Health Worker Satisfaction Research Articles

Hubungan Kepuasan Tenaga Kesehatan dalam Penggunaan Sistem Informasi Management Puskesmas (Simpus) di Puskesmas Pakuniran Kecamatan Pakuniran Kabupaten Probolinggo

Introduction: Simpus puskesmas management application that simplifies and speeds up services to manage patient information starting from registration, registration, examination (diagnosis) and patient care. The satisfaction of health workers, the response or feedback from users about the use of the system, as well as the assessment of the good and bad sides of the system, is the starting point for system developers to improve the performance of the information system built. Purpose of the study: To determine the relationship between satisfaction of health workers in the use of the puskesmas management information system (Simpus) at the Pakuniran health center. Method: This study uses a quantitative descriptive approach using Nonprobability sampling technique using Total sampling technique using statistical test Spearman's rho correlation, with data collection instruments using questionnaires. This research was conducted at the Pakuniraan health center in July 2023. Research Results: The results of the spearman rank correlation statistical test obtained results namely (p = 0.000) because the p value <0.05 then Ho was rejected and Ha was accepted Conclusion: that there is a relationship between health worker satisfaction in using the puskesmas management information system (SIMPUS), which means that the better and more appropriate the puskesmas management information system, the higher the level of health worker satisfaction.

The Relationship between Work Conditions and Performance and Satisfaction of Health Workers in the Inpatient Room of the Bahteramas Hospital Regional Public Service Agency

Introduction: Job satisfaction of State Civil Service health workers is a process of activities in the practice of health services directly to patients, to meet the basic needs of patients who are guided by the standards and ethics of good, optimal and professional health services. Preliminary surveys show that organizational policies are less than optimal, working conditions are less conducive and work performance has decreased, thus affecting performance in serving patients. This study aims to analyze the relationship between work conditions and performance with the satisfaction of health workers in the inpatient ward of the Bahteramas Hospital Regional Public Services Agency. Method: This research is quantitative using a Cross Sectional Study design, with a population of 213 people and a sample of 139 respondents using the Cluster Random Sampling technique. Result: The chi square statistical test at the 95% confidence level (α=0.05) shows that the p value = 0.006 because Ho is rejected or Ha is accepted, which means there is a relationship between working conditions and health worker satisfaction and the results of the chi square statistical test at the 95% confidence level (α=0.05) shows that the p value = 0.001 because Ho is rejected or Ha is accepted, which means there is a relationship between work performance and satisfaction of health workers. Conclusion: There is a relationship between working conditions and work performance and the performance of health workers in the inpatient ward of the Bahteramas Hospital Regional Public Services Agency.

Impact of Policies and Supervision on Health Worker Satisfaction at Bahteramas Hospital

Providing quality services is inseparable from human resources that produce good performance and achievement. One of the factors related to the performance or work performance of nurses is the low satisfaction of a person with their job. Currently, it is known that the main problem that often arises in human resource management is how to find the best way to achieve employee job satisfaction. Employee complaints about supervision that is very rarely carried out. This makes employees feel that their work is not supervised. This study aims to study the relationship between organizational policies and supervision with the satisfaction of health workers in the BLUD inpatient room of Bahteramas Hospital. This research is a quantitative study with a cross-sectional study approach, and research was conducted on February 2023 in the inpatient room of Bahteramas Hospital. The population in this study were all health workers who worked in the BLUD inpatient room of Bahteramas Hospital, totaling 213 people with a sample of 139 respondents. Data analysis was carried out computerized using the SPSS version 25.0 program, to analyze the relationship between the independent and dependent variables together, the Logistic Regression test was used. Results of the analysis show that all variables that have a probability value (p-value) <0.05 include organizational policies (p=0.141), and supervision (p=0.032). These results indicate that the supervision variable has a significant relationship. Meanwhile, the organizational policy variable does not have a significant relationship with the satisfaction of health workers in the BLUD Inpatient Room of Bahteramas Hospital. There is a moderate relationship between organizational policies and supervision with the satisfaction of health workers in the BLUD Inpatient Room of Bahteramas Hospital.

