Job satisfaction and turnover intentions among health care staff providing services for prevention of mother-to-child transmission of HIV in Dar es Salaam, Tanzania

Abstract

BackgroundOption B+ for the prevention of mother-to-child transmission (PMTCT) of HIV (i.e., lifelong antiretroviral treatment for all pregnant and breastfeeding mothers living with HIV) was initiated in Tanzania in 2013. While there is evidence that this policy has benefits for the health of the mother and the child, Option B+ may also increase the workload for health care providers in resource-constrained settings, possibly leading to job dissatisfaction and unwanted workforce turnover.MethodsFrom March to April 2014, a questionnaire asking about job satisfaction and turnover intentions was administered to all nurses at 36 public-sector health facilities offering antenatal and PMTCT services in Dar es Salaam, Tanzania. Multivariable logistic regression models were used to identify factors associated with job dissatisfaction and intention to quit one’s job.ResultsSlightly over half (54%, 114/213) of the providers were dissatisfied with their current job, and 35% (74/213) intended to leave their job. Most of the providers were dissatisfied with low salaries and high workload, but satisfied with workplace harmony and being able to follow their moral values. The odds of reporting to be globally dissatisfied with one’s job were high if the provider was dissatisfied with salary (adjusted odds ratio (aOR) 5.6, 95% CI 1.2–26.8), availability of protective gear (aOR 4.0, 95% CI 1.5–10.6), job description (aOR 4.3, 95% CI 1.2–14.7), and working hours (aOR 3.2, 95% CI 1.3–7.6). Perceiving clients to prefer PMTCT Option B+ reduced job dissatisfaction (aOR 0.2, 95% CI 0.1–0.8). The following factors were associated with providers’ intention to leave their current job: job stability dissatisfaction (aOR 3.7, 95% CI 1.3–10.5), not being recognized by one’s superior (aOR 3.6, 95% CI 1.7–7.6), and poor feedback on the overall unit performance (aOR 2.7, 95% CI 1.3–5.8).ConclusionJob dissatisfaction and turnover intentions are comparatively high among nurses in Dar es Salaam’s public-sector maternal care facilities. Providing reasonable salaries and working hours, clearer job descriptions, appropriate safety measures, job stability, and improved supervision and feedback will be key to retaining satisfied PMTCT providers and thus to sustain successful implementation of Option B+ in Tanzania.Electronic supplementary materialThe online version of this article (10.1186/s12960-017-0235-y) contains supplementary material, which is available to authorized users.

Costs of streamlined HIV care delivery in rural Ugandan and Kenyan clinics in the SEARCH Study

“…Lastly, employing MOH-salaried clinic staff reduced costs modestly (8%). However, lower salaries must be cautiously approached as they have been linked to lower clinician performance and shortening of clinic hours [ 43 ], possibly challenging streamlined care adoption. Nevertheless, the fact that our model expanded services overall (with viral load testing and NCD care) while remaining cost-neutral and in some cases reducing costs, should create optimism that streamlined care models will be crucial for ongoing ART expansion.…”

WITHDRAWN: Humorous Dispositions Predicting Turnover among Early-Career Israeli Medical Clowns

“…Medical staff turnover has been identi ed as a global concern. Its rami cations extend to nancial loss along with impairing patient treatment and health outcomes [9,26]. High turnover rates may affect the treatment e ciency due to the costs associated with recruitment and orientation of the newly hired clowns.…”

Human Resource Management for Ghanaian Nurses: Job Satisfaction Versus Turnover Intentions

“…The constructs of nurses' turnover intentions and nurses' job satisfaction have both been studied in at least eight previous investigations in surveys related to nurses (Bonenberger et al [18]; Lum et al [29]; Naburi et al [35]; Gieter, Hofmans, and Pepermans [36]; Murrells, Robinson, and Griffiths [37]; Delobelle et al [39]; Gillet et al [58]; Ekici, Cerit, and Mert [78]). The goodness-of-fit statistics of the current study's model were very good, suggesting a very good fit of data on the model.…”

“…The highest percentage of participants (19.7%) had been working in the nursing profession for three years, while 30.2% had been working for 2 years with their current employer. Of the participants, 26.9% were aged between 18-25, 54.4% between [26][27][28][29][30][31][32][33][34][35]13.8% between 36-45, 2.5% between 46-55 and 2.5% were 56 and above. The majority of participants were female (72%), and concerning the marital status of the participants, 60.1% were single, 39.3% married, and 0.6% in other categories.…”