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The relationship between leadership style and health worker motivation, job satisfaction and teamwork in Uganda.

ABSTRACT: Background:Leadership is key to strengthening performance of Health Systems. Leadership styles are important organizational antecedents, especially in influencing employee's motivation, job satisfaction, and teamwork. There is limited research exploring this relationship among health workers in resource-limited settings such as Uganda. The aim of this study was to examine the relationship between transformational, transactional, and laissez-faire leadership styles and motivation, job satisfaction, and teamwork of health workers in Uganda. Method:We conducted a cross-sectional study in 3 geographic regions of Uganda in November 2015, using self-administered questionnaires with 564 health workers from 228 health facilities. Data were collected on health workers' perception of leadership styles displayed by their facility leaders, their level of motivation, job satisfaction, and team work. Using Pearson correlation, relationships among variables were identified and associations of the components of leadership styles with motivation, job satisfaction, and teamwork was found using multivariable logistic regression. Results:Health workers in Uganda preferred leaders who were transformational (62%) compared with being transactional (42%) or laissez-faire (14%). Transformational leadership was positively correlated with motivation (r=0.32), job satisfaction (r=0.38), and team work (r=0.48), while transactional leadership was positively correlated with job satisfaction (r=0.21) and teamwork (r=0.18). Motivation was positively associated with leaders who displayed idealized influence-behavior (odds ratio [OR]=3.7; 95% CI, 1.33-10.48) and intellectual stimulation (OR=2.4; 95% CI, 1.13-5.15) but negatively associated with management by exception (OR=0.4; 95% CI, 0.19-0.82). Job satisfaction was positively associated with intellectual stimulation (OR=5.7; 95% CI, 1.83-17.79). Teamwork was positively associated with idealized influence-behavior (OR=1.07-8.57), idealized influence-attributed (OR=3.9; 95% CI, 1.24-12.36), and contingent reward (OR=5.6; 95% CI, 1.87-17.01). Conclusion:Transformational styles had a positive impact on stimulating motivation, assuring job satisfaction, and consolidating teamwork among health workers compared with those who demonstrated transactional skills or laissez-faire styles. Recommendation:Supporting transformational leadership skills development in health facility leaders could encourage health worker motivation, strengthen job satisfaction, and maintain cohesion among health workers for better service delivery.

SUBMITTER: Musinguzi C

PROVIDER: S-EPMC5922238 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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The relationship between leadership style and health worker motivation, job satisfaction and teamwork in Uganda.

Musinguzi Conrad C Namale Leticia L Rutebemberwa Elizeus E Dahal Aruna A Nahirya-Ntege Patricia P Kekitiinwa Adeodata A

Journal of healthcare leadership 20180423

<h4>Background</h4>Leadership is key to strengthening performance of Health Systems. Leadership styles are important organizational antecedents, especially in influencing employee's motivation, job satisfaction, and teamwork. There is limited research exploring this relationship among health workers in resource-limited settings such as Uganda. The aim of this study was to examine the relationship between transformational, transactional, and laissez-faire leadership styles and motivation, job sat ...[more]

PMID: 29719425

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Project description:IntroductionTeamwork is identified as a key contributor to patient safety and good teamwork is recognized as one of the presumptions of healthy work environment in nursing. The importance of job satisfaction in nursing has repeatedly been confirmed, but only recently has the association of job satisfaction and nursing teamwork been identified.ObjectiveTo identify the level of nursing teamwork in hospitals in Iceland and its relationship with job satisfaction.MethodsThis was a quantitative descriptive cross-sectional study. Data were collected with the Nursing Teamwork Survey administered to nursing staff in medical, surgical, and intensive care units in hospitals in Iceland. This study is based on data from 567 participants.ResultsA logistic regression analysis indicated that work experience on current unit and perceived staffing adequacy contributes to job satisfaction and when controlling for unit type, role, experience on current unit and staffing adequacy, those reporting better teamwork are significantly more likely to be satisfied with their current position. With an additional unit for overall nursing teamwork, participants are almost five times likelier to be satisfied with their current position.ConclusionStudy findings show that there is a significant relationship between nursing teamwork and job satisfaction. The findings of this study confirm the importance of adequate staffing and good teamwork for nurses' job satisfaction. Staffing however, will remain the most challenging part of the equation as lack of nursing staff is foreseen globally in the coming decades turning the spotlight to teamwork. All stakeholders, including clinical nurse leaders, administrators, and instructors, need to emphasize on strengthening nursing teamwork. Good teamwork with increased job satisfaction may prevent turnover and shortage of nurses, an issue expected to grow during and following the COVID-19 pandemic. Facilitating good teamwork should be one of the priorities of every nurse leader.

Project description:BACKGROUND: Motivation and job satisfaction have been identified as key factors for health worker retention and turnover in low- and middle-income countries. District health managers in decentralized health systems usually have a broadened 'decision space' that enables them to positively influence health worker motivation and job satisfaction, which in turn impacts on retention and performance at district-level. The study explored the effects of motivation and job satisfaction on turnover intention and how motivation and satisfaction can be improved by district health managers in order to increase retention of health workers. METHODS: We conducted a cross-sectional survey in three districts of the Eastern Region in Ghana and interviewed 256 health workers from several staff categories (doctors, nursing professionals, allied health workers and pharmacists) on their intentions to leave their current health facilities as well as their perceptions on various aspects of motivation and job satisfaction. The effects of motivation and job satisfaction on turnover intention were explored through logistic regression analysis. RESULTS: Overall, 69% of the respondents reported to have turnover intentions. Motivation (OR?=?0.74, 95% CI: 0.60 to 0.92) and job satisfaction (OR?=?0.74, 95% CI: 0.57 to 0.96) were significantly associated with turnover intention and higher levels of both reduced the risk of health workers having this intention. The dimensions of motivation and job satisfaction significantly associated with turnover intention included career development (OR?=?0.56, 95% CI: 0.36 to 0.86), workload (OR?=?0.58, 95% CI: 0.34 to 0.99), management (OR?=?0.51. 95% CI: 0.30 to 0.84), organizational commitment (OR?=?0.36, 95% CI: 0.19 to 0.66), and burnout (OR?=?0.59, 95% CI: 0.39 to 0.91). CONCLUSIONS: Our findings indicate that effective human resource management practices at district level influence health worker motivation and job satisfaction, thereby reducing the likelihood for turnover. Therefore, it is worth strengthening human resource management skills at district level and supporting district health managers to implement retention strategies.

Project description:A shortage of competent health-care providers is a major contributor to poor quality health care in sub-Saharan Africa. To increase the retention of skilled health-care providers, we need to understand which factors make them feel satisfied with their work and want to stay in their job. This study investigates the relative contribution of provider, facility and contextual factors to job satisfaction and intention to stay on the job among health-care providers who performed obstetric care in Uganda and Zambia. This study was a secondary analysis of data from a maternal and newborn health program implementation evaluation in Uganda and Zambia. Using a Likert scale, providers rated their job satisfaction and intention to stay in their job. Predictors included gender, cadre, satisfaction with various facility resources and country. We used the Shapley and Owen decomposition of R2 method to estimate the variance explained by individual factors and groups of factors, adjusting for covariates at the facility and provider levels. Of the 1134 providers included in the study, 68.3% were female, 32.4% were nurses and 77.1% worked in the public sector. Slightly more than half (52.3%) of providers were strongly satisfied with their job and 42.8% strongly agreed that they would continue to work at their facility for some time. A group of variables related to facility management explained most of the variance in both job satisfaction (37.6%) and intention to stay (43.1%). Among these, the most important individual variables were satisfaction with pay (20.57%) for job satisfaction and opinions being respected in the workplace (17.52%) for intention to stay. Doctors reported lower intention to stay than nurses. Provider demographics and facility level and ownership (public/private) were not associated with either outcome. There were also differences in job satisfaction and intention to stay between Ugandan and Zambian health-care providers. Our study suggests that managers play a crucial role in retaining a sufficient number of satisfied health-care providers providing obstetric care in two sub-Saharan African countries, Uganda and Zambia. Prioritizing and investing in health management systems and health managers are essential foundations for high-quality health systems.