Usability of pulse oximeters used by community health and primary care workers as screening tools for severe illness in children under five in low resource settings: A cross-sectional study in Cambodia, Ethiopia, South Sudan, and Uganda.

Timely recognition and referral of severely ill children is especially critical in low-resource health systems. Pulse-oximeters can improve health outcomes of children by detecting hypoxaemia, a severity indicator of the most common causes of death in children. Cost-effectiveness of pulse-oximeters has been proven in low-income settings. However, evidence on their usability in community health settings is scarce.This study explores the usability of pulse-oximeters for community health and primary care workers in Cambodia, Ethiopia, South Sudan, and Uganda. We collected observational data, through a nine-task checklist, and survey data, using a five-point Likert scale questionnaire, capturing three usability aspects (effectiveness, efficiency, and satisfaction) of single-probe fingertip and multi-probe handheld devices. Effectiveness was determined by checklist completion rates and task completion rates per checklist item. Efficiency was reported as proportion of successful assessments within three attempts. Standardized summated questionnaire scores (min = 0, max = 100) determined health worker's satisfaction. Influencing factors on effectiveness and satisfaction were explored through hypothesis tests between independent groups (device type, cadre of health worker, country). Checklist completion rate was 78.3% [CI 72.6-83.0]. Choosing probes according to child age showed the lowest task completion rate of 68.7% [CI 60.3%-76.0%]. In 95.6% [CI 92.7%-97.4%] of assessments a reading was obtained within three attempts. The median satisfaction score was 95.6 [IQR = 92.2-99.0]. Significantly higher checklist completion rates were observed with single-probe fingertip devices (p<0.001) and children 12-59 months (p<0.001). We found higher satisfaction scores in South Sudan (p<0.001) and satisfaction varied slightly between devices. From a usability perspective single-probe devices for all age groups should be prioritized for scaled implementation. Further research on easy to use and accurate devices for infants is much needed.

Analysis Of The Effect Of The Process Of Issuing Health Personnel Licenses Using The Sipandu Medan Application On Health Worker Satisfaction In Dpmptsp Medan City

In the era of global reform and information, public services by government officials today still have many weaknesses so that they have not been able to meet the quality expected by the community. This is indicated by the existence of various public complaints submitted through the mass media and social networks as well as the results of a community satisfaction survey which stated that the permit issuance process took a long time, the information conveyed was not clear and not transparent.&#x0D; The purpose of this study was to analyze the effect of the process of issuing health worker permits using the Medan Sipandu Application on Community Satisfaction in Dpmptsp Medan City&#x0D; This type of research is Quantitative Analytical research, namely the method in the form of numeric data using a cross sectional approach, with a sample of 200 people.&#x0D; The results of this study are that the variable that has the most influence on the satisfaction of health workers regarding the use of the Sipandu Medan Application is complaint handling. statistical test resultsearned valuep significance is 0.000 &lt;0.05. So it can be concluded that there is an effect of handling complaints on the satisfaction of health workers regarding the use of the Sipandu Medan Application.SIPANDU is here to make it easier for the public to submit related complaints.

Experiences from the Philippine grassroots: impact of strengthening primary care systems on health worker satisfaction and intention to stay

