Balancing workload, motivation and job satisfaction in Rwanda: assessing the effect of adding family planning service provision to community health worker duties.
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ABSTRACT:
SUBMITTER: Chin-Quee D
PROVIDER: S-EPMC4702334 | biostudies-other | 2016 Jan
REPOSITORIES: biostudies-other
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Project description:BackgroundLeadership 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.MethodWe 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.ResultsHealth 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).ConclusionTransformational 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.RecommendationSupporting 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.
| S-EPMC5922238 | biostudies-literature
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.
| S-EPMC4130118 | biostudies-literature
Project description:The study investigated perception of workload balance and employee job satisfaction in work organisations. It sought to find out the extent to which employee perception of workload balance influences job satisfaction. Seven hundred and sixty-four (764) randomly selected employees from 8 multinational organizations and two private universities in Nigeria participated in the study. Structural equation modelling was employed. Results show that comparison of workload with those of colleagues and employees' role alliance with their competencies significantly influence their perception of workload balance and job satisfaction, organisation's staff strength influences perception of workload balance and employees' perception of workload balance significantly influences job satisfaction.
| S-EPMC6953715 | biostudies-literature
Project description:BackgroundNurses and midwives are a critical part of the healthcare team and make up the largest section of health professionals. Leadership styles are believed to be an important determinant of job satisfaction and retention making effective leadership within nursing and midwifery crucial to health systems success. In Rwanda, there are gaps in knowledge of managerial leadership styles of nurses and midwives and the influence of these styles on job satisfaction and retention for nurses and midwives who report to them, as well as their influence on the provision of health services. This study describes the managerial leadership styles adopted by nurses/midwives and examines the relationship between managerial leadership styles and job satisfaction, intention to stay, and service provision.MethodsThe Path-Goal Leadership questionnaire was adopted and used to collect data on leadership styles while other questionnaires with high validity and reliability were used to collect data on job satisfaction, intention to stay and service provision. The study involved 162 full-time nurses and midwives practicing in 5 selected hospitals with a minimum of 6 months of experience working with their current direct managers. Regression analysis was used to draw conclusions on relationships between variables.ResultsNurses and midwives managers were more inclined to the directive leadership style followed by a supportive leadership style, and the participative leadership style. The nurse and midwife’s managerial leadership styles together significantly explained 38, 10 and 23% of the variance in job satisfaction, intention to stay and service provision, respectively.ConclusionThe findings of this study indicate that managerial leadership styles play a substantial role in enhancing job satisfaction, intention to stay and service provision.The implication for nursing and midwifery managementThere is a need to develop a comprehensive formal professional continuous development course on leadership styles and ensure that all nurses and midwives managers benefit from this course prior to or immediately after being appointed as a manager. Having such a course may even prepare future leaders for their role early in their career. Effective leadership in nursing and midwifery should be enhanced at all levels to improve the job satisfaction of nurses and midwives, address the issue of retention in their respective health facilities and strengthen service provision.
| S-EPMC7201775 | biostudies-literature
Project description:This study uses latent semantic analysis (LSA) to explore how prevalent measures of motivation are interpreted across very diverse job types. Building on the Semantic Theory of Survey Response (STSR), we calculate “semantic compliance” as the degree to which an individual’s responses follow a semantically predictable pattern. This allows us to examine how context, in the form of job type, influences respondent interpretations of items. In total, 399 respondents from 18 widely different job types (from CEOs through lawyers, priests and artists to sex workers and professional soldiers) self-rated their work motivation on eight commonly applied scales from research on motivation. A second sample served as an external evaluation panel (n = 30) and rated the 18 job types across eight job characteristics. Independent measures of the job types’ salary levels were obtained from national statistics. The findings indicate that while job type predicts motivational score levels significantly, semantic compliance as moderated by job type job also predicts motivational score levels usually at a lesser but significant magnitude. Combined, semantic compliance and job type explained up to 41% of the differences in motional score levels. The variation in semantic compliance was also significantly related to job characteristics as rated by an external panel, and to national income levels. Our findings indicate that people in different contexts interpret items differently to a degree that substantially affects their score levels. We discuss how future measurements of motivation may improve by taking semantic compliance and the STSR perspective into consideration.
| S-EPMC7316959 | biostudies-literature
Project description:Understanding health worker job preferences can help policymakers better align incentives to retain a motivated workforce in the public sector. However, in stated preference choice modelling, health worker motivation to do their jobs has not been incorporated, perhaps surprisingly, as an important antecedent to health worker job choices. This paper is the first application of a hybrid choice model to measure the extent to which variations in the job preferences of community health workers (CHWs) can be explained by multidimensional motivation. We interviewed 202 CHWs in Ethiopia in 2019. Motivation was assessed quantitatively using a series of thirty questions, on a five-point Likert scale. Stated preferences for hypothetical jobs were captured using an unlabelled discrete choice experiment. We estimated three models and explored which best fitted choice data. We found that the hybrid choice model fitted better than simpler choice models and provides additional behavioural insight into the preferences of CHWs. Intrinsically motivated CHWs had strong disutility towards a higher than average salary, but preferred good facility quality and good health outcomes. On the contrary, CHWs who were assessed to be extrinsically motivated had disutility attached to a heavy workload and preferred higher than average salaries. We show a link between heterogeneity in the job preferences of CHWs and their motivation, demonstrating that its important for policy makers and managers to understand this link in order to get health workers to exert more effort in return for the right incentives and to retain a motivated workforce in the long run.
