Job satisfaction among healthcare workers in Ghana and Kenya during the COVID-19 pandemic: Role of perceived preparedness, stress, and burnout

Patience A Afulani, Jerry John Nutor, Pascal Agbadi, Akua O Gyamerah, Joseph Musana, Raymond A Aborigo, Osamuedeme Odiase, Monica Getahun, Linnet Ongeri, Hawa Malechi, Moses Obimbo Madadi, Benedicta Arhinful, Ann Marie Kelly, John Koku Awoonor-Williams, Patience A Afulani, Jerry John Nutor, Pascal Agbadi, Akua O Gyamerah, Joseph Musana, Raymond A Aborigo, Osamuedeme Odiase, Monica Getahun, Linnet Ongeri, Hawa Malechi, Moses Obimbo Madadi, Benedicta Arhinful, Ann Marie Kelly, John Koku Awoonor-Williams

Abstract

The COVID-19 pandemic has affected job satisfaction among healthcare workers; yet this has not been empirically examined in sub-Saharan Africa (SSA). We addressed this gap by examining job satisfaction and associated factors among healthcare workers in Ghana and Kenya during the COVID-19 pandemic. We conducted a cross-sectional study with healthcare workers (N = 1012). The two phased data collection included: (1) survey data collected in Ghana from April 17 to May 31, 2020, and (2) survey data collected in Ghana and Kenya from November 9, 2020, to March 8, 2021. We utilized a quantitative measure of job satisfaction, as well as validated psychosocial measures of perceived preparedness, stress, and burnout; and conducted descriptive, bivariable, and multivariable analysis using ordered logistic regression. We found high levels of job dissatisfaction (38.1%), low perceived preparedness (62.2%), stress (70.5%), and burnout (69.4%) among providers. High perceived preparedness was positively associated with higher job satisfaction (adjusted proportional odds ratio (APOR) = 2.83, CI [1.66,4.84]); while high stress and burnout were associated with lower job satisfaction (APOR = 0.18, CI [0.09,0.37] and APOR = 0.38, CI [0.252,0.583] for high stress and burnout respectively). Other factors positively associated with job satisfaction included prior job satisfaction, perceived appreciation from management, and perceived communication from management. Fear of infection was negatively associated with job satisfaction. The COVID-19 pandemic has negatively impacted job satisfaction among healthcare workers. Inadequate preparedness, stress, and burnout are significant contributing factors. Given the already strained healthcare system and low morale among healthcare workers in SSA, efforts are needed to increase preparedness, better manage stress and burnout, and improve job satisfaction, especially during the pandemic.

Conflict of interest statement

The authors declare that they have no competing interests.

Copyright: © 2021 Afulani et al. This is an open access article distributed under the 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.

References

    1. Zhang SX, Liu J, Afshar Jahanshahi A, Nawaser K, Yousefi A, Li J, et al.. At the height of the storm: Healthcare staff’s health conditions and job satisfaction and their associated predictors during the epidemic peak of COVID-19. Brain, Behavior, and Immunity. Academic Press Inc.; 2020. pp. 144–146. doi: 10.1016/j.bbi.2020.05.010
    1. Zhang SX, Chen J, Afshar Jahanshahi A, Alvarez-Risco A, Dai H, Li J, et al.. Succumbing to the COVID-19 Pandemic—Healthcare Workers Not Satisfied and Intend to Leave Their Jobs. International Journal of Mental Health and Addiction. 2021; 1–10. doi: 10.1007/s11469-020-00418-6
    1. Said RM, El-Shafei DA. Occupational stress, job satisfaction, and intent to leave: nurses working on front lines during COVID-19 pandemic in Zagazig City, Egypt. Environmental Science and Pollution Research. 2021;28: 8791–8801. doi: 10.1007/s11356-020-11235-8
    1. George J, Jones G. Understanding and Managing Organizational Behavior, Student Value Edition. 6th edition. Pearson; 2011.
    1. Siegel L, Lane IM. Personnel and Organizational Psychology. Subsequent edition. Homewood, Ill: Richard d Irwin; 1987.
    1. Ali Jadoo SA, Aljunid SM, Dastan I, Tawfeeq RS, Mustafa MA, Ganasegeran K, et al.. Job satisfaction and turnover intention among Iraqi doctors—A descriptive cross-sectional multicentre study. Human Resources for Health. 2015;13: 1–11. doi: 10.1186/1478-4491-13-1
    1. Bonenberger M, Aikins M, Akweongo P, Wyss K. The effects of health worker motivation and job satisfaction on turnover intention in Ghana: A cross-sectional study. Human Resources for Health. 2014;12: 1–12. doi: 10.1186/1478-4491-12-1
    1. Delobelle P, Rawlinson JL, Ntuli S, Malatsi I, Decock R, Depoorter AM. Job satisfaction and turnover intent of primary healthcare nurses in rural South Africa: a questionnaire survey. Journal of Advanced Nursing. 2011;67: 371–383. doi: 10.1111/j.1365-2648.2010.05496.x
    1. Heponiemi T, Kouvonen A, Virtanen M, Vänskä J, Elovainio M. The prospective effects of workplace violence on physicians’ job satisfaction and turnover intentions: The buffering effect of job control. BMC Health Services Research. 2014;14: 19. doi: 10.1186/1472-6963-14-19
    1. Rouleau D, Fournier P, Philibert A, Mbengue B, Dumont A. The effects of midwives’ job satisfaction on burnout, