Stigma, an important source of dissatisfaction of health workers in HIV response in Vietnam: a qualitative study

Abstract

BackgroundLike in many other low- and middle-income countries, the recent development of an HIV epidemic in Vietnam has led to a growing need for prevention, treatment, care, and support services for people living with HIV (PLHIV). This puts greater demands on the national HIV services, primarily on health workers, which increases the importance of their job satisfaction and working conditions. This study describes health worker perceptions and explores the factors that influence job satisfaction and dissatisfaction of health personnel working on the HIV response in Vietnam. Spector’s job satisfaction model was used as the theoretical framework for the study design and analysis.MethodsThe study employed a qualitative design with 7 focus group discussions and 15 semi-structured interviews with health workers, purposively selected from national and provincial organizations responsible for HIV services in 5 cities and provinces in Vietnam. Data were analyzed using a hybrid approach of theory-driven and data-driven coding and theme development using qualitative analysis software.ResultsHIV services are perceived by Vietnamese health workers as having both positive and negative aspects. Factors related to job satisfaction included training opportunities, social recognition, and meaningful tasks. Factors related to job dissatisfaction included unsatisfactory compensation, lack of positive feedback and support from supervisors, work-related stress from a heavy workload, fear of infection, and HIV-related stigma because of association with PLHIV. An adjusted Spector’s model of job satisfaction for HIV service health workers was developed from these results.ConclusionThis study confirmed the relationship between stigmatization of PLHIV and stigma experienced by staff because of association with PLHIV from families, colleagues, and society. The experiencing stigma results in additional work-related stress, low self-esteem, poor views of their profession, and lower income. The study shows the importance of actions to improve staff job satisfaction such as pay raises, supportive supervision, stress management, stigma reduction and workplace safety. Immediate actions could be the provision of more information; education and communication in mass media to improve the public image of HIV services, as well as improvement of workplace safety, therefore making health workers feel that their work is valued and safe.

Model to Reduce HIV Related Stigma among Indonesian Nurses

“…Job satisfaction describes how people feel about their jobs-whether they like or dislike their jobs [12]. Job dissatisfaction has been cited as the primary reason for high turnover and absenteeism, which in turn poses a IJPHS ISSN: 2252-8806 …”

“…189 threat to organizations' capacities to provide quality service and meet the needs of customers [12]. Studies have shown that dissatisfied employees are more likely to quit their jobs or be absent than satisfied employees [12].…”

“…Studies have shown that dissatisfied employees are more likely to quit their jobs or be absent than satisfied employees [12]. Therefore, increasing job satisfaction and organizational commitment are potentially good strategies for reducing absenteeism and turnover intentions [12].…”

“…Studies have shown that dissatisfied employees are more likely to quit their jobs or be absent than satisfied employees [12]. Therefore, increasing job satisfaction and organizational commitment are potentially good strategies for reducing absenteeism and turnover intentions [12]. Spector's job satisfaction survey assesses job satisfaction through nine job facets: pay, promotion, supervision, fringe benefits, contingent rewards, operating procedures, co-workers, nature of work, and communication [12].…”

“…Therefore, increasing job satisfaction and organizational commitment are potentially good strategies for reducing absenteeism and turnover intentions [12]. Spector's job satisfaction survey assesses job satisfaction through nine job facets: pay, promotion, supervision, fringe benefits, contingent rewards, operating procedures, co-workers, nature of work, and communication [12]. UNAIDS defines HIV-related stigma as "a process of devaluation of people either living with or associated with HIV" [12] .…”