| S-EPMC7614882 | biostudies-literature
Project description:BackgroundEthiopia has been providing health care to its rural population since 2004 using female Community Health Workers called Health Extension Workers (HEWs). The HEWs are credited with several achievements in improving the country's health indicators. However, information about the HEWs' motivation and job satisfaction is limited. The aim of this study was to assess the HEWs' motivation and job satisfaction, as well as the factors that influence them.MethodsA mixed-methods study was nested within a national health extension program assessment conducted from March 01 to May 31, 2019. A structured questionnaire which looked at motivation and satisfaction with Likert type single-question and multiple-item measures was used to collect quantitative data from 584 HEWs. Focus group discussion and in-depth interviews were used to gather qualitative data. Means and percentages were used to descriptively summarize important variables. Linear regression was used to identify factors associated with job satisfaction. The qualitative data was analysed thematically.ResultsOverall, 48.6% of HEWs were satisfied with their job, with a mean score of 2.5 out of 4.0. The result showed a high level of satisfaction with autonomy (72%), relationships with co-workers (67%), and recognition (56%). Low level of satisfaction was linked to pay and benefits (13%), opportunities for promotion (29%), and education (34%). Regression analysis showed that HEWs in the age category of 30 years and older had lower satisfaction scores as compared to HEWs in the age category of 18-24 years (adjusted β = - 7.71, 95% CI: - 14.42, - 0.99). The qualitative result revealed that desire to help their community, recognition or respect gained from the community, and achievement were the major motivating factors. In contrast, inadequate pay and benefit, limited education and career advancement opportunities, workload, work environment, limited supportive supervision, and absence of opportunity to change workplace were the demotivating factors.ConclusionsThe overall job satisfaction of HEWs was low; extrinsic factors, such as inadequate pay, limited education and career advancement opportunities were the major sources of demotivation. Policy makers and human resource managers should revise their human resource policies and guidelines to address the main sources of low level of job satisfaction and demotivation.
| S-EPMC10152586 | biostudies-literature
Project description:BackgroundRecent research has shown that a high degree of task delegation is associated with the practise staff's overall job satisfaction, and this association is important to explore since job satisfaction is related to medical as well as patient-perceived quality of care.ObjectivesThis study aimed: (1) to investigate associations between degrees of task delegation in the management of chronic disease in general practice, with chronic obstructive pulmonary disease (COPD) as a case and the staff's work motivation, (2) to investigate associations between the work motivation of the staff and their job satisfaction.MethodsThe study was based on a questionnaire to which 621 members of the practice staff responded. The questionnaire consisted of a part concerning degree of task delegation in the management of COPD in their respective practice and another part being about their job satisfaction and motivation to work.ResultsIn the first analysis, we found that 'maximal degree' of task delegation was significantly associated with the staff perceiving themselves to have a large degree of variation in tasks, odds ratio (OR) = 4.26, confidence interval (CI) = 1.09, 16.62. In the second analysis, we found that this perceived large degree of variation in tasks was significantly associated with their overall job satisfaction, OR = 2.81, confidence interval = 1.71, 4.61.ConclusionThe results suggest that general practitioners could delegate highly complex tasks in the management of COPD to their staff without influencing the staff's work motivation, and thereby their job satisfaction, negatively, as long as they ensure sufficient variation in the tasks.
| S-EPMC6192095 | biostudies-literature
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.
| S-EPMC6794848 | biostudies-literature
Project description:AimTo determine the level of job satisfaction of nursing professionals in Slovenian hospitals and factors influencing job satisfaction in nursing.MethodsThe study included 4 hospitals selected from the hospital list comprising 26 hospitals in Slovenia. The employees of these hospitals represent 29.8% and 509 employees included in the study represent 6% of all employees in nursing in Slovenian hospitals. One structured survey questionnaire was administered to the leaders and the other to employees, both consisting 154 items evaluated on a 5 point Likert-type scale. We examined the correlation between independent variables (age, number of years of employment, behavior of leaders, personal characteristics of leaders, and managerial competencies of leaders) and the dependent variable (job satisfaction - satisfaction with the work, coworkers, management, pay, etc) by applying correlation analysis and multivariate regression analysis. In addition, factor analysis was used to establish characteristic components of the variables measured.ResultsWe found a medium level of job satisfaction in both leaders (3.49±0.5) and employees (3.19±0.6), however, there was a significant difference between their estimates (t=3.237; P=lt;0.001). Job satisfaction was explained by age (Plt;0.05; β=0.091), years of employment (Plt;0.05; β=0.193), personal characteristics of leaders (Plt;0.001; β=0.158), and managerial competencies of leaders (Plt;0.000; β=0.634) in 46% of cases. The factor analysis yielded four factors explaining 64% of the total job satisfaction variance.ConclusionSatisfied employees play a crucial role in an organization's success, so health care organizations must be aware of the importance of employees' job satisfaction. It is recommended to monitor employees' job satisfaction levels on an annual basis.
| S-EPMC3368291 | biostudies-literature