Beyond patient care: the impact of healthcare reform on job satisfaction in the Ethiopian public healthcare sector

Human Resources for Health

Research

Mokgadi C. Matlakala¹  Tsegahun Manyazewal¹ 

[1] Department of Health Studies, College of Human Science, University of South Africa, PO Box 392, Pretoria, South Africa;

关键词: Healthcare reform;    Job satisfaction;    Health professionals;    Ethiopia;    Public healthcare sector;    Moral satisfaction;    Management style;    Workload;    Task;   

DOI  :  10.1186/s12960-017-0188-1

 received in 2016-07-26, accepted in 2017-01-28,  发布年份 2017

来源: Springer

【 摘 要 】

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.

【 授权许可】

CC BY   
© The Author(s). 2017