BackgroundInequities in health access and outcomes persist in low- and middle-income countries. While strengthening primary care is integral in improving patient outcomes, primary care networks remain undervalued, underfunded, and underdeveloped in many LMICs such as the Philippines. This paper underscores the value of strengthening primary care system interventions in LMICs by examining their impact on job satisfaction and intention to stay among healthcare workers in the Philippines.MethodsThis study was conducted in urban, rural, and remote settings in the Philippines. A total of 36 urban, 54 rural, and 117 remote healthcare workers participated in the study. Respondents comprised all family physicians, nurses, midwives, community health workers, and staff involved in the delivery of primary care services from the sites. A questionnaire examining job satisfaction (motivators) and dissatisfaction (hygiene) factors was distributed to healthcare workers before and after system interventions were introduced across sites. Interventions included the introduction of performance-based incentives, the adoption of electronic health records, and the enhancement of diagnostic and pharmaceutical capabilities over a 1-year period. A Wilcoxon signed-rank test and a McNemar’s chi-square test were then conducted to compare pre- and post-intervention experiences for each setting.ResultsAmong the factors examined, results revealed a significant improvement in perceived compensation fairness among urban (p = 0.001) and rural (p = 0.016) providers. The rural workforce also reported a significant improvement in medicine access (p = 0.012) post-intervention. Job motivation and turnover intention were sustained in urban and rural settings between periods. Despite the interventions introduced, a decline in perceptions towards supply accessibility, job security, and most items classified as job motivators was reported among remote providers. Paralleling this decline, remote primary care providers with the intent to stay dropped from 93% at baseline to 75% at endline (p < 0.001).ConclusionThe impact of strengthening primary care on health workforce satisfaction and turnover intention varied across urban, rural, and remote settings. While select interventions such as improving compensation were promising for better-supported settings, the immediate impact of these interventions was inadequate in offsetting the infrastructural and staffing gaps experienced in disadvantaged areas. Unless these problems are comprehensively addressed, satisfaction will remain low, workforce attrition will persist as a problem, and marginalized communities will be underserved.

HUBUNGAN BUDAYA ORGANISASI, MOTIVASI KERJA DAN LINGKUNGAN KERJA TERHADAP KEPUASAN KERJA PETUGAS KESEHATAN

Some aspects of work affect the achievement of job satisfaction. Such as good work motivation, a positive work environment and a good organizational culture will foster a positive attitude in loving work and workers will feel satisfied with the work they do. The purpose of this research is to analyze the relationship of organizational culture, work motivation and work environment to the job satisfaction of health workers in Dlanggu Health Center of Mojokerto district. This research design is observational analytics with a crossectional approach. Independent variables in research are organizational culture, motivation and work environment, while dependent variables are job satisfaction. The research population is all health workers in Dlanggu Health Center 52 employees. The sample was taken with purposive sampling techniques as many as 46 respondents. The data was collected with questionnaire instruments and tested with chi square and spearman rho tests. The results showed that all values of ρ &lt; α so that H1 is accepted means that there is a relationship between organizational culture, work motivation and the work environment to the job satisfaction of health workers in Dlanggu Health Center of Mojokerto district. Management or leadership at Dlanggu Health Center of Mojokerto Regency is expected to improve the application of organizational culture better through the attachment of the role of the organization or puskesmas in fostering morale for officers, in addition, facilities or work environments can be modified more comfortably and complete so that officers can carry out activities in providing services to patients well and officers can also feel comfortabel in working so as to spur better work motivation.

Sự hài lòng đối với công việc của nhân viên y tế và một số yếu tố ảnh hưởng tại bệnh viện Đa khoa Khu vực huyện Tiểu Cần, tỉnh Trà Vinh năm 2020

Objective : Describe job satisfaction and analyze some factors affecting job satisfaction of health workers in Regional General Hospital Tieu Can district - Tra Vinh province, 2020. Methods: The cross-sectional study desgin with the combination of quantitative and qualitative methods was applied with total 153 health workers, performed from May to August 2020. Main findings: The rate of job satisfaction was low at 28.8%. Overall satisfaction score of 3.72. There is a relationship between the factors of income (p = 0.006; χ2 = 7.56; OR = 3.74), education level (p = 0.009; χ2 = 6.87; OR = 4.29), working position (p = 0.001; χ2 = 11.15; OR = 4.60) with job satisfaction. Income factor; working environment factors; leadership and colleague factors; Personal characteristics factors affecting job satisfaction of health workers. Job satisfaction rate is low, hospitals need to increase income for health workers, improve the working environment, leaders pay more attention to employees, implement a work performance evaluation system. The health worker needs to share difficulties with the hospital, strive to strive for himself and love his job. Keywords: job satisfaction, health workers, Tieu Can hospital

