What elements of the work environment are most responsible for health worker dissatisfaction in rural primary care clinics in Tanzania?
What elements of the work environment are most responsible for health worker dissatisfaction in rural primary care clinics in Tanzania?
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DOI：
10.1186/1478-4491-12-38
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发表时间：
2014-08-03
影响因子：
4.5
通讯作者：
Kruk, Margaret E.
中科院分区：
文献类型：
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作者：
Mbaruku, Godfrey M.;Larson, Elysia;Kruk, Margaret E.
背景：在孕产妇和新生儿发病率和死亡率较高的国家，农村地区可靠地获得高质量的医疗保健对于挽救生命至关重要。对工作满意的卫生工作者更有可能留在农村岗位。了解哪些因素影响卫生工作者的满意度，有助于确定应将资源集中在哪里。尽管有越来越多的研究评估医院卫生工作者的满意度，但对农村初级卫生诊所卫生工作者满意度的了解较少。本研究探讨坦桑尼亚农村初级卫生诊所卫生工作者的工作满意度。方法：总体上，坦桑尼亚农村卫生工作者参与了一项自我管理的工作满意度调查。我们计算了工作环境17个方面的平均评分。我们使用主成分分析(PCA)来确定这些变量的分组。结果：73.9%的医务人员强烈认同他们对自己的工作感到满意，但只有11.6%的人强烈同意他们对自己的薪酬水平感到满意，2.9%的人对设备和用品的可用性感到满意。PCA产生了两类因素：提供护理的工具和基础设施，以及支持性的人际环境。护士和医务人员(与临床医生相比)和老年卫生工作者的满意度较高。结论：卫生工作者工作环境的两个维度，即基础设施和支持性人际工作环境，解释了坦桑尼亚基层卫生诊所卫生工作者满意度的大部分差异。卫生工作者通常对支持性的人际关系比对基础设施更满意。人力资源政策应考虑如何改进这两个方面的工作，以此作为提高卫生工作者士气和潜在的农村自然减员的手段。
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.