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SUMMARY:<br/><br/>Background: Any health-care system relies heavily on human resources. Human <br/>resources are the critical core of a health-care system, but they are underutilized, with <br/>low and middle-income countries having fewer and less skilled workers than high<br/>income countries. <br/><br/>Aim: To assess the factors influencing job satisfaction and work motivation among <br/>health professional in Nuwakot, Nepal. <br/>Design: A mixed-method study using a triangulation design. <br/><br/>Methods: The study included 346 health workers with at least two months of <br/>experience taken from both public and private health facilities in Nuwakot, District. The <br/>required numbers of respondents were selected using simple random sampling without <br/>replacement from a list of health workers from each municipality. All the Palikas (rural <br/>and urban municipalities) were sampled with proportionate allocation. A pretested, self<br/>administered questionnaire in quantitative and an interview guide were used for the <br/>qualitative study. Face-to-face interviews were taken and recorded with participants' <br/>consent. The quantitative data was entered in Epi data version 3.1 and exported to <br/>Excel, and analysis was done in EZR software using bi-variate logistic regression, whose <br/>p< 0.25 was taken for multivariate analysis. The odds ratios with a p value < 0.05 were <br/>calculated. <br/><br/>Result: More than half (55.78%) of respondents’ ages were less than or equal to the <br/>median age (29 years). Among the total participants, 62% were female. Sixty three <br/>percentage of the participants were married. This present study showed that more than <br/>half of the participants (57.8%) were overall satisfied with their jobs. The multivariate <br/>analysis showed that respondents from primary health care centers were 29.1 <br/>[AOR,95% CI (3.55-239)] times more likely to be satisfied with their job compared to <br/>those from government hospitals. The respondents from the health post were 3.79 [AOR ,95% CI (3.55-239)] times more <br/>likely satisfied, and the respondents from the Community Health Clinic (CHU) were 3.95 <br/>[AOR 95% CI (1.45-10.70)] times more likely satisfied with their job compared to the <br/>government hospital after controlling other variables. The study showed that nine out of <br/>ten (91.33%) of the respondents were overall motivated in their jobs. In bi-variate <br/>logistic regression analysis, participant’s age, sex, marital status, monthly salary, job <br/>title, health institution category, work duration and work in home district were <br/>significant with work motivation. The result of multivariate logistic analysis showed the <br/>female respondent was 2.73 [AOR, 95% CI (1.27–5.88)] times more likely to be <br/>motivated by their job compared to the male after controlling other variables. <br/>In the qualitative study, the majority of participants were not motivated in their current <br/>work after federalization as they perceived a low reward and punishment system, <br/>unclear health policy, a low salary, ineffective supervision and monitoring, and a high <br/>work load, but the respect from clients, co-workers coordination, a good information <br/>system, a good salary, and an allowance were motivating factors in their work. In the <br/>qualitative study, the good coordination and timely supply of essential drugs and the <br/>provision of necessary training were also necessary for job satisfaction. The majority of <br/>participants were dissatisfied with their jobs due to perceived limited career <br/>development opportunities for advancement, Political influences in working conditions, <br/>and an unfair employee adjustment process. <br/><br/>Conclusion: This study showed that 58% of the 346 participants were generally satisfied <br/>with their jobs, 2% were dissatisfied, and 40% were unsure or ambivalent about their <br/>jobs. Job satisfaction was significantly related to age, marital status, monthly income, <br/>type of healthcare facility, and job title-. According to the qualitative findings, the <br/>majority of participants were dissatisfied with their current situation due to perceived <br/>limited opportunities for advancement, unfavorable working conditions, and the <br/>employee adjustment process. The qualitative findings showed that job satisfaction <br/>required effective coordination, prompt supply of necessary medications, and training. |
