Job adjustment predictive factors of healthcare midwives in health system reform in Iran

Abstract

Background Having sensitive duties and multiple responsibilities in the country's health system, especially after the implementation of the health reform in Iran, midwives need to be able to perform their duties optimally in their new job position as healthcare providers. However, it is not clear to what extent the midwives have adjusted to their new roles and related duties since the implementation of this plan in the country. The aim of the present study was to determine the predictive factors of job adjustment of healthcare midwives in Iran. Methods In this cross-sectional analytical study, 310 midwives were selected from 209 health centers of West Azarbaijan province in Iran and entered the study by census method to answer the research questionnaires. Data were collected using job adjustment, job satisfaction and organizational commitment scales. For data analysis, SPSS software version 25 was used to calculate coefficients of ANOVA and multiple linear regression tests. Moreover, to determine predictive variables, path analysis was used by AMOS software. Results The mean age of the participants was 37.67 ± 7.1 years. Most of the participants (35.5%) were interested in their occupation as a midwife, and mostly had a medium to high tendency (76.1%) to stay in their new profession. Additionally, 58.1% of the participants had moderate job adjustment. "Desire to stay in the midwifery profession" and "organizational commitment" were important predictors of job adjustment for healthcare midwives. “Desire to stay in the midwifery profession”, with a direct effect, and “interest in the new profession” with an indirect effect affected the job adjustment of midwives. Moreover, “adequacy of income to expenses”, “job satisfaction” and “organizational commitment” through the mediating role of the “desire to stay in the profession” can directly and indirectly affect their job adjustment. Conclusion Based on the results of this study, in order to make midwives more adjusted to their role as healthcare provider midwife, organizational managers should focus their efforts and planning mainly on providing incentives to increase the longevity of staying in the profession of midwifery in order to increase job adjustment, job satisfaction and organizational commitment, thereby, improving the quality-of-service delivery.