Determinan Quality of life Pada Pasien TB Paru di Kota Surabaya

Tuberkulosis (TB) is an infectious disease caused by Mycobacterium tuberculosis, which can attack various organs, especially the lungs. The infectius disease untreated or treatment is not complete can causing complications dangerous until death. TB estimated to have existed in the world since 5000 BC, but advances in the discovery and control of new TB disease occurred in 2 of the last century. This study aimed determinant of quality of life in patients with pulmonary TB in Surabaya&#x0D; Type a descriptive research with survey approach on three large health centers with a total population sample of 150 respondents. The variable determinant of quality of life includes the respondents perception of the disease, health care search is done, the meaning of life for the respondents, satisfaction with family and health care. Data were collected through questionnaires, through purpusive sampling techniques, then performed the frequency distribution and crostabulasi.&#x0D; The results showed that the respondents' perceptions of the disease is mostly 78.4% said the illness as a result of the process of transmission of TB bacteria mycobaterium, the search for health services 95.7% went to the clinic, the meaning of life for themselves 78.6% said there was no hope for healed, satisfaction with family 67.5% are satisfied with the spirit given by family members and satisfaction of health workers say 85.3% are satisfied with the services provided by a health worker.&#x0D; The conclusion shows that detrminan quality of life in patients with pulmonary tuberculosis have searched for health services to the health service, satisfied with the health workers, but there is no hope of life to recover. Suggestions for further research to dig deeper into the life expectancy of the respondents

Shedding light on quality of care: a study protocol for a randomized trial evaluating the impact of the Solar Suitcase in rural health facilities on maternal and newborn care quality in Uganda

BackgroundContinued progress in reducing maternal and newborn morbidity and mortality in low-income countries requires a renewed focus on quality of delivery care. Reliable electricity and lighting is a cornerstone of a well-equipped health system, but most primary maternity care facilities in sub-Saharan Africa are either not connected to the electrical grid or suffer frequent blackouts. Lack of reliable electricity and light in maternity facilities may contribute to poor quality of both routine and emergency obstetric and newborn care, by hindering infection control, increasing delays in providing care, and reducing health worker morale. The “Solar Suitcase” is a solar electric system designed specifically for maternity care facilities in low-resource environments. The purpose of this trial is to evaluate the impact of the Solar Suitcase on reliability of light, quality of obstetric and newborn care, and health worker satisfaction.MethodsWe are conducting a study with 30 maternity care facilities in rural Uganda that lack access to a reliable, bright light source. The study is a stepped wedge cluster randomized controlled trial. Study facilities are identified according to predefined eligibility criteria, and randomized by blocking on baseline covariates. The intervention is a “Solar Suitcase”, a complete solar electric system that provides essential lighting and power for charging phones and small medical devices. The primary outcomes are the reliability and quality of light during intrapartum care, the process quality of obstetric and newborn care, and health worker satisfaction. Outcomes will be assessed via direct clinical observation by trained enumerators (estimated n = 1980 birth observations), as well as interviews with health workers and facility managers. Lighting and blackouts will be captured through direct observation and via light sensors installed in facilities.DiscussionA key feature of a high quality health system is appropriate infrastructure, including reliable, bright lighting and electricity. Rigorous evidence on the role of a reliable light source in maternal and newborn care is needed to accelerate the “electrification” of maternity facilities across sub-Saharan Africa. This study will be the first to rigorously assess the extent to which reliable light is an important driver of the quality of care experienced by women and newborns.Trial registrationClinicalTrials.gov: NCT03589625 (July 18, 2018); socialscienceregistry.org: AEARCTR-0003078 (dated June 16, 2018).

