Abstract
BackgroundWhile healthcare reform has been a central attention for local governments, its impact on job satisfaction is poorly understood. This study aimed to determine the impact of healthcare reform on job satisfaction in the public healthcare sector in Ethiopia.MethodsThe study was designed as a facility-based cross-sectional survey of healthcare professionals and carried out in all public hospitals in central Ethiopia which have been implementing healthcare reform (n = 5). All healthcare professionals in the hospitals who were involved in the reform from the inception (n = 476) were purposively sourced to complete a self-administered questionnaire adapted from a framework proposed for measuring job satisfaction of health professionals in sub-Saharan Africa. Kaiser-Meyer-Olkin and Bartlett’s tests were conducted to measure sampling adequacy and sphericity for factor analysis. Likert’s transformation formula was used to numerically analyse the satisfaction level of the respondents and to determine the cut-off value of satisfaction levels. Non-parametric and multiple logistic regression analysis were conducted to determine predictors of job satisfaction.ResultsA total of 410 healthcare professionals completed the survey, representing an 88% response rate. The median and mean job satisfaction scores were 50 and 49, respectively, on a scale 1–100, which was equivalent to ‘Job dissatisfied’ on the Likert scale. Only 25% of respondents perceived job satisfaction due to implementation of the reform. Moral satisfaction (adjusted odds ratio (aOR), 177.65; 95% confidence interval (CI), 59.54–530.08), management style (aOR, 4.02; 95% CI, 1.49–10.83), workload (aOR, 2.42; 95% CI, 0.93–6.34), and task (aOR, 5.49; 95% CI, 2.31–13.07) were the most significant predictors. Job satisfaction results were significantly different among the study hospitals (χ2 = 30.56, p < .001).ConclusionsThe healthcare reform significantly and negatively influences public healthcare professionals’ job satisfaction and its overall impact on job satisfaction was poor, which would hinder the ‘Health Sector Transformation’ movement of Ethiopia. Healthcare reform efforts are contingent on job satisfaction of healthcare professionals, and such efforts should balance the demand and supply of both patients and providers for improved healthcare outcomes.
Highlights
While healthcare reform has been a central attention for local governments, its impact on job satisfaction is poorly understood
Setting and participants The study was designed as a facility-based crosssectional survey of health professionals and carried out in major and highly complex public hospitals in Addis Ababa, Ethiopia, between January to June 2015
The overall job satisfaction of the workforce was low, which was consistent with previous studies that focused on public healthcare professionals in Ethiopia [30,31,32,33] and other countries in sub-Saharan African such as in Kenya [34], South Africa [35], Uganda [36, 37] and Ghana [38]
Summary
While healthcare reform has been a central attention for local governments, its impact on job satisfaction is poorly understood. Healthcare professionals, as their patients, are clients of the healthcare system, in that their work requires the infrastructure, supervision, equipment, and physical setting to operate efficiently and cultivate a sustainable basic healthcare [1]. The recent World Health Organization global strategy on human resources for health: workforce 2030 has among its major principles to “uphold the personal, employment and professional rights of all healthcare workers, including safe and decent working environments and freedom from all kinds of discrimination, coercion, and violence” [3] In essence, flourishing this into action thereby developing an emotionally strong, dedicated and job-satisfied healthcare professional that can go an extra distance to improve the quality of care will remain at the shoulder of each country
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