Comparing the job satisfaction and intention to leave of different categories of health workers in Tanzania, Malawi, and South Africa

Figures & data

Table 1. Comparison of key indicators in study countries – 2010

Indicator	Tanzania	Malawi	South Africa
Population (Million)	42.5	14.8	49.7
Population in rural areas	75%	81%	39%
GNP per capita (PPP)	$1,230	$830	$9,780
Population living on < $1 (PPP) per day	88.5%	73.9%	26.2%
Total expenditure on health (% GDP)	5.3%	9.9%	8.6%
Per capita total expenditure on health (PPP)	$22	$50	$819
Life expectancy at birth	53 yrs	53 yrs	53 yrs
IMR (per 1,000 live births)	67	65	48
MMR (per 100,000 live births)	950	1,100	400
HIV prevalence	6.2%	11.9%	18.1%
Number of nurses	9,440	3,896	184,459
Nurses per 10,000 population	2	3	41
Number of doctors	300	257	34,829
Doctors per 10,000 population	<0.5	<0.5	8

Source: WHO World Health Statistics 58.

Table 2. Characteristics of study participants

Variables	Total	Tanzania	Malawi	South Africa	p
N	2,221	567	937	717
Sex
% Female	62.5	68.2	47.9	77.0	<0.01 †
Age
Mean±SD	38.2±11.4	41.0±9.4	35.9±12.5	39.3±10.5	<0.01 ‡
Marital status
% Single	35.0	23.2	37.7	40.7	<0.01 †
% Married	54.7	66.6	52.0	48.8
Any children
% Yes	70.5	82.7	60.9	73.4	<0.01 †
Facility type
% Clinic	21.0	14.2	41.3	0.0	<0.01 †
% Public hospital	72.3	85.8	42.7	100.0
% Mission hospital	6.8	0.0	16.1	0.0
Years in current post
Mean±SD	7.7±8.5	12.1±9.4	4.0±5.3	9.3±9.3	<0.01 ‡

†Chi-squared test; ‡ANOVA.

Table 3. Breakdown of health worker cadres in each country

	Tanzania		Malawi		South Africa		Total
Category	N	%	n	%	n	%	n	%
Auxiliary/enrolled nurse	163	28.8	424	45.2	258	36.0	845	38.0
Registered nurse	186	32.8	97	10.4	270	37.7	553	24.9
Medical assistant/clinical officer	104	18.3	285	30.4			389	17.5
Medical officer/specialist	25	4.4	5	0.5	189	26.3	219	9.9
Allied health workers	89	15.7	126	13.5			215	9.7
Total	567	100.0	937	100.0	717	100.0	2,221	100.0

Table 4. Satisfaction with job characteristics and intention to leave by country

	% Agreeing			Satisfaction score (Mean±SD)			Significance (ANOVA)
Job attribute	Tanzania	Malawi	South Africa	Tanzania	Malawi	South Africa	Overall	Post-hoc comparison
In general, I am satisfied with this job	82.3	71.0	52.1	4.03±0.91	3.72±1.23	3.22±1.19	F=82.28, p<0.001	a, b, c
I feel that I am able to use my abilities to their full potential	88.9	78.2	62.7	4.22±0.83	3.94±1.1	3.56±1.15	F=64.1, p<0.001	a, b, c
I have a variety of duties, tasks and activities in my job	88.5	93.5	86.7	4.19±0.83	4.33±0.78	4.04±0.87	F=25.3, p<0.001	a, b, c
I find that my opinions are respected at work	72.9	63.1	48.0	3.76±0.97	3.49±1.13	3.22±1.1	F=39.64, p<0.001	a, b, c
I am satisfied with the recognition I get for the work that I do	77.2	51.2	38.8	3.8±0.93	3.16±1.26	2.98±1.17	F=87.1, p<0.001	a, b, c
I am satisfied with the personal relationship between my manager and myself	75.6	65.6	55.1	3.82±0.98	3.55±1.16	3.35±1.17	F=28.4, p<0.001	a, b, c
I am satisfied with the way my manager handles staff	62.8	46.8	43.2	3.53±1.07	3.11±1.21	3.02±1.22	F=32.9, p<0.001	b, c
I feel that my job conditions allow me to perform at high levels	60.0	55.9	43.3	3.47±1.18	3.35±1.25	3.03±1.2	F=22.8, p<0.001	a, c
I am satisfied with the availability of drugs and equipment	46.2	39.9	36.7	3.11±1.18	2.85±1.2	2.78±1.24	F=12.7, p<0.001	b, c
I am satisfied with the educational/training opportunities that I get	41.0	29.9	39.2	2.98±1.17	2.53±1.28	2.8±1.29	F=24.7, p<0.001	a, b, c
I am actively seeking other employment	18.8	26.5	41.4	2.42±1.13	2.64±1.31	3.05±1.34	F=39.9, p<0.001	a, b, c