Project description:Background:Poor job conditions and limited resources are reducing job satisfaction and motivation among nurses in low-income countries, which may affect the quality of services and attrition rates. The objective of this study was to examine job satisfaction, motivation and associated factors among nurses working in the public health facilities of Ethiopia, with the aim of improving performance and productivity in the health care system. Methods:The study employed a cross-sectional two-stage cluster sampling design. From a random sample of 125 health facilities, 424 nurses were randomly selected for face-to-face interviews in all regions of Ethiopia. Nurses responded to questions about their overall job satisfaction and job conditions, including items related to intrinsic and extrinsic motivation, using a 5-point Likert scale. Multilevel analysis was performed to adjust for different clustering effects. Satisfaction levels (percent of respondents who were satisfied) were calculated for individual items, and composite mean scores (range: 1-5) were calculated for motivational factors. Adjusted odds ratios were computed to examine the association of these factors with overall job satisfaction. Results:Overall, 60.8% of nurses expressed satisfaction with their job. Composite mean scores for intrinsic and extrinsic motivational factors were 3.5 and 3.0, respectively. Job satisfaction levels were significantly higher for female nurses (65.6%, p?=?0.04), those older than 29?years (67.8%, p?=?0.048) and had over 10?years work experiences (68.8%, p?=?0.007). Satisfaction with remuneration (AOR?=?2.04, 95% CI?=?1.36, 3.06), recognition (AOR?=?2.21; 95% CI?=?1.38, 3.53), professional advancement (AOR?=?1.54; 95% CI?=?1.06, 2.29), features of the work itself (AOR?=?1.65; 95% CI?=?1.20, 2.91) and nurses' work experiences from 5 to 10?years (AOR?=?0.37, 95% CI?=?0.17, 0.79) were significantly associated with overall job satisfaction after controlling for other predictors. Conclusions:The study findings are signals for the Ministry of Health to strengthen the human resource management system and practices to improve nurses' overall job satisfaction and motivation, especially among nurses with 5 to 10?years of experience on the job. Expanded recognition systems and opportunities for advancement are required to increase nurses' job satisfaction and motivation. Equitable salary and fringe benefits are also needed to reduce their dissatisfaction with the job.

Project description:BackgroundMotivation is critical to health worker performance and work quality. In Bihar, India, frontline health workers provide essential health services for the state's poorest citizens. Yet, there is a shortfall of motivated and skilled providers and a lack of coordination between two cadres of frontline health workers and their supervisors. CARE India developed an approach aimed at improving health workers' performance by shifting work culture and strengthening teamwork and motivation. The intervention-"Team-Based Goals and Incentives"-supported health workers to work as teams towards collective goals and rewarded success with public recognition and non-financial incentives.MethodsThirty months after initiating the intervention, 885 health workers and 98 supervisors completed an interviewer-administered questionnaire in 38 intervention and 38 control health sub-centers in one district. The questionnaire included measures of social cohesion, teamwork attitudes, self-efficacy, job satisfaction, teamwork behaviors, equitable service delivery, taking initiative, and supervisory support. We conducted bivariate analyses to examine the impact of the intervention on these psychosocial and behavioral outcomes.ResultsResults show statistically significant differences across several measures between intervention and control frontline health workers, including improved teamwork (mean = 8.8 vs. 7.3), empowerment (8.5 vs. 7.4), job satisfaction (7.1 vs. 5.99) and equitable service delivery (6.7 vs. 4.99). While fewer significant differences were found for supervisors, they reported improved teamwork (8.4 vs. 5.3), and frontline health workers reported improved fulfillment of supervisory duties by their supervisors (8.9 vs. 7.6). Both frontline health workers and supervisors found public recognition and enhanced teamwork more motivating than the non-financial incentives.ConclusionsThe Team-Based Goals and Incentives model reinforces intrinsic motivation and supports improvements in the teamwork, motivation, and performance of health workers. It offers an approach to practitioners and governments for improving the work environment in a resource-constrained setting and where there are multiple cadres of health workers.

