Influence of Health Approaches on Job Satisfaction Among Healthcare Workers: a Case of Tier 3 Public Hospitals in Busia County, Kenya

Abstract

One of the greatest challenges facing the Ministry of Health has been to device and adopt a win –win practice, that which will lead to high productivity among its stretched workforce and at the same time mitigate staff turnover and absenteeism. This is because human resource remains the most important resource and the driving pillar to enable them deliver optimally to meet the overall health goals. This study aimed to understand the effects of health approaches on job satisfaction among healthcare workers stationed at the main county referral hospital and the 6 sub-county hospitals categorized as tier 3 facilities within Busia County. The study aimed to establish whether career advancement, health financial autonomy, motivation and status of workplace environment had an influence on job satisfaction among the health workers of the aforementioned health institutions. The study adopted a descriptive survey research design. 2 types of data collection tools were used; questionnaire and Focused Group Discussion. 191 out of 214 healthcare workers from the seven county and sub county hospitals within the county constituted the sample, with cluster sampling as the main sampling technique applied. Qualitative and quantitative methods were used to analyse data with the aid of statistical package for social science (SPSS) version 23. Frequency distribution tables were used to present data which was followed by interpretation then discussion. From the analysis, 88.7% of the respondents said they were able to use their abilities well, with a further 63% admitting there were opportunities for career advancement. On health finance autonomy, a significant majority pointed out that they were not in control of the user fees generated at the facility level thus compromised on their ability to respond to emergencies, thus lowering their job satisfaction. On motivation influencing job satisfaction, 67.1% of the respondents said they do not receive recognition for exemplary performance from their supervisors. Also, 78.6 of the respondents said there was no linkage between performance and pay. Promotion was also identified as a key factor in boosting staff morale, with 85% of those who had been promoted over the last 4 years admitting it had impacted positively on their work. The study also revealed work environment influences job satisfaction. The major concern identified here was lack of adequate infrastructure, dilapidated or non-availability of equipment and inconsistent supply of drugs and non-pharmaceuticals, which was affecting their passion for work. The study noted that health workers in tier 3 public facilities are moderately satisfied with their job. On health worker socio demographic trends with job satisfaction, the study revealed that years in service was statistically significant with the overall level of job satisfaction ie p<0.05. Further analysis revealed that health worker who has served for less than 5 years was 11 times more likely to have higher satisfaction than those that have served more years. The study recommends that the department fully embraces performance contracting as a basis for rewarding performance, revert back ownership of user fees to the facilities, the department’s human resource unit avails opportunities for training and the department to complete the building projects initiated across the tier 3 facilities across the county and equipping them.