The present study provides information regarding the factors associated with job satisfaction among health workers at a regional referral hospital in Uganda, Arua Regional Referral Hospital. To be able to perform, the health work force requires an enabling environment which could be created by drawing health workforce policy reforms that are based on a thorough understanding of their working conditions. It is therefore paramount to understand what aspects motivate health workers and to what factors influence their satisfaction. If not satisfied, health workers would absent themselves from work, become less productive or even leave the hospital. The information generated by this study could guide the revision of strategic plans to suit the factors that were raised by the participants. It also provides information to bridge the knowledge gap in relation to level of satisfaction and its associated factors among health workers in public facilities. From the current study, the level of job satisfaction among the health workers was 60.7% (fair) while factors associated with job satisfaction included health worker age, sex, religion and duration in practice.
The overall level of job satisfaction indicated that 6 in every 10 health workers at Arua Regional Referral Hospital were satisfied with their job. This job satisfaction level is low given the problems that would arise if workers in a hospital setting were not satisfied with their job. In fact, health workers who are not satisfied with their job will most likely absent themselves from work or even offer poor services leaving most of the work to lower cadres such as internship doctors and training nurses[13]. The recruitment and selection human resource policy requires that the ministry/ management of the hospital procures suitably educated and efficient personnel by offering relative wages, good working conditions, safety and security, and better future prospects for the health professionals. Like other public health facilities in Uganda, Arua Regional Referral hospital may have high rates of absenteeism and poor service delivery (Unpublished literature). With high rates of absenteeism and poor service delivery, it is obvious that there will be increased mortalities especially maternal & neonatal mortalities and poor diagnosis of diseases[14].
Results from the multivariable analysis showed that satisfaction with the job increases with increase in the age of a health worker. As such, health workers aged between 35 and 39 years had a 46% higher prevalence of job satisfaction when compared to those aged below 25 years. Similarly, health workers aged 40 and above were 3 times more likely to be satisfied with their job compared to those aged below 25 years. This finding can be explained by the fact that the desire to learn and acquire more experience gives younger professionals a more positive perspective on certain aspects of their job. These same aspects of the job cause workers in the intermediate age range to express dissatisfaction. Similarly, the greater experience of older professionals allows them to better adapt to the job in many cases, and their experience also gives them a more objective point of view about those aspects of the job that cause other professionals dissatisfaction (e.g., their relationship with managerial professionals and the way in which the hospital operates)[15]
The female health workers participating the current study had a 30% significantly higher prevalence of job satisfaction compared to their male counterparts. In the healthcare field, substantial progress toward gender working equality has been made in the past few decades. The increase in the proportion of women in medical schools denotes that women are receiving more equal educational and professional opportunities[16].
The results also showed that satisfaction with the job reduced with increase with the duration in service. As such, health workers who had worked for 5 - <10 years were 40% less likely to be satisfied with their job compared to those who had been in service for less than a year. In addition,
those who had worked for 10 or more years were 56% less likely to be satisfied with their job compared to their less than a year counterparts. This finding can be explained by the fact that workers who have been in service for less than a year will very much have a strong desire to learn and acquire more experience hence having a more positive perspective on certain aspects of their job and eventually expressing satisfaction with the job that they have just acquired.
Health workers who were of Islam faith had significantly higher levels of job satisfaction. Indeed, business ethics studies have linked job satisfaction to spirituality due to aspects related to work-related values and attitudes of health workers. Other studies have also attempted to explore the relation of Islam to work attitudes such as job satisfaction and have found similar findings as those in the current study[17].
Results from the principal component analysis indicated that health professionals get some kind of recognition from their peers while doing their job, those who are recognized by other professional groups as well as recognition from the general public contributed significantly to the overall job satisfaction. Recognition would involve acknowledgement and appreciation of the health professional’s work by either their peers, the general public or even people in other professions other than health. When individuals are recognized, to them, it would be a sign that the effort they put in the work is valued and appreciated for the benefit of retention. Similar findings have been reported in studies in Pakistan[18] and from evidence from several organizations in Switzerland[19]
With regard to autonomy, those with an opportunity to think independently contributed significantly to the overall job satisfaction. This can be explained by the fact that those who are able to think independently are able to pull off job tasks even when there is minimum supervision and management[20].
Having a good relationship with a co-worker as well as team work contributed significantly to the overall job satisfaction levels among health professionals at Arua Regional Referral Hospital. Chang et al. showed that interprofessional teamwork was one of the most important predictors of job satisfaction in their study[21].
It was also not surprising that having an opportunity for on job training also impacted the job satisfaction of the health workers at Arua Regional Referral Hospital. Individuals who have such opportunities will indeed vision on job training as a chance to grow themselves professionally as well contribute to the overall goal of the organization/ institution.
The leadership style employed at the regional referral hospital was as well indicative of a positive influencer of improved job satisfaction. Prior studies have indicated that job satisfaction significantly depends on the leadership style[22].
This study was without some limitations. Some responses from the participants were based on objectivity (self-reports) which could have limited the truthfulness and hence information bias. This may also have led to the overestimation or underestimation of the attributes leading to measurement of satisfaction. To minimize information bias, the participants were briefed about the study and assured of how the responses would only be used for research purposes. Selection bias could also be present in this study because data was collected within just a short period. Participants who were selected could have therefore been those who were available at that particular time of the study when they are supposed to be there. To reduce selection bias, all participants reachable were included to obtain a representative sample. The study also suffered from the usual limitation of a cross sectional study. The sample size was relatively small and restricted to health care providers at Arua Regional Referral Hospital. Consequently, the findings may not be generalized to health workers in other regional referral hospitals.
In conclusion, the study highlights the level of job satisfaction among health workers at Arua Regional Referral Hospital in Uganda. The findings show that the job satisfaction level is relatively low, which is a concern, given the impact it could have on the quality of services provided to patients. The study also identifies the factors associated with job satisfaction among healthcare professionals, including age, sex, religion, duration of practice, and recognition. Health worker policy reforms based on these findings could help create an enabling environment that motivates healthcare professionals and increases job satisfaction. The results of this study can inform the revision of strategic plans to improve job satisfaction among health workers at Arua Regional Referral Hospital and other public health facilities in Uganda. Ultimately, improving job satisfaction among healthcare professionals is critical to improving the quality of health services and reducing mortality rates in Uganda.
Based on the findings of this study, several recommendations were made to improve job satisfaction among health workers at Arua Regional Referral Hospital: a) Implement policies that promote a better work environment: The study highlights the need for an enabling work environment to promote job satisfaction among health workers. Hospital management and policymakers should prioritize policies that improve working conditions, safety, security, and future prospects for health professionals; b) Consider age, sex, and duration of practice in human resource policies: The study indicates that age, sex, and duration of practice are factors that influence job satisfaction among health workers. Therefore, human resource policies should take these factors into account when designing recruitment, retention, and promotion policies; c) Provide recognition and appreciation to health professionals: Recognition and appreciation of the work done by health professionals are important factors that contribute to job satisfaction. Therefore, hospital management should implement policies that promote recognition of the work done by health professionals both within and outside the healthcare industry and d) Conduct regular job satisfaction surveys: Regular surveys can help identify factors that influence job satisfaction among health workers at Arua Regional Referral Hospital. Hospital management should conduct regular surveys to gather feedback from their staff and use the results to improve job satisfaction levels.