Working relationships between obstetric care staff and their managers: a critical incident analysis

Abstract

BackgroundMalawi continues to experience critical shortages of key health technical cadres that can adequately respond to Malawi’s disease burden. Difficult working conditions contribute to low morale and frustration among health care workers. We aimed to understand how obstetric care staff perceive their working relationships with managers.MethodsA qualitative exploratory study was conducted in health facilities in Malawi between October and December 2008. Critical Incident Analysis interviews were done in government district hospitals, faith-based health facilities, and a sample of health centres’ providing emergency obstetric care. A total of 84 service providers were interviewed. Data were analyzed using NVivo 8 software.ResultsPoor leadership styles affected working relationships between obstetric care staff and their managers. Main concerns were managers’ lack of support for staff welfare and staff performance, lack of mentorship for new staff and junior colleagues, as well as inadequate supportive supervision. All this led to frustrations, diminished motivation, lack of interest in their job and withdrawal from work, including staff seriously considering leaving their post.ConclusionsPositive working relationships between obstetric care staff and their managers are essential for promoting staff motivation and positive work performance. However, this study revealed that staff were demotivated and undermined by transactional leadership styles and behavior, evidenced by management by exception and lack of feedback or recognition. A shift to transformational leadership in nurse-manager relationships is essential to establish good working relationships with staff. Improved providers’ job satisfaction and staff retentionare crucial to the provision of high quality care and will also ensure efficiency in health care delivery in Malawi.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1694-x) contains supplementary material, which is available to authorized users.

Perceptions and predictors of organizational justice among healthcare professionals in academic hospitals in South-Eastern Nigeria

“…Notwithstanding its high perception, interactional justice was limited by reduced information sharing with, and lack of respect for subordinates, by supervisors among all professional sub-groups. Our findings support the evidence that health managers tend to be unsupportive, lack respect for junior staff and provide negative feedbacks during supervision [2,4,[18][19][20][21][23][24][25][26][27]. The study further revealed that nurses and AHPs had significantly lower perception of interactional justice than doctors, which contrasts insignificant differences in interactional justice between doctors and non-doctors found in a previous Nigerian study [11].…”

“…Perception of unfairness in salaries decreased perception of distributive justice among healthcare professionals [3,11,[13][14][15][16][17][18][19][20]. In Tanzania, the experience of being by-passed by colleagues with shorter working experience and longer formal training was most dissatisfying for health workers with longer working experience [14].…”

“…In Malawi, lack of clear criteria for promotion after upgrading their qualification decreased distributive justice among nursing staff and clinical officers [19]. Access to training differed among different categories of nurses in Tanzania and Malawi [14,20]. Doctors, unlike other health professionals, have access to residency training [17].…”

“…Doctors lacked respect for other health professional [16]. Health managers tend to be authoritarian, unsupportive, overuse behavioral control, lack respect for junior staff and provide negative feedbacks during supervision [2,4,[18][19][20][21][23][24][25][26][27].…”

The influence of supervisor/subordinate social support on employee performance in the South African retail sector

“…Scholars of social support agreed that the concept is a positive tool to enhance interpersonal relationships among cadres of employees (Chipeta, Bradley, Chimwaza-Manda & McAuliffe, 2016). The general concern is whether all employees have uniform perception towards helpful assistance available from the organisation through supervisors and colleagues, or not (Diestel, Wegge & Schmidt, 2014).…”