Abstract
BackgroundDuring the last two decades, the Iraqi human resources for health was exposed to an unprecedented turnover of trained and experienced medical professionals. This study aimed to explore prominent factors affecting turnover intentions among Iraqi doctors.MethodsA descriptive cross-sectional multicentre study was carried out among 576 doctors across 20 hospitals in Iraq using multistage sampling technique. Participants completed a self-administered questionnaire, which included socio-demographic information, work characteristics, the 10-item Warr-Cook-Wall job satisfaction scale, and one question on turnover intention. Descriptive and bivariate and multiple logistic regression analyses were conducted to identify significant factors affecting turnover intentions.ResultsMore than one half of Iraqi doctors (55.2%) were actively seeking alternative employment. Factors associated with turnover intentions among doctors were low job satisfaction score (odds ratio (OR) = 0.97; 95% confidence interval (CI): 0.95, 0.99), aged 40 years old or less (OR = 2.9; 95% CI: 1.74, 4.75), being male (OR = 4.2; 95% CI: 2.54, 7.03), being single (OR = 5.0; 95% CI: 2.61, 9.75), being threatened (OR = 3.5; 95% CI: 1.80, 6.69), internally displaced (OR = 3.1; 95% CI: 1.43, 6.57), having a perception of unsafe medical practice (OR = 4.1; 95% CI: 1.86, 9.21), working more than 40 h per week, (OR = 2.3; 95% CI: 1.27, 4.03), disagreement with the way manager handles staff (OR = 2.2; 95% CI: 1.19, 4.03), being non-specialist, (OR = 3.9, 95% CI: 2.08, 7.13), and being employed in the government sector only (OR = 2.0; 95% CI: 1.09, 3.82).ConclusionThe high-turnover intention among Iraqi doctors is significantly associated with working and security conditions. An urgent and effective strategy is required to prevent doctors’ exodus.
Highlights
During the last two decades, the Iraqi human resources for health was exposed to an unprecedented turnover of trained and experienced medical professionals
Four hundred and seven (70.7%) of the doctors reported that their relation with the patients was excellent, and 385 (66.8%) of them considered their medical practice in Iraq was unsafe or risky
Forty percent disagreed with the way their senior manager handled staff, and 45.1% were dissatisfied with their training and educational opportunities (Table 1)
Summary
During the last two decades, the Iraqi human resources for health was exposed to an unprecedented turnover of trained and experienced medical professionals. The global healthcare sector has been facing major challenges through retention problems and labor shortages [1]. Labor shortage is detrimental to healthcare system performance and services [4]. According to the World Health Organization (WHO) [5], healthcare labor shortages are common globally; this phenomenon is crucial in countries where healthcare performance indicators are the worst. WHO in its report during the Third Global Forum on Human Resources for Health indicated that by 2035 the world will be short of 12.9 million healthcare workers [5]. The civil and regional wars jointly with security disturbances in countries such as Lebanon, Somalia, Liberia, Iran, Afghanistan, and other similar nations had
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