The Determinants of Job Satisfaction among Nurses, Midwives, and Auxiliary Nurses in Health Clinics

The Case of Bénin, West Africa

by Nono Ayivi-Guedehoussou

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Health workers are a crucial component of a well-functioning health system. Their motivation and attitudes have significant ramifications for patient health outcomes. In low- and middle-income countries, low performance and suboptimal behaviors of health workers have often been reported as contributing factors leading to adverse health outcomes. One possible solution to reduce suboptimal health worker practices is to increase health worker job satisfaction.

Using secondary data from a performance-based financing project in health facilities, this dissertation examines the concept of work satisfaction among health workers in Bénin. First, I validate the instrument used — The Minnesota Satisfaction Questionnaire. I then use it to examine the level of satisfaction among midwives, nurses, and auxiliary nurses. I find that, on average, health workers are moderately satisfied. I then investigate the determinants of work satisfaction at both the individual and the health facility level, using a multilevel analysis to take advantage of the nested structure of my data. My findings indicate that tenure, gender, training opportunities, working conditions, and style of management are all factors that play a role in explaining work satisfaction.

Finally, to understand how different kinds of health workers relate to their work environments, I conducted semi-structured interviews on a selected sample of health professionals. The qualitative evaluation of these interviews shows that these health workers perceive their work environments to be an important contributing factor to their satisfaction. This has potentially important implications on the level of the quality of care health workers can provide to their patients.

As a whole, the results of my research provide a better understanding of work satisfaction among health workers in Bénin, and identify future research questions on a subject overlooked in low- and middle-income sub-Saharan African countries. The implications of my findings are discussed in order to benefit hospital administrators, the Ministry of Health in Bénin, and international organizations.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    Background, Context, and Literature Review

  • Chapter Three

    Data & Methods

  • Chapter Four

    Understanding Satisfaction

  • Chapter Five

    Characteristics of Health Workers and Health Centers

  • Chapter Six

    Multi-level Analysis

  • Chapter Seven

    Qualitative Results

  • Chapter Eight

    Discussion

  • Chapter Nine

    Implications of findings

  • Chapter Ten

    References

Research conducted by

This document was submitted as a dissertation in May 2016 in partial fulfillment of the requirements of the doctoral degree in public policy analysis at the Pardee RAND Graduate School. The faculty committee that supervised and approved the dissertation consisted of Gery Ryan (Chair), Lisa Meredith, and Jeremy Miles.

This report is part of the RAND Corporation dissertation series. Pardee RAND dissertations are produced by graduate fellows of the Pardee RAND Graduate School, the world's leading producer of Ph.D.'s in policy analysis. The dissertations are supervised, reviewed, and approved by a Pardee RAND faculty committee overseeing each dissertation.

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