Older and Longer Tenure Healthcare Workers are Less Satisfied with their Job. A Case Study of Arua Regional Referral Hospital, Uganda
Authors: Hamud Omar Mohamed , Orishaba Philip , Kisakye Angela , Kiwanuka Suzanne 
Published: May 2023

Abstract
Objective: Human resources are vital for delivering health services, and health systems cannot function effectively without sufficient numbers of skilled, motivated, and well-supported health workers. Job satisfaction of health workers is important for motivation and efficiency, because higher job satisfaction improves both employee performance and patient satisfaction.
Methods: This was a cross sectional study conducted between December 2020 and April 2021 at the Arua Regional Referral Hospital. This study consecutively enrolled 219 health care workers. A pre-tested self-administered questionnaire was used. Job satisfaction was assessed using a survey consisting of 69 questions specifically related to job satisfaction. The average/mean value was used as the cutoff point to determine whether the respondents were satisfied with their job or not. Principal component analysis was used to summarize the factors for further analysis. Differences between groups for categorical variables were assessed using chi-squared or Fisher's exact tests. Associations between job satisfaction and independent variables were explored using a modified poisson regression model. A p-value <0.05 was considered significant at 95% level of confidence. Independent variables with a p value of 0.2 were considered for multivariate analysis to assess for interaction and confounding. Principal score matching was used to identify the main contributing factors to the overall job satisfaction.
Results:The age (mean ± SD) of the participating 219 health workers was 35.4 ± 7.5 years, with the youngest being aged 25 years and the oldest 57 years. The majority of the health workers were aged between 30 and 34 years, 27.8% (61/219). More than half, 52.5% (115/219) of the health workers were females while half, 50.2% (110/219) were Anglican. With regard to cadre, nurses were the majority, 46.6% (102/219) with the least being medical officers, 6.4% (14/219). Two thirds, 66.2% (145/219) were married while the majority had spent between 1 and 2 years in service, 43.8% (96/219). Being aged between 35-39 years (aPR = 1.46, CI 1.01 – 2.13), and 40 and above (aPR = 2.87, 95%CI 1.92 – 4.29), female (aPR = 1.30, 95%CI 1.04 – 1.63), Muslim
(aPR = 1.45, 95%CI 1.13 – 1.87) were associated with increased job satisfaction while being in practice for 5 - <10 years (aPR = 0.60, 95%CI 0.39 – 0.93) and 10 or more years (aPR = 0.44, 95%CI 0.28 – 0.69) were associated with reduced job satisfaction. Recognition from peers, other professional groups as well as from the general public, opportunity to think independently, relationship with a co-worker as well as team work, presence of on-job training and the leadership style were the main contributors to the overall job satisfaction.
Conclusion: The level of job satisfaction among the health workers at Arua Regional Referral Hospital was 60.7% (fair). Factors associated with job satisfaction included health worker age, sex, religion and duration in practice. Major contributors to overall job satisfaction were recognition, autonomy, co-worker aspects, promotion and supervision. It is vital for the management of the regional referral hospital and the Ministry of Health to consider promoting, providing autonomy and better incentives to health workers who have been in practice for 5 or more years as a way of motivating them.