Absenteeism amongst health workers – developing a typology to support empiric work in low-income countries and characterizing reported associations

Human Resources for Health

Mike English¹  Patrick Mbindyo²  Alice Belita² 

[1] Nuffield Department of Medicine and Department of Paediatrics, University of Oxford, Old Road Campus, Oxford, OX3 7BN, UK;Kenya Medical Research Institute -Wellcome Trust Research Programme, Kenyatta National Hospital, Hospital Road, Nairobi, 00100, Kenya

关键词: Sickleave;    Workforce;    Absenteeism;   

Others  :  822440
DOI  :  10.1186/1478-4491-11-34

 received in 2013-01-21, accepted in 2013-07-01,  发布年份 2013

【 摘 要 】

The contribution of inadequate health worker numbers and emigration have been highlighted in the international literature, but relatively little attention has been paid to absenteeism as a factor that undermines health-care delivery in low income countries. We therefore aimed to review the literature on absenteeism from a health system manager’s perspective to inform needed work on this topic. Specifically, we aimed to develop a typology of definitions that might be useful to classify different forms of absenteeism and identify factors associated with absenteeism. Sixty-nine studies were reviewed, only four were from sub-Saharan Africa where the human resources for health crisis is most acute. Forms of absenteeism studied and methods used vary widely. No previous attempt to develop an overarching approach to classifying forms of absenteeism was identified. A typology based on key characteristics is proposed to fill this gap and considers absenteeism as defined by two key attributes, whether it is: planned/unplanned, and voluntary/involuntary. Factors reported to influence rates of absenteeism may be broadly classified into three thematic categories: workplace and content, personal and organizational and cultural factors. The literature presents an inconsistent picture of the effects of specific factors within these themes perhaps related to true contextual differences or inconsistent definitions of absenteeism.

