Research Article
One Step Towards Improving Healthcare System Using Doctors’ Job Satisfaction in Nigeria
Abstract
Background: Healthcare organizations are now recognizing the association between doctor’s job satisfaction and healthcare system as a driver to determine effective system. Sadly, this connection has been hampered by knowledge dearth of doctor job satisfaction in Niger state Nigeria which could serve as the first step.
Aim: This study aimed to identify the dimensions of job satisfaction among doctors in Niger state, north-central Nigeria.
Methodology: This quantitative study with non-probability purposive sampling was conducted by administering an adopted validated self-administered questionnaire in English language to a cross-section of 164 doctors through September 2018. Using SPSS version 26 to analyze the collected data. Factor analysis was performed to summarize and rename the variables of job satisfaction.
Result: The doctors are generally satisfied but are dissatisfied with issues surrounding promotion, recognition for work accomplishment, lack of opportunity for additional training and support. By summarizing the variables using factors analysis (Principal Component Analysis), the result indicated that employee benefit and career development is the dominant factor that plays a key role in determining overall job satisfaction. The other factor that influences a doctor’s job satisfaction is managerial and co-worker support.
Conclusion: From the finding, it can be recommended that for Niger state government to improve healthcare system through improving doctors’ satisfaction it should consider framing and realizing an appropriate updated civil service package that will cover in detail the employee’s benefit and career development as well as improving the managerial and co-workers’ support.
Keywords: Job satisfaction, factor analysis, doctor, principal component analysis, Niger state, Nigeria
Introduction
Africa and indeed Nigeria has been observing an upsurge in the departure of a health professional at all levels over a long period. This has led to professionals seeking greener pasture abroad. Whilst several factors such as the inimical macro-economic environment could explain the loss of human resources in the country, job satisfaction is often identified as one of the factors that influence the decision to quit [1].
Job satisfaction has been considered as an attitudinal variable that unveils the extent to which an individual likes his job, and it directly correlates with job performance [2]. For some decades studies have shown inconsistent evidence about the factors that are more dominant in employees’ satisfaction, while some studies suggest the dominance of extrinsic rewards [3,4]. other findings suggest the importance of the intrinsic factor for motivating employees [5]. The overall objective of an organization that is of utmost indispensable importance is to improve employees’ performance maximally to accomplish set goal0073. Higher job satisfaction can give employees a stronger sense of belonging to the company and improve their motivation. In contrast, lower job satisfaction can weaken the feeling of belonging and enthusiasm of employees and increases employees’ willingness to quit [6]. Many studies at different times have identified conditions of service, type of social insurance, co-worker’s support, supervision, promotion, job design, organization environment, age gender, and managerial support as a factor that influence job satisfaction. See for example [1,6–8].
For physicians, job satisfaction does not only affect their career but also affects the patient’s satisfaction and organization output [9]. This is why Managers and researchers are interested in job satisfaction studies because of their relevance to organizational outcomes. Niger state is not immune to this brain drain epidemic that has led to significant loss of qualify medical doctors. And little is known about organizational factors and personal
characteristics that predict job satisfaction among doctors in Niger state north-central Nigeria. And hence, this study aimed to identify the determinants of job satisfaction among doctors in Niger state, north-central Nigeria.
Methodology
This study is a quantitative descriptive cross-sectional study carried out among doctors serving in the state’s public setting across all levels of healthcare in Niger state. The sample size that represents the total population was based on Yamane’s formula sample size measurement. The total population of doctors in the public setting under the payroll of Niger state at the time of data collection was 221 and the appropriate sample size for the study was calculated as 164. The non-probability purposive sampling technique was used to select the respondents. The study adopted a validated self-administered questionnaire in English language. The questions were related to sociodemographic characteristics and closed-ended satisfaction questions.
For this study, the satisfaction level is measured by a 5 items Likert scale as extremely dissatisfied, dissatisfied, uncertain, satisfied, and extremely satisfied. The variables were recoded as dissatisfied as strongly dissatisfied and dissatisfied, uncertain remains as uncertain and satisfied as strongly satisfied and satisfied. Moreover, scheduling data collection was done only on working days, through September 2018. All doctors at all levels that have been working for more than 6 months who consented are included in the study. And it was analyzed with SPSS version 20. The researcher obtained approval from the Niger state hospital management board research Minna, ethics, and publication committee before the commencement of the study. And an assurance was given to the respondents that all their responses will be kept confidential.
