Predictors of Health-Workforce Job Satisfaction in Primary Care Settings: Insights from a Cross-Sectional Multi-Country Study in Eight African Countries

Samuel Muhula, Yvonne Opanga, Saida Kassim (), Lazarus Odeny, Richard Zule Mbewe, Beverlyne Akoth, Mable Jerop, Lizah Nyawira, Ibrahima Gueye, Richard Kiplimo, Thom Salamba, Jackline Kiarie and George Kimathi
Additional contact information
Samuel Muhula: Amref Health Africa, Headquarters, Nairobi P.O. Box 27691-00506, Kenya
Yvonne Opanga: Amref Health Africa, Kenya Country Office, Nairobi P.O. Box 30125-00100, Kenya
Saida Kassim: Amref Health Africa, Headquarters, Nairobi P.O. Box 27691-00506, Kenya
Lazarus Odeny: Amref Health Africa, Headquarters, Nairobi P.O. Box 27691-00506, Kenya
Richard Zule Mbewe: Amref Health Africa, Headquarters, Nairobi P.O. Box 27691-00506, Kenya
Beverlyne Akoth: Amref Health Africa, Headquarters, Nairobi P.O. Box 27691-00506, Kenya
Mable Jerop: Amref Health Africa, Headquarters, Nairobi P.O. Box 27691-00506, Kenya
Lizah Nyawira: Amref Health Africa, Headquarters, Nairobi P.O. Box 27691-00506, Kenya
Ibrahima Gueye: Amref Health Africa, Headquarters, Nairobi P.O. Box 27691-00506, Kenya
Richard Kiplimo: Amref Health Africa, Headquarters, Nairobi P.O. Box 27691-00506, Kenya
Thom Salamba: Amref Health Africa, Malawi Country Office, Lilongwe P.O. Box 30768, Malawi
Jackline Kiarie: Amref Health Africa, Headquarters, Nairobi P.O. Box 27691-00506, Kenya
George Kimathi: Amref Health Africa, Headquarters, Nairobi P.O. Box 27691-00506, Kenya

IJERPH, 2025, vol. 22, issue 7, 1-26

Abstract: Job satisfaction in sub-Saharan Africa is crucial as it directly impacts employee productivity, retention, and overall economic growth, fostering a motivated workforce that drives regional development. In sub–Saharan Africa, poor remuneration, limited professional development opportunities, and inadequate working conditions impact satisfaction. This study examined job-satisfaction predictors among health workers in primary healthcare settings across eight countries: Ethiopia, Kenya, Malawi, Senegal, South Sudan, Tanzania, Uganda, and Zambia. A cross-sectional study surveyed 1711 health workers, assessing five dimensions: employer–2employee relationships, remuneration and recognition, professional development, physical work environment, and supportive supervision. The study was conducted from October 2023 to March 2024. The job-satisfaction assessment tool was adopted from a validated tool originally developed for use in low-income healthcare settings. The tool was reviewed by staff from all the country offices to ensure contextual relevance and organization alignment. The responses were measured on a five-point Likert scale: 0: Not applicable, 1: Very dissatisfied, 2: Dissatisfied, 3: Neutral, 4: Satisfied, and 5: Very satisfied. The analysis employed descriptive and multivariable regression methods. Job satisfaction varied significantly by country. Satisfaction with the employer–employee relationship was highest in Zambia (80%) and lowest in Tanzania (16%). Remuneration satisfaction was highest in Senegal (63%) and Zambia (49%), while it was very low in Malawi (9.8%) and Ethiopia (2.3%). Overall, 44% of respondents were satisfied with their professional development, with Uganda leading (62%) and Ethiopia having the lowest satisfaction level (29%). Satisfaction with the physical environment was at 27%, with Uganda at 40% and Kenya at 12%. Satisfaction with supervisory support stood at 62%, with Zambia at 73% and Ethiopia at 30%. Key predictors of job satisfaction included a strong employer–employee relationships (OR = 2.20, p < 0.001), fair remuneration (OR = 1.59, p = 0.002), conducive work environments (OR = 1.71, p < 0.001), and supervisory support (OR = 3.58, p < 0.001. Improving the job satisfaction, retention, and performance of health workers in sub-Saharan Africa requires targeted interventions in employer–employee relationships, fair compensation, supportive supervision, and working conditions. Strategies must be tailored to each country’s unique challenges, as one-size-fits-all solutions may not be effective. Policymakers should prioritize these factors to build a motivated, resilient workforce, with ongoing research and monitoring essential to ensure sustained progress and improved healthcare delivery.

Keywords: job satisfaction; health workforce; primary healthcare; sub-Saharan Africa (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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