【 授权许可】

   
2013 Belita et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Chen L, et al.: Human resources for health: overcoming the crisis. Lancet 2004, 364:1984-1990.
• [2]Joint Learning Initiative: Human resources for health. Overcoming the crisis. Cambridge, MA: Global Equity Initiative, Harvard University; 2004.
• [3]Dovlo D: Wastage in the health workforce: some perspectives from African countries. Hum Resour Heal 2005, 3:6. BioMed Central Full Text
• [4]Working together for health. Geneva: World Health Organization; 2006.
• [5]Kombe G, Galaty D, Gadhia R, Decker C: The human and financial resource requirements for scaling up HIV/AIDS services in Ethiopia. In The Partners for Health Reformplus Project. Bethesda, MD: Abt Associates Inc; 2005.
• [6]Anand S, Bärnighausen T: Human resources and health outcomes: cross-country econometric study. Lancet 2004, 364:1603-1609.
• [7]Lindelow M, Serneels P: The performance of health workers in Ethiopia: results from qualitative research. Soc Sci Med 2006, 62:2225-2235.
• [8]Adano U: The health worker recruitment and deployment process in Kenya: an emergency hiring program. Hum Resour Heal 2008, 6:19. BioMed Central Full Text
• [9]Rakuom C: Nursing human resources in Kenya: case study. Geneva: International Centre for Human Resources in Nursing; 2010.
• [10]Dambisya YM: A review of non-financial incentives for health worker retention in east and southern Africa.Discussion paper 44. In The Regional Network for Equity in Health in East and Southern Africa Edited by Loewenson R. 2007.
• [11]Kober K, Van Damme W: Public sector nurses in Swaziland: can the downturn be reversed? Hum Resour Heal 2006, 4:13. BioMed Central Full Text
• [12]Liese B, Dussault G: The state of the health workforce in sub-Saharan Africa: evidence of crisis and analysis of contributing factors. Washington, DC: World Bank; 2004.
• [13]Yumkella F: Retention of health care workers in low-resource settings: challenges and responses. IntraHealth International 2006.
• [14]Hagopian A, et al.: The flight of physicians from West Africa: views of African physicians and implications for policy. Soc Sci Med 2005, 61:1750-1760.
• [15]Ferrinho P, et al.: Dual practice in the health sector: review of the evidence. Hum Resour Heal 2004, 2:14. BioMed Central Full Text
• [16]Alexopoulos EC, et al.: Knee and low back complaints in professional hospital nurses: occurrence, chronicity, care seeking and absenteeism. Work: A Journal of Prevention Assessment and Rehabilitation 2011, 38:329-335.
• [17]Steenstra I, et al.: Prognostic factors for duration of sick leave due to low-back pain in Dutch health care professionals. J Occup Rehabil 2005, 15:591-605.
• [18]Genevay SP, et al.: Work-related characteristics of back and neck pain among employees of a Swiss University Hospital. Joint Bone Spine 2011, 78:392-397.
• [19]Williams ES, Rondeau KV, Xiao Q, Francescutti LH: Heavy physician workloads: impact on physician attitudes and outcomes. Health Serv Manage Res 2007, 20:261-269.
• [20]Weir R, et al.: The efficacy and effectiveness of process consultation in improving staff morale and absenteeism. Medical Care 1997, 35:334-353.
• [21]Chaudhury N, Hammer JS: Ghost doctors: absenteeism in rural Bangladeshi health facilities. The World Bank Economic Review 2004, 18:423-441.
• [22]Manzi F, et al.: Human resources for health care delivery in Tanzania: a multifaceted problem. Hum Resour Heal 2012, 10:3. BioMed Central Full Text
• [23]Beil-Hildebrand M: Nurse absence—the causes and the consequences. J Nurs Manag 1996, 4:11-17.
• [24]Becker SG, Oliveira MLC: Study on the absenteeism of nursing professionals in a psychiatric center in Manaus, Brazil. Rev Lat Am Enfermagem 2008, 16:109-114.
• [25]UNHCO: Establishing incidence of health provider absenteeism in Bushenyi district. Kampala: Uganda National Health Users’/Consumers’ Organization; 2010.
• [26]Tripathi M, et al.: Absenteeism among nurses in a tertiary care hospital in India. Natl Med J India 2010, 23:143-146.
• [27]Peterson U, et al.: Burnout levels and self-rated health prospectively predict future long-term sickness absence: a study among female health professionals. J Occup Environ Med 2011, 53:788-793.
• [28]Schalk R: The influence of organizational commitment and health on sickness absenteeism: a longitudinal study. J Nurs Manag 2011, 19:596-600.
• [29]Andreasson H, Ortengren U, Barregard L, Karlsson S: Work-related skin and airway symptoms among Swedish dentists rarely cause sick leave or change of professional career. Acta Odontol Scand 2001, 59:267-272.
• [30]Fujishiro K, Gee GC, de Castro AB: Associations of workplace aggression with work-related well-being among nurses in the Philippines. Am J Public Health 2011, 101:861-867.