Climate Organization With Employee Satisfaction Implementation

&#x0D; &#x0D; Nurses are health workers who dominate as a whole and as the first and longest established contact with customers (patients and families) so that they need serious attention from the hospital management. The job satisfaction of health workers can be influenced by the organizational climate. This study aims to determine the relationship of the organizational climate with the job satisfaction of nurses in the inpatient room of RSUD H. Andi Sulthan Daeng Radja, Bulukumba Regency. This research is an analytic observational study with a cross-sectional approach. Sampling was done by a stratified random sampling technique. The population in this study were nurses in the inpatient room of H.Andi Sulthan Daeng Radja Hospital, Bulukumba Regency, as many as 218 people. The sample in this study was 87 people. The measuring instruments used were questionnaires and observations. Data analysis used with the Chi-Square test. The results of the respondents 'perceptions of the organizational climate are good categories with satisfied job satisfaction as many as 59 respondents (86.76%), and organizational climate of less categories with satisfied job satisfaction, namely 9 respondents (13.23%), while respondents' perceptions of organizational climate less categories with less satisfying job satisfaction as many as 15 respondents (78.94%), and less satisfied category job satisfaction, namely 4 respondents (21.05%). Based on the results of the analysis using the Chi-Square test statistic test obtained p-value &lt;0.002 which indicates the existence of organizational climate relations with the job satisfaction of the nurses in the inpatient room of H. Andi Sulthan Daeng Radja Hospital, Bulukumba District.

Biometric Tracking, Healthcare Provision, and Data Quality: Experimental Evidence from Tuberculosis Control

Developing countries increasingly use biometric identification technology in hopes of improving the reliability of administrative information and delivering social services more efficiently. This paper exploits the random placement of biometric tracking devices in tuberculosis treatment centers in urban slums across four Indian states to measure their effects both on disease control and on the quality of health records. The devices record health worker attendance and patient adherence to treatment, and they automatically generate prompts to follow up with patients who miss doses. Combining data from patient and health worker surveys, independent field visits, and government registers, we first find that patients enrolled at biometric-equipped centers are 25 percent less likely to interrupt treatment—an improvement driven by increased attendance and efforts by health workers and greater treatment adherence by patients. Second, biometric tracking decreases data forgery: it reduces overreporting of patient numbers in both NGO data and government registers and underreporting of treatment interruptions. Third, the impact of biometric tracking is sustained over time and it decreases neither health worker satisfaction nor patient satisfaction. Overall, our results suggest biometric tracking technology is both an effective and sustainable way to improve the state's capacity to deliver healthcare in challenging areas. Institutional subscribers to the NBER working paper series, and residents of developing countries may download this paper without additional charge at www.nber.org.

Performance-Based Financing Empowers Health Workers Delivering Prevention of Vertical Transmission of HIV Services and Decreases Desire to Leave in Mozambique.

Background: Despite increased access to treatment and reduced incidence, vertical transmission of HIV continues to pose a risk to maternal and child health in sub-Saharan Africa. Performance-based financing (PBF) directed at healthcare providers has shown potential to improve quantity and quality of maternal and child health services. However, the ways in which these PBF initiatives lead to improved service delivery are still under investigation. Methods: Therefore, we implemented a longitudinal-controlled proof-of-concept PBF intervention at health facilities and with community-based associations focused on preventing vertical transmission of HIV (PVT) in rural Mozambique. We hypothesized that PBF would increase worker motivation and other aspects of the workplace environment in order to achieve service delivery goals. In this paper, we present two objectives from the PBF intervention with public health facilities (n=6): first, we describe the implementation of the PBF intervention and second, we assess the impact of the PBF on health worker motivation, key factors in the workplace environment, health worker satisfaction, and thoughts of leaving. Implementation (objective 1) was evaluated through quantitative service delivery data and multiple forms of qualitative data (eg, quarterly meetings, participant observation (n=120), exit interviews (n=11)). The impact of PBF on intermediary constructs (objective 2) was evaluated using these qualitative data and quantitative surveys of health workers (n=83) at intervention baseline, midline, and endline. Results: We found that implementation was challenged by administrative barriers, delayed disbursement of incentives, and poor timing of evaluation relative to incentive disbursement (objective 1). Although we did not find an impact on the motivation constructs measured, PBF increased collegial support and worker empowerment, and, in a time of transitioning implementing partners, decreased against desire to leave (objective 2). Conclusion: Areas for future research include incentivizing meaningful quality- and process-based performance indicators and evaluating how PBF affects the pathway to service delivery, including interactions between motivation and workplace environment factors.