Findings and Discussion
Responses from a cross-section of 164 doctors: these include 138 and 28 doctors working in secondary and primary facility respectively. Participants are mainly male (69%, n= 164). Close to half of the participants are between 26 and 40years. About 35% and 36% of the participants have worked in the health facility for more than 6 years and have held the current position for 4 to 6 years respectively. The majority of the participants (61%) are in the rank of either medical officer 2 or 1. (Table 1)
Table 1. Sociodemographic characteristics of the respondent.
Frequency | Percentage | |
---|---|---|
Gender Male Female Total | 100 64 164 | 61 39 100 |
Age 21-25 26-30 31-35 36-40 41-45 46-50 51-55 Total | 6 31 50 20 28 25 4 164 | 3.7 18.9 30.5 12.2 17.1 15.2 2.4 100 |
Level of care Secondary Tertiary Total | 136 28 164 | 82.9 17.1 100 |
How many years have you been working in your present organization? < 1Year 1-3 Year 4-6 Year >6year Total | 33 50 23 58 164 | 20.1 30.5 14.0 35.4 2.4 100.0 |
what is your job title? Medical officer 2 Medical officer 1 Senior medical officer Principal medical officer Consultant Total | 67 34 20 38 5 164 | 40.9 20.7 12.2 23.2 3.0 100.0 |
How long have you held your current position? 1-3 4-6 7-10 > 10 5 7 10 11 15 20 Total | 13 21 8 8 1 3 1 1 1 1 58 | 22.4 36.2 13.8 13.8 1.7 5.2 1.7 1.7 1.7 1.7 100.0 |
Participant’s satisfaction level
Study findings (figure 1) showed that satisfaction level was generally higher than dissatisfaction across salary (39.7%), location of the work (77.6%), hours work on each week (56.9%)., flexibility in scheduling (50%), job security (43.2%), relationship with co-workers (93.2%), relationship with supervisors (79.4%), support for additional training (79.7%), and opportunity to utilize skills and talent (67.7%). However, participants are largely dissatisfied with job promotion (63.8%), recognition for work accomplishment (47.3%), and opportunity for additional training and education (57.7%).
Figure 1. showing doctors job satisfaction level.
Factor analysis findings
In this study, the KMO value was 0.912 which can be interpreted as adequate to predict each factor. Furthermore, the Bartlett test conducted was significant because the value in this study is less than 0.005, (Table 2), this indicates that all the items measured were highly correlated to provide reasonable bases for factor analysis. Doctors’ job satisfaction was determined with 18 item questions. We tried to reduce the number of variables with principal component analysis. The normality of the distribution in this study are normally distributed, the skewness values were between -3 and 3. The result indicated there are two dimensions after running a factor analysis. This was determined based on the initial eigenvalues, the assumption explained the total variance as greater than 1.0 which is a common criterion for the factor to be useful. The first two factors have an integral value greater than one. Maximum eigenvalue belongs to the first factor and it is equal to 58.86 while factor 2 comprised 10.50 of the variances and together the first two factors explained 69.36% of the total variance (Table 3). In the case of the variables, 1,2,4,5,6,7,8,9,15 and 18 have high factor weight for the first factor see (Table 4), the variables, therefore, clarify the content of the first factor which explains the rotation of 58.8% of the total variance. Considering the content of this variable the first factor should be called employee benefit and career development. Variables 3,10,11,12,13,14,16& 17 have high factor weights for the second factor, and it is called the managerial and co-worker’s support.
Table 2. Showing the KMO and Bartlett’s test.
KMO and Bartlett's Test | ||
---|---|---|
Kaiser-Meyer-Olkin Measure of Sampling Adequacy. | .912 | |
Bartlett's Test of Sphericity | Approx. Chi-Square | 2702.336 |
df | 153 | |
Sig. | 0.000 |
Table 3. Eigenvalues and explaining the variance.