• [31]Donovan TL, Moore KM, VanDenKerkhof EG: Employee absenteeism based on occupational health visits in an urban tertiary care Canadian hospital. Public Health Nurs 2008, 25:565-575.
• [32]Junkes MB, Pessoa VF: Financial expense incurred by medical leaves of health professionals in Rondonia public hospitals, Brazil. Rev Lat Am Enfermagem 2010, 18:406-412.
• [33]Libet JM, et al.: Absenteeism and productivity among mental health employees. Administration and Policy in Mental Health and Mental Health Services Research 2001, 29:41-50.
• [34]Garcia-Prado A, Chawla M: The impact of hospital management reforms on absenteeism in Costa Rica. Health Policy Plan 2006, 21:91-100.
• [35]Gaudine A, Gregory C: The accuracy of nurses’ estimates of their absenteeism. J Nurs Manag 2010, 18:599-605.
• [36]Davey MM, Cummings G, Newburn-Cook CV, Lo EA: Predictors of nurse absenteeism in hospitals: a systematic review. J Nurs Manag 2009, 17:312-330.
• [37]Borda RG, Norman IJ: Testing a model of absence and intent to stay in employment: a study of registered nurses in Malta. Int J Nurs Stud 1997, 34:375-384.
• [38]Isah EC, Omorogbe VE, Orji O, Oyovwe L: Self-reported absenteeism among hospital workers in Benin city, Nigeria. Ghana Med J 2008, 42:2-7.
• [39]Johnson CJ, Croghan E, Crawford J: The problem and management of sickness absence in the NHS: considerations for nurse managers. J Nurs Manag 2003, 11:336-342.
• [40]Verhaeghe R, et al.: Impact of recurrent changes in the work environment on nurses’ psychological well-being and sickness absence. J Adv Nurs 2006, 56:646-656.
• [41]Allen PT: Size of workforce, morale and absenteeism: a re-examination. Br J Ind Relat 1982, 20:83-100.
• [42]Muthama T, Maina T, Mwanje J, Kibua T: Absenteeism of health care providers in Machakos district. Nairobi: Kenya. Report of the Institute of Policy Analysis and Research; 2008.
• [43]Josephson M, et al.: The same factors influence job turnover and long spells of sick leave–a 3-year follow-up of Swedish nurses. Eur J Public Health 2008, 18:380-385.
• [44]Kivimaki M, et al.: Sickness absence in hospital physicians: 2 year follow up study on determinants. Occup Environ Med 2001, 58:361-366.
• [45]Nyathi M, Jooste K: Working conditions that contribute to absenteeism among nurses in a provincial hospital in the Limpopo Province. Curationis 2008, 31:28-37.
• [46]Plant M: Primary care nurses’ attitude to sickness absence: a study. Br J Community Nurs 2003, 8:421-427.
• [47]Bourbonnais R, Mondor M: Job strain and sickness absence among nurses in the province of Québec. Am J Ind Med 2001, 39:194-202.
• [48]Bourbonnais R, Vinet A, Vezina M, Gingras S: Certified sick leave as a non-specific morbidity indicator: a case referent study among nurses. Br J Ind Med 1992, 49:673-678.
• [49]Verhaeghe R, et al.: Job stress among middle-aged health care workers and its relation to sickness absence. Stress Heal 2003, 19:265-274.
• [50]Rauhala A, et al.: What degree of work overload is likely to cause increased sickness absenteeism among nurses? Evidence from the RAFAELA patient classification system. J Adv Nurs 2007, 57:286-295.
• [51]Trinkoff AM, Storr CL, Lipscomb JA: Physically demanding work and inadequate sleep, pain medication Use, and absenteeism in registered nurses. J Occup Environ Med 2001, 43:355-363.
• [52]Gimeno D, et al.: Association of occupation and safety practices with work-injury absence among public hospital employees in Latin America: a study from Costa Rica. Inj Prev 2007, 13:264-269.
• [53]Ritchie KA, Macdonald EB, Gilmour WH, Murray KJ: Analysis of sickness absence among employees of four NHS trusts. Occup Environ Med 1999, 56:702-708.
• [54]Burke RJ, Greenglass ER: Effects of hospital restructuring on full time and part time nursing staff in Ontario. Int J Nurs Stud 2000, 37:163-171.
• [55]Carosi A, Lightfoot N: Predictors of workplace absenteeism in cancer care workers. Curr Oncol 2009, 16:1-4.
• [56]Gorman E, Yu S, Alamgir H: When healthcare workers get sick: exploring sickness absenteeism in British Columbia, Canada. Work: A Journal of Prevention, Assessment and Rehabilitation 2010, 35:117-123.
• [57]Kivimaki M, Elovainio M, Vahtera J: Workplace bullying and sickness absence in hospital staff. Occup Environ Med 2000, 57:656-660.
• [58]Wilson BL, Diedrich A, Phelps CL, Choi M: Bullies at work: the impact of horizontal hostility in the hospital setting and intent to leave. J Nurs Adm 2011, 41:453-458.
• [59]Franche R, et al.: Examining the impact of worker and workplace factors on prolonged work absences among Canadian nurses. J Occup Environ Med 2011, 53:919-927.
• [60]Pinar R, Ucmak F: Verbal and physical violence in emergency departments: a survey of nurses in Istanbul, Turkey. J Clin Nurs 2011, 20:510-517.
• [61]Ng K, et al.: Workplace violence-a survey of diagnostic radiographers working in public hospitals in Hong Kong. J Occup Health 2009, 51:355-363.