Development, evaluation and implementation of an Interprofessional Collaboration Competency Framework – Experiences from a Canadian Inner City Teaching Hospital

Introduction: Competency as a collaborator in practice is becoming increasingly important in today’s health care system. The WHO (2014) identified interprofessional collaboration in health care delivery as an essential element in addressing a currently fragmented healthcare system. As such, the teaching, attainment and assessment of collaborative competency have been prioritized to support interprofessional practice and integrated care. It continues to remain challenging however, for health care institutions to implement these best practice approaches. At St. Michael’s Hospital, an Interprofessional Collaboration Competency (IPC-C) Working Group has been dedicated to the development, evaluation and implementation of a unique IPC-C Framework to be applied across all health teams and disciplines in this large urban teaching hospital. Over the past 2.5 years, the group undertook a literature review, created a draft framework, conducted validation testing of the framework and its accompanying toolkit, and undertook pilot testing of components of the frameworks’ implementation strategy. This presentation will share information about these development, validation and implementation processes and lessons learned from this initiative. Learning objectives: By the end of the workshop, participants will be able to: 1) Describe the methodologies and approaches used to embed an IPC-competencies framework within a teaching hospital. 2) Identify challenges and opportunities to teach the IPC competencies. 3) Familiarize themselves with the IPC-competency framework and consider applicability to their own settings. Methods: After a brief presentation about the framework and lessons learned from our experience, we will work in break-out groups through virtual examples for teaching collaboration as a competency in the hospital setting. Using the IPC-C Framework, break-out groups will discuss whether or how a similar process may occur within their own setting. A particular focus will include how to enhance IPC across disciplines specific to the participants’ own healthcare environment. Implications: Implementation of an IPC-C Framework within teaching hospitals has the potential to encourage attainment of collaborator competencies for healthcare professionals and to enhance team-based care. According to the WHO (2010), optimal team-based care results in improved health care delivery, patient outcomes and satisfaction as well as improved satisfaction of health workers in their day-to-day work life. It is our theory that embedding IPC-competencies within daily practice will result in these healthcare improvements and ultimately improve quality of care delivered. Target Population/Stakeholders: Hospital administrators, managers, health care professionals, students, health disciplines and medical educators Timeline: The IPC-C framework educational strategy is in early implementation with pilot testing of the educational approaches utilized in knowledge translation across the institution. The framework will be fully launched and integrated into provider performance evaluation in the coming year. Highlights: To our knowledge, this type of initiative has not previously been implemented in a teaching hospital in Canada. The long-term outcome is to improve HP collaborative competency amongst over 5,000 health providers at St. Michael’s Hospital and ultimately to improve patient outcomes. Transferability: This initiative should be transferable to other similar hospital settings.

Altruism and Primary Healthcare Workers’ Job Satisfaction: Findings from Central Vietnam

To achieve the Sustainable Development Goals, particularly to promote healthy living and well-being for all ages, we must ensure a high quality of healthcare services at primary facilities. However, the shortage of healthcare workers in primary facilities is a problem in many countries, including Vietnam. Despite concerns about the low job satisfaction of health workers and value of altruism in this field, no existing research has thus far addressed its effect on job satisfaction. This study thus contributes to the body of knowledge on healthcare workers’ job satisfaction by observing the role of altruism.We conducted a quantitative analysis by using data collected from healthcare workers employed at primary facilities in central Vietnam in 2014. The survey administered to healthcare workers (n=241) included a hypothetical dictator game questionnaire to elicit their level of altruism. We then used an ordered probit model to examine the factors associated with healthcare workers’ job satisfaction, focusing particularly on altruism by controlling for both individual-level attributes and the condition of their workplaces.We found that a higher level of altruism is associated with lower job satisfaction. Further analysis revealed that more altruistic workers are also likely to have a stricter self-evaluation of healthcare quality, including the availability of drugs. Altruistic healthcare workers may be frustrated when working in environments in which resources are constrained and workers cannot perform to their full ability despite a wish to help others.