Total Variance Explained | |||||||||
---|---|---|---|---|---|---|---|---|---|
Component | Initial Eigenvalues | Extraction Sums of Squared Loadings | Extraction Sums of Squared Loadings | ||||||
Total | % Of Variance | Cumulative % | Total | % Of Variance | Cumulative % | Total | % Of Variance | Cumulative % | |
1 | 10.596 | 58.865 | 58.865 | 10.596 | 58.865 | 58.865 | 6.997 | 38.872 | 38.872 |
2 | 1.890 | 10.502 | 69.367 | 1.890 | 10.502 | 69.367 | 5.489 | 30.496 | 69.367 |
3 | .957 | 5.319 | 74.686 | ||||||
4 | .710 | 3.942 | 78.628 | ||||||
5 | .590 | 3.278 | 81.906 | ||||||
6 | .571 | 3.173 | 85.079 | ||||||
7 | .387 | 2.152 | 87.231 | ||||||
8 | .356 | 1.977 | 89.208 | ||||||
9 | .320 | 1.777 | 90.985 | ||||||
10 | .285 | 1.585 | 92.570 | ||||||
11 | .257 | 1.428 | 93.998 | ||||||
12 | .246 | 1.366 | 95.364 | ||||||
13 | .206 | 1.142 | 96.506 | ||||||
14 | .176 | .978 | 97.485 | ||||||
15 | .150 | .835 | 98.320 | ||||||
16 | .139 | .774 | 99.093 | ||||||
17 | .102 | .568 | 99.661 | ||||||
18 | .061 | .339 | 100.000 | ||||||
Extraction Method: Principal Component Analysis. |
Table 4. Factor analysis.
Rotated Component Matrix | |||
---|---|---|---|
Component | |||
1 | 2 | ||
1 | hours worked each week | .754 | |
2 | flexibility in scheduling | .759 | |
3 | location of work | .702 | |
4 | amount of paid vacation time /sick leave offered | .806 | |
5 | salary | .668 | |
6 | opportunities for promotion | .741 | |
7 | health insurance | .795 | |
8 | job security | .720 | |
9 | recognition for work accomplished | .808 | |
10 | relationship with co-worker | .641 | |
11 | relationship with your supervisors | .845 | |
12 | relationship with your subordinates | .819 | |
13 | opportunities to utilize your skills and talents | .724 | |
14 | opportunities to learn new skills | .635 | |
15 | support for additional training and education | .786 | |
16 | variety of job responsibilities | .684 | |
17 | degree of independence associated with your work roles | .816 | |
18 | adequate opportunity for periodic changes in duties | .742 | |
Extraction Method: Principal Component Analysis. Rotation Method: Varimax with Kaiser Normalization. |
|||
a. Rotation converged in 3 iterations. |
Discussion
This is the first article that explore doctors’ satisfaction in Niger state, Nigeria. And it is important to interpret the findings of this study with caution because of differences in the diverse healthcare systems, and unlike measurement instrument have been described in the literature [10]. Literatures have shown that the resultant effect of doctor’s satisfaction to be linked to issues such as anxiety factors, work stress and prevention of burnout [11]. These are highly relevant not only for the doctors involved but also for the organization in which they work. Organization that are healthcare focus like hospitals, hospices and care homes are now paying attention to the association between doctors’ satisfaction and effectiveness of the healthcare system [11].
For this study, the dimension of the factors related to the doctor’s job satisfaction were grouped into two (1) employee benefit and career development and (2) managerial and co-worker’s support. Our findings are consistent with those of other studies, which indicate personal accomplishments as a factor connected to doctors’ satisfaction [12]. The benefit of doctor’s job satisfaction cannot be overemphasized, for example research have shown that the association between doctor’s job satisfaction and adherence to medication have been demonstrated [13]. Our study is also consistent to comparative studies which revealed acceptable working hours, salary, and control over clinical work to be the most likely reasons for higher level of life and job satisfaction in Norwegian hospital doctors than German hospital doctors [14].
Conclusion and Recommendation
The doctor’s satisfaction with both personal and professional life is an important factor that has a positive impact on job performance. The researchers concludes that doctors are generally satisfied but are dissatisfied with issues surrounding promotion, recognition for work accomplishment, lack of opportunity for additional training and support. By summarizing the variables using factors analysis, the result indicated that employee benefit and career development is the dominant factor that plays a key role in determining overall job satisfaction. The other factor that influences a doctor’s job satisfaction is managerial and co-worker support.
From the finding, it can be recommended that Niger state government should consider formulating a convenient and an updated package that will cover in detail the employees benefit and career development as well as improving the managerial and co-worker’s support.
Limitation and area of further study
The questionnaires were self-reported by the doctors on a working day. Bias could be introduced depending on their daily workload, experience with clients/ Patients, and overall frame of mind at the time administering the questionnaires. A qualitative approach could be used to explore an in-depth knowledge of doctor’s satisfaction in the state.
Competing Interests
The authors declared that there are no potential competing interests concerning the research, authorship, and/or publication of this paper.
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Copyright: © 2024 Ahmed Abdulsalam, this is an open-access article distributed underthe terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.