• [62]Kivimäki M, et al.: Sickness absence and the organization of nursing care among hospital nurses. Scand J Work Environ Health 2004, 30:468-476.
• [63]Albion MJFG, Machin MA, Patrick J: Predicting absenteeism and turnover intentions in the health professions. Australian Health Review: a publication of the Australian Hospital Association 2008, 32:271-281.
• [64]Siu O-L: Predictors of job satisfaction and absenteeism in two samples of Hong Kong nurses. J Adv Nurs 2002, 40:1-13.
• [65]Song R, et al.: Nurses’ job satisfaction, absenteeism, and turnover after implementing a special care unit practice model. Res Nurs Health 1997, 20:443-452.
• [66]Matrunola P: Is there a relationship between job satisfaction and absenteeism? J Adv Nurs 1996, 23:827-834.
• [67]Pompeii L, Lipscombb H, Dementb J: Predictors of lost time from work among nursing personnel who sought treatment for back pain. Work 2010, 285-295.
• [68]Pines A, et al.: Rates of sickness absenteeism among employees of a modern hospital: the role of demographic and occupational factors. Br J Ind Med 1985, 42:326-335.
• [69]Bamgboye E, Adeleye A: Sickness absenteeism in a Nigerian teaching hospital. East Afr Med J 1992, 69:450-455.
• [70]Al-Shammari SA, Bamgboye EA, Olubuyide I: Sickness absenteeism among employees of a teaching hospital in Saudi Arabia. J R Soc Promot Health 1994, 114:6-10.
• [71]Kristensen T, Jensen S, Kreiner S, Mikkelsen S: Socioeconomic status and duration and pattern of sickness absence. A 1-year follow-up study of 2331 hospital employees. Biomed Central Public Health 2010, 10:1-11. BioMed Central Full Text
• [72]Rajbhandary S, Basu K: Working conditions of nurses and absenteeism: is there a relationship? An empirical analysis using national survey of the work and health of nurses. Health policy (Amsterdam, Netherlands) 2010, 97:152-159.
• [73]Bamgboye E, Olubuyide I, Al-Shammari S: The rate of sickness absenteeism among employees at King Khalid University Hospital, Riyadh, Saudi Arabia. East Afr Med J 1993, 70:515-518.
• [74]Lim A, et al.: Influence of work type on sickness absence among personnel in a teaching hospital. J Occup Health 2002, 44:254-263.
• [75]Eriksen W, Bruusgaard D, Knardahl S: Work factors as predictors of sickness absence: a three month prospective study of nurses’ aides. Occup Environ Med 2003, 60:271-278.
• [76]Anagnostopoulos F, Niakas D: Job burnout, health-related quality of life, and sickness absence in Greek health professionals. Eur Psychol 2010, 15:132-141.
• [77]Republic of Kenya Ministry of Health: Report on challenges facing the Kenyan health workforce in the Era of HIV/AIDS. Nairobi: Republic of Kenya Ministry of Health; 2004.
• [78]Tawfik L, Kinoti SN: The impact of HIV/AIDS on the health workforce in developing countries. In World Health Report - Working Together for Health. Geneva: World Health Organization; 2006.
• [79]Schreuder JAH, et al.: Leadership effectiveness and recorded sickness absence among nursing staff: a cross-sectional pilot study. J Nurs Manag 2011, 19:585-595.
• [80]Boumans NPG, Landeweerd JA: Leadership in the nursing unit: relationships with nurses’ well-being. J Adv Nurs 1993, 18:767-775.
• [81]Remsburg R, Armacost KA, Bennett RG: Managing nursing assistant absenteeism. J Nurs Adm 1999, 29:11-14.
• [82]Swedish Social Insurance: Sickness benefit. Stockholm: Forsakringskassan; 2012. http://www.forsakringskassan.se/wps/wcm/connect/57599e77-65d6-4326-a15a-0342bc624bf3/Sjukpenning_FK_4086+Fa_enGB.PDF?MOD=AJPERES&CACHEID=57599e77-65d6-4326-a15a-0342bc624bf3&useDefaultText=0&useDefaultDesc=0 webcite
• [83]Unruh L, Joseph L, Strickland M: Nurse absenteeism and workload: negative effect on restraint use, incident reports and mortality. J Adv Nurs 2007, 60:673-681.
• [84]Kalisch BJ, Tschannen D, Lee KH: Do staffing levels predict missed nursing care? Int J Qual Health Care 2011, 23:302-308.
• [85]Lindahl B, OECD: Norway trumps sick leave costs of all industrial countries. Nordic Labour Journal; 2012. http://www.nordiclabourjournal.org/nyheter/news-2012/article.2012-02-17.2621171737/ webcite
• [86]Wallin G: Myths muddle debate on sick leave. Nordic Labour Journal; 2010. http://www.nordiclabourjournal.org/artikler/debat/opinion-2010/myths-muddle-debate-on-sick-leave/ webcite
• [87]Wegge J, Schmidt K-H, Parkes C, Van Dick R: ‘Taking a sickie’: Job satisfaction and job involvement as interactive predictors of absenteeism in a public organization. J Occup Organ Psychol 2007, 80:77-89.
• [88]Dellve L, Hadzibajramovic E, Ahlborg G Jr: Work attendance among healthcare workers: prevalence, incentives, and long-term consequences for health and performance. Journal ofAdvanced Nursing 2011, 67:1918-1929.
• [89]Van Wyk BE, Pillay-Van Wyk V: Preventive staff-support interventions for health workers. Cochrane Database Syst Rev 2010, 3:CD003541.