Job Satisfaction Analysis in Rural China: A Qualitative Study of Doctors in a Township Hospital.

Background. Township hospitals in China provide rural communities with basic but much needed critical health care services. The doctors working in these hospitals often feel unsatisfied when considering their work schedules and financial rewards. Method. To explore job satisfaction of health workers in a township hospital, a qualitative study was conducted of 39 doctors from five township hospitals in Guangxi Zhuang Autonomous Region. The goal was to understand the level of job satisfaction of doctors and to make recommendations for improvements. Results. About 75% (28/39) of the doctors expressed negative attitudes related to their work conditions. Slightly more than half (22/39) mentioned they should receive greater compensation for their work and more than one were seriously considering other options. Many participants (35/39) showed their satisfaction about the achievement of serving as a doctor. Conclusion. Their main concerns related to job satisfaction included working conditions, financial rewards, and the doctor's relationships with patients. Increasing the incomes and fringe benefits of healthcare workers, improving their work conditions, and providing training and continuing education opportunities would help rural clinics retain doctors and eliminate the current unsatisfactory conditions. The findings also highlight the need for the government to increase financial support of township hospitals.

What elements of the work environment are most responsible for health worker dissatisfaction in rural primary care clinics in Tanzania?

BackgroundIn countries with high maternal and newborn morbidity and mortality, reliable access to quality healthcare in rural areas is essential to save lives. Health workers who are satisfied with their jobs are more likely to remain in rural posts. Understanding what factors influence health workers’ satisfaction can help determine where resources should be focused. Although there is a growing body of research assessing health worker satisfaction in hospitals, less is known about health worker satisfaction in rural, primary health clinics. This study explores the workplace satisfaction of health workers in primary health clinics in rural Tanzania.MethodsOverall, 70 health workers in rural Tanzania participated in a self-administered job satisfaction survey. We calculated mean ratings for 17 aspects of the work environment. We used principal components analysis (PCA) to identify groupings of these variables. We then examined the bivariate associations between health workers demographics and clinic characteristics and each of the satisfaction scales.ResultsResults showed that 73.9% of health workers strongly agreed that they were satisfied with their job; however, only 11.6% strongly agreed that they were satisfied with their level of pay and 2.9% with the availability of equipment and supplies. Two categories of factors emerged from the PCA: the tools and infrastructure to provide care, and supportive interpersonal environment. Nurses and medical attendants (compared to clinical officers) and older health workers had higher satisfaction scale ratings.ConclusionsTwo dimensions of health workers’ work environment, namely infrastructure and supportive interpersonal work environment, explained much of the variation in satisfaction among rural Tanzanian health workers in primary health clinics. Health workers were generally more satisfied with supportive interpersonal relationships than with the infrastructure. Human resource policies should consider how to improve these two aspects of work as a means for improving health worker morale and potentially rural attrition.Trial registration(ISRCTN 17107760)

Improving recognition of severe illness and patient pathways in primary health services using mHealth technology in urban Blantyre, Malawi