Project description:Background: In the last years, many changes have involved the labor context: new ways of working, more flexibility and uncertainty, new and more insecure job contracts. In this framework, perceived job insecurity, worker's perception about potential involuntary job loss, has received renewed interest, also for those workers with a permanent contract in Italy. Consequences of job insecurity on work-related outcomes such as job satisfaction have been demonstrated; nevertheless, its possible effects outside the workplace seem to be underestimated so far. Moreover, literature highlighted the importance to consider gender as a possible moderator in the relationship between one partner's stressors and the other partner's strain. Aim: According to spillover and crossover theories, this study aim was to investigate the relationship between job insecurity and family life satisfaction of both partners, through the mediation of job satisfaction. The model has been simultaneously tested in two groups, women and men, in a sample of permanent workers. Method: The research involved a convenience sample of 344 employees with permanent contract (53% female) from different occupational sectors. Participants (focal persons) and their partners filled out a self-report questionnaire. Results: The multi-group SEM indicated a full mediation of job satisfaction in the relationship between job insecurity on the one side, and both individual's and his/her partner's family life satisfaction on the other side in both groups. Conclusion: These study findings highlighted how job insecurity may be indirectly and negatively related to both members' family life satisfaction, through the mediation of job satisfaction. As regards gender, similar spillover and crossover patterns emerged, contributing to that literature that highlights a greater similarity in the models of interaction between work and family among women and men. Interventions should be aimed at reducing perception of job insecurity among workers, including those with permanent contract. Employers should improve communication and flow of information about future organizational changes. Moreover, interventions useful to monitor and reinforce employees' job satisfaction should be planned. Finally, career practitioners may provide counseling and coaching projects aimed at strengthening employees' employability and their ability to deal with changes.

Project description:BACKGROUND:To explore the nature of the relationship between and factors associated with productivity and performance among the community health volunteer (CHV) cadre (Village Health Teams, VHT) in Busia District, Eastern Uganda. The study was carried out to contribute to the global evidence on strategies to improve CHV productivity and performance. METHODS:This cross-sectional study was conducted with 140 VHT members as subjects and respondents. Data were collected between March and May 2013 on the performance and productivity of VHT members related to village visits and activities for saving maternal and child lives, as well as on independent factors that may be associated with these measures. Data were collected through direct observation of VHT activities, structured interviews with VHTs, and review of available records. The correlation between performance and productivity scores was estimated, and LASSO regression analyses were conducted to identify factors associated with these two scores independently. RESULTS:VHTs demonstrated wide variation in productivity measures, conducting a median of 13.2 service units in a three-month span (range: 2.0-114.9). Performance of the studied VHTs was generally high, with a median performance score (out of 100) of 96.4 (range: 50.9-100.0). We observed a weak correlation coefficient of 0.05 (p?=?0.57) between productivity and performance scores. Older VHT age (?50 years old, reference: <50 years old) (11.14, 95% CI: 3.26-19.01) and knowledge of danger signs (in units of ten-percentage points, 1.92, 95% CI: 0.01-3.83) were positively associated with productivity scores. Job satisfaction (1.46, 95% CI: 0.13-2.80) and knowledge of danger signs (in units of ten-percentage points, 1.02, 95% CI: 0.05-1.98) were positively associated with performance scores. CONCLUSIONS:Older VHT age and knowledge of danger signs were positively associated with productivity, and job satisfaction and knowledge of danger signs were positively associated with performance. No correlation was observed between productivity and performance scores. This lack of correlation suggests that interventions to improve CHV effectiveness may affect the two dimensions of effectiveness differently. We recommend that productivity and performance both be monitored to evaluate the overall impact of interventions to increase CHV effectiveness.

Dataset Information

The relationship between leadership style and health worker motivation, job satisfaction and teamwork in Uganda.

Publications

The relationship between leadership style and health worker motivation, job satisfaction and teamwork in Uganda.

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