.1 above. The mean score was higher for the equivalence of Fiche General Hospital employee benefit package with similar jobs in other companies is 3.69, followed by the employee motivation level as a result of benefit offered by Fiche General Hospital is 3.41 and the level of training and development practices as employee benefit package in Fiche General Hospital is 3.37 correspondingly. This infers that the majority of participants scored highest level of agreement (strongly agree) about equivalence of employee benefit package with similar jobs in other companies raised questions. As presented in Table 4.2: the mean value of employee empowerment practices sub factors study result differs from 4.21 to 2.14 and it would be described from general to specific as follows. The level of employee mastered skills after working in Fiche General Hospital was scored higher mean 4.21; followed by the level of employee involvement in decisions making that affect their work has been the next highest mean scored 3.51. This implies that majority respondent levels of agreement have been strongly agreed with raised statement of item 4 & 6. This means that there are good practices of item 4 & 6 in Fiche General Hospital. However, with the level of employee control over those aspect of their job for which they are accountable has the mean score of 2.88, followed by the level of employee autonomy in determining how they do their job has 2.57 mean scores; the level of resource allocated for employees so as to accomplish their job has 2.16 mean scores and the availability of clear system of handling employee dissatisfaction practices has 2.14 mean scores with the level of disagreement respectively in Fiche General hospital. The mean responses of all items of employee working condition are range between 2.21 and 3.98, as presented in table 4.4 above. With regard to getting sufficient information to protect against hazards in the wok area has highest mean score 3.98, followed by change in employee workload is 3.45 and the level of getting relevant information from manager practices is 3.43. This suggests that the majority of members scored higher level of agreement (agree) about item 5, 4 & 6 raised questions. This means these items mean shows there are good employee working condition in Fiche General Hospital. On the other hand, the level of employee recognition and appreciation for their achievements has the mean score 2.37, followed by the employee workplace atmosphere has the mean score of 2.24 and adequacy of working equipment supply has the mean score of 2.21, shows the lower level of agreement, which is disagree respectively in Fiche General hospital. As presented in table 4.5: the mean value of employee job performance sub factors study result differs from 2.68 to 2.17 and it would be also analyzed from general to specific as follows. The employee recognition for better job performance practices has higher mean 2.68; followed by employee motivation practices for better job performance has the next higher mean score.2.61; employee benefit package for superior job performance has 2.55 mean scored; the level of working condition for healthier job performance has 2.46 mean scored; the level of employee independence in how they do their job has 2.31 mean scored; employee empowerment practices for superior job performance has 2.26 mean score and the level of employee satisfaction about Fiche General Hospital job performance standard criteria. The mean scores indicate that all the participants have been disagreed to sub factors of job performance question raised in association with Fiche General Hospital employee motivational practices. As showed in table 4.6: the overall mean score of independent variables of the study were ranging from 2.401 to 2.940 with their corresponding standard deviation have been ranging from 0.66918 to 0 .49421. Relatively, the mean score was higher for working condition practices 2.9404; followed by benefits package 2.9283; empowerment practices 2.9125; recognition practices 2.4358 and job performance 2.4008 respectively. This implies that the below the average respondents has been disagree. In general, all of this study finding shows there is poor practices of employee motivational practices for their better job performance in Fiche General Hospital. The job performance has the highest standard deviation 0.66918; followed by empowerment practices with value of standard deviation 0.59684; recognition practices 0.57127, benefits package 0.50278 & working condition practices 0.49421 respectively. According to the observed standard deviation value of table 4.7; shows there is high variability of respondent rating of job performance with strongly disagree, disagree, neutral, agree & strongly agree at Fiche General hospital.

Correlation Analysis
With an objective of measuring the relation between motivational factors and employee job performance in Fiche General Hospital the researcher has used Pearson correlation analysis as follows. As it can be seen from table 4.8; there is significant relation between the dependent variable and all independent variable under study. Employee job performance has strong positive relation with employee recognition practices accounting for 76.9% showing that the better employee recognition practices would better improve the Employee job performance. The second most correlated motivational factor with employee job performance is employee empowerment practices have also a strong positive relation which accounts 75.2% showing that improving employee empowerment practices by Fiche General Hospital will increase employee job performance and also empowering the employees at different level is shown to have direct initiation to the job performance at the same time improving the promotion and better training provision to the employees have been shown to have an ability to raise the employee's job performance level to better level. The third correlated motivational factor with employee job performance is employee working condition have strong positive relation; which accounts 70.4% showing that better employee working condition will improve the employee job performance in Fiche General hospital. The fourth correlated motivational factor with employee job performance is employee working condition have moderate positive relation; which accounts 64.8% showing that better employee benefits package will improve the employee job performance in Fiche General hospital. Conversely, all controlling variables under study have shown to have almost insignificant/not visible relation with the employee job performance except educational qualification of participants in Fiche General Hospital. The model summary table above shows the sum degree of association that the stated independent variable and controlling variables have with the dependent one that is employee job performance. As such, it has been shown by R that the stated independent variables (the employee motivational factors) all together with the controlling variables have stronger positive relation have at a rate of 84.6% this shows that the better the variables are treated the more the job performance of the employees will be. The R-square result in the same table being 71.6% shows that the sum total effect of the variables under consideration on the job performance of the employees in Fiche General hospital. This is to mean that certain level of improvement in the level of these motivational factors will have 71.6% positive influence on the job performance of the employees under consideration at a significant level.