Hospital-based studies suggest that late presentation at tertiary level is a driving factor for mortality from severe febrile illness in resource-poor contexts. Recent research into health seeking pathways in Malawi identified primary level barriers linked to service provision and misdiagnoses. In Malawi an Emergency Triage, Assessment and Treatment (ETAT) package, approved by the World Health Organisation (WHO) has been introduced at tertiary level and is being rolled out to district and primary clinics. mHealth technologies are likely to sustain quality in implementing clinical protocols, particularly when community-based health providers with limited formal training are increasingly working to offset primary level staff shortages. We aimed to develop and evaluate feasibility and acceptability of a prototype primary care level intervention to improve triage, assessment and referral of children with severe illness in Blantyre and to investigate whether this facilitates systematic and timely recognition and response to severe illness. All paediatric cases within five primary clinics in urban Blantyre were triaged and assigned Red for Emergency, Amber for Priority and Green for Queue using the mHealth triage algorithm. Phones were assigned to triage, to clinicians and the A&E department within the local tertiary, referral hospital (Queen Elizabeth Central Hospital (QECH)) for monitoring patient referrals. We conducted a rigorous evaluation using a combination of quantitative and qualitative approaches, both pre- and post and, using the phone as a monitoring tool, in parallel to the intervention. Seventy-four healthcare staff were trained across five urban primary clinics. A total of 41,358 patients were assessed using the mHealth triage algorithm from December 2012 to May 2013, of whom 1.56% were referred to QECH. Rates of concordance between triage and clinician assessment showed a good level of agreement above chance (Kappa value = 0.71). Pre- and post-Patient Journey Modelling tools identified positive changes in patient flows. Overall patient and health worker satisfaction was high with indirect impact on quality of clinical assessment amongst health workers based at intervention clinics but not directly involved in the intervention. This study has shown that mHealth technologies have the potential to improve primary level health services in resource-poor contexts with high patient numbers and overburdened health staff. Working in collaboration with the Ministry of Health the data we present will inform the development of a cluster-randomised trial to rigorously evaluate the role of mHealth in the implementation of ETAT. This will aid policy decisions around ETAT implementation at primary health level.

Health Worker Satisfaction and Motivation: An Empirical Study of Incomes, Allowances and Working Conditions in Zambia

Health worker salaries in Zambia are low by any standard. In recent times there have been real reductions in thesalaries of health workers. This has resulted in significant attrition in the public sector as health workers areattracted to the private sector or leave Zambia entirely, leaving a large deficit in public sector health workers. Inthis study we examine the relationship between health worker incomes and their satisfaction and motivation.Cross-sectional data collection was undertaken using both quantitative and qualitative methods. A refined surveyinstrument was used for the quantitative data method. Document review (past and current records) was employedfor the qualitative method. Data was collected in three regions that represent extremes in overall remunerationand benefits. Lusaka represented the favourable area while Monze and Nyimba represented less favourable areasfor study in Zambia.There are hefty disparities between different health workers. There are also enormous salary differentials for thesame workers between the public and private sectors. These salary differentials explain the experience of publicto private “traffic” of health workers as well as casual private sector work by public sector health workers. Inaddition, there are negligible efforts by government to reduce the benefits gaps among key public health cadres.The low incomes received by public health workers in Zambia have many negative implications: it begetsabsenteeism, results in low output, poor quality health care, and the departure of health workers to the privatesector and overseas.

Health Workers and their Retention: The Situation of Health Care Work in Leprosy Settlements in Abia, Ebonyi and Oyo States of Nigeria.

Introduction: Retention of trained, qualified and motivated health workers is a key component for health system strengthening and achieving world health organization’s (WHO) global strategy for reducing leprosy burden and sustaining leprosy control activities. Study aimed to elucidate the factors and conditions that influence health workers’ job satisfaction in settlements. Materials and method: A total of 31 health workers employed in the three settlements were studied. Data were collected using semi-structured focus group discussion and in-depth interview. Further, situational analyses and informal observation of the activities in the settlements were done. Also Nottingham’s life satisfaction index was used to assess job satisfaction of health workers. Data were analyzed qualitatively and quantitatively. Results: There was acute shortage of highly qualified health staff in the settlements. Two factors, personal factors and institutional factors affected health workers’ retention negatively. Workers remained in one post for prolonged periods of time before earning promotion. In all, 10 (76.9%)of health workers in Abia and 8(72.7%) in Ebonyi States stayed 6-9 years respectively on one post before earning promotion while 4(57.1%) from Oyo stayed 3-7 years. Conclusion: the study showed that retention of health workers in the three settlements was associated with better conditions of service like increased allowances and salaries. Key words: health care, motivation, leprosy, incentive, settlement, and salary