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

Human Resources for Health

Margaret E Kruk¹  Angela Kimweri²  Elysia Larson¹  Godfrey M Mbaruku² 

[1] Mailman School of Public Health, Columbia University, 722 West 168th Street, Room 603, 10032 New York, NY, USA;Ifakara Health Institute, PO Box 78 373, Dar es Salaam, Tanzania

关键词: Tanzania;    Rural healthcare;    Job satisfaction;    Health systems;   

Others  :  1161187
DOI  :  10.1186/1478-4491-12-38

 received in 2014-02-28, accepted in 2014-07-19,  发布年份 2014

【 摘 要 】

Background

In 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.

Methods

Overall, 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.

Results

Results 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.

Conclusions

Two 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)

【 授权许可】

   
2014 Mbaruku et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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