Bonferroni post-hoc comparisons: a: Malawi and South Africa significantly different; b: Malawi and Tanzania significantly different; c: South Africa and Tanzania significantly different.

Table 5. Multiple linear regression of predictors of job satisfaction

Variable	Coefficient	95% CI	p
Constant	−0.215	[−0.686; 0.256]	0.371
Female	−0.146	[−0.377; 0.086]	0.217
Age group
< 30 years	–	–	–
30–50 years	0.177	[−0.081; 0.435]	0.178
> 50 years	0.751	[0.409; 1.093]	<0.001
Marital status
Single	–	–	–
Married/living together	−0.015	[−0.249; 0.220]	0.901
Separated/divorced/widowed	0.405	[0.049; 0.761]	0.026
Number of children	0.005	[−0.256: 0.266]	0.970
Facility type
Clinic/health centre	–	–	–
Public hospital	−0.440	[−0.693; −0.187]	0.001
Mission hospital	−0.180	[−0.567; 0.208]	0.363
Years in current post	0.002	[−0.011: 0.016]	0.730
Health worker cadre
Auxiliary/enrolled nurse	–	–	–
Registered nurse	−0.087	[−0.328; 0.153]	0.476
Medical assistant/clinical officer	−0.219	[−0.514; 0.075]	0.144
Medical officer/specialist	0.062	[−0.317; 0.442]	0.748
Allied health workers	−0.021	[−0.367; 0.325]	0.905
Country
Malawi	–	–	–
South Africa	−0.461	[−0.76; −0.161]	0.003
Tanzania	0.923	[0.657; 1.189]	<0.001

F=14.9, p<0.001, R²=0.107.

Table 6. Multiple logistic regression of predictors of intention to leave

Variable	OR	95% CI	p
Constant	0.420	[0.239; 0.737]	0.003
Female	0.954	[0.722; 1.26]	0.741
Age group
< 30 years	–	–	–
30–50 years	0.726	[0.535; 0.985]	0.039
> 50 years	0.495	[0.318; 0.770]	0.002
Marital status
Single	–	–	–
Married/living together	0.838	[0.634; 1.107]	0.214
Separated/divorced/widowed	0.847	[0.537; 1.336]	0.475
Any children	1.244	[0.91; 1.701]	0.171
Facility type
Clinic/health centre	–	–	–
Public hospital	0.895	[0.650; 1.231]	0.493
Mission hospital	1.085	[0.675; 1.743]	0.738
Years worked at this facility	0.989	[0.971; 1.007]	0.224
Health worker cadre
Auxiliary/enrolled nurse	–	–	–
Registered nurse	1.088	[0.811; 1.461]	0.574
Medical assistant/clinical officer	1.063	[0.741; 1.526]	0.739
Medical officer/specialist	0.849	[0.543; 1.326]	0.471
Allied health workers	0.950	[0.614; 1.472]	0.820
Country
Malawi	–	–	–
South Africa	2.158	[1.501; 3.103]	<0.001
Tanzania	1.029	[0.725; 1.461]	0.871
Job satisfaction index	0.733	[0.693; 0.776]	<0.001

LR χ²=240.9, p<0.001, Pseudo R²=0.106.

WHO. (2010). World health statistics 2010. Geneva: World Health Organization.

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