比较坦桑尼亚、马拉维和南非不同类别的卫生工作者的工作满意度和离职意愿。
Comparing the job satisfaction and intention to leave of different categories of health workers in Tanzania, Malawi, and South Africa.
机构信息
Centre for Health Policy, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
出版信息
Glob Health Action. 2013 Jan 24;6:19287. doi: 10.3402/gha.v6i0.19287.
BACKGROUND
Job satisfaction is an important determinant of health worker motivation, retention, and performance, all of which are critical to improving the functioning of health systems in low- and middle-income countries. A number of small-scale surveys have measured the job satisfaction and intention to leave of individual health worker cadres in different settings, but there are few multi-country and multi-cadre comparative studies.
OBJECTIVE
The objective of this study was to compare the job satisfaction and intention to leave of different categories of health workers in Tanzania, Malawi, and South Africa.
METHODS
We undertook a cross-sectional survey of a stratified cluster sample of 2,220 health workers, 564 from Tanzania, 939 from Malawi, and 717 from South Africa. Participants completed a self-administered questionnaire, which included demographic information, a 10-item job satisfaction scale, and one question on intention to leave. Multiple regression was used to identify significant predictors of job satisfaction and intention to leave.
RESULTS
There were statistically significant differences in job satisfaction and intention to leave between the three countries. Approximately 52.1% of health workers in South Africa were satisfied with their jobs compared to 71% from Malawi and 82.6% from Tanzania (χ2=140.3, p<0.001). 18.8% of health workers in Tanzania and 26.5% in Malawi indicated that they were actively seeking employment elsewhere, compared to 41.4% in South Africa (χ2=83.5, p<0.001). The country differences were confirmed by multiple regression. The study also confirmed that job satisfaction is statistically related to intention to leave.
CONCLUSIONS
We have shown differences in the levels of job satisfaction and intention to leave between different groups of health workers from Tanzania, Malawi, and South Africa. Our results caution against generalising about the effectiveness of interventions in different contexts and highlight the need for less standardised and more targeted HRH strategies than has been practised to date.
背景
工作满意度是激励卫生工作者、留住卫生工作者和提高其工作表现的重要决定因素，而这些因素对于改善中低收入国家卫生系统的运行都至关重要。一些小规模调查已经测量了不同环境下个别卫生工作者群体的工作满意度和离职意愿，但很少有多国和多群体的比较研究。
目的
本研究旨在比较坦桑尼亚、马拉维和南非不同卫生工作者群体的工作满意度和离职意愿。
方法
我们对分层整群抽样的 2220 名卫生工作者进行了横断面调查，其中 564 名来自坦桑尼亚，939 名来自马拉维，717 名来自南非。参与者完成了一份自我管理的问卷，其中包括人口统计学信息、10 项工作满意度量表和一个关于离职意愿的问题。多回归用于确定工作满意度和离职意愿的显著预测因素。
结果
三个国家的工作满意度和离职意愿存在统计学差异。南非约有 52.1%的卫生工作者对其工作满意，而马拉维和坦桑尼亚分别有 71%和 82.6%的卫生工作者满意（χ2=140.3，p<0.001）。坦桑尼亚有 18.8%的卫生工作者和马拉维有 26.5%的卫生工作者表示正在积极寻找其他工作机会，而南非只有 41.4%（χ2=83.5，p<0.001）。多回归证实了国家间的差异。该研究还证实，工作满意度与离职意愿呈统计学相关。
结论
我们已经表明，来自坦桑尼亚、马拉维和南非的不同卫生工作者群体之间的工作满意度和离职意愿存在差异。我们的研究结果告诫人们不要对不同背景下干预措施的效果进行泛化，并强调需要制定比目前更为标准化和有针对性的卫生人力资源战略。
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