Regression analysis
The Analysis of Variance table above shows the model fitness test. The significance level (.000) proved that F is large enough to prove that the model used is suitable for the measurement of effects that these independent variables have on the job performance of the employees. From the four motivational factors are employee empowerment practices (t=4.08, P<0.05), employee working condition (t=3.87, p<0.05) employee benefits package (t=3.82, p<0.05) and employee recognition practices (t=3.02, P<0.05) were significantly contribute for positive prediction of employee job performance. To ascertain the level of individual contributing variable the unstandardized coefficient Beta value of the four motivational factors have been considered. The unstandardized coefficient Beta of empowerment is 0.281, recognition is 0.233, working condition is 0.225 and benefits package 0.216. Consequently, employee empowerment practices contribute more than employee recognition practices, employee working condition and employee benefits package, since it had larger unstandardized coefficient. This finding implies that employee empowerment practices has been identified as the most determinant variable that predicted employee job performance as practiced in Fiche General Hospital. That means as one standard deviation increase in employee empowerment the level of employee job performance increase by 0.281; as one standard deviation increase in employee recognition the level of employee job performance increase by 0.233 and as one standard deviation increase in employee working condition the level of employee job performance increase by 0.225 and as one standard deviation increase in employee benefits package the level of employee job performance increase by 0.216 in Fiche General hospital. Here, the contribution of employee benefits package on employee job performance is low as compared to empowerment, recognition and employee working condition in Fiche General hospital. Depending on this fact if manager of Fiche General Hospital employed more employee empowerment, the employee job performance would be better improved. Based on the extent of weighted beta, it can be concluded that if all independent variables are ignored, then Fiche General Hospital itself have the value of 0.026 on the employee job performance. Nevertheless, if there is one additional standard deviation changes in independent and controlling variables; empowerment, recognition, working condition, benefits package, education level, gender, experience, age and salary would be improved the employee job performance with a value of 28.1% ,23.3%, 22.5%, 21.6%,6.2%, 2.4%, 1.9 %,-2.3%, and -8.5% respectively. The objective of the regression in this study is to find such an equation that could be used to find the effect of predictors on dependent variable. The specified regression equation takes the following form: Y= 0.026 + 0.281X1 + 0.233X2 + 0.225X3 + 0.216X4 + 0.062X5 + 0.024X6 + 0. 019X7 + (-0.023) X8 + (-0.085) X9 + e Where; Y is the job performance that used as dependent variable of the study and the explanatory variables used in regression analysis includes, X1 is empowerment, X2 is recognition, X3 is working condition, X4 is working condition, X5 is education, X6 is gender, X7 is experience, X8 is age and X9 is salary are factor that affects the employee job performance and ℮ is the residual amount which are represented in the above regression model.

Recommendations
Based on the findings and conclusions of the study, the following recommendations are forwarded in order to improve the employee motivation and job performance in Fiche General Hospital. Out of study the variable, all of the study variables are under practice, particularly, employee job performance is relatively poorly practiced or the lowest score in the study area. Hence, the management of Fiche General Hospital& other stakeholders are politely recommended to motivate employee by improving the existing benefits package; empowerment practices; recognition practices and work condition for better employee job performance. Among the motivating factor studied the most dominant contributor for better employee job performance come from the empowerment; followed by recognition, working condition, and benefits package have the degree of first, second, third & fourth significant effect on the employee job performance in Fiche General hospital. Hence, the concerned management body of Fiche General Hospital have been advised to give due attention for the employee empowerment practices so as to improve employee job performance. As per this study result, even though the researcher has identified the recognition, working condition, and benefit package are relatively lesser contributor to employee job performance, the management of Fiche General Hospital& other stakeholders are also advised to give due attention for further improvement. Notwithstanding the useful contributions of the study, it is clear that this research study had the following limitations. Firstly, the study design was a cross-sectional data or participants are only from one sector at the same time so that the findings could only be inferred to the study area. Because data were collected at one point in time, the direction of causality of the relationships examined in this study is not certain. Secondly, the scope of the study is limited to Fiche General Hospital. This means that organizations which come under a different law, other organization were not included. Concerning the work motivational factors issue selected for the survey nearly most of the sample respondent at Fiche General Hospital where get disagree. Therefore, the management of organization understudy advisable to pay attention for improvement of employee empowerment, benefits package; work condition & recognition in connection with their job performance practices. It advantageous, if the management of Fiche General Hospital wisely work towards developing a mechanism to motivate their needy employee on these identified gaps. It is also valuable, if the management intervention is undertaken to visit their employee's level of their employee job performance and support them on the identified motivational factors. In order to enhance the employee motivation and their job performance at Fiche General Hospital, the management of that organization is suggested to assess their employee's needs periodically to take proper action for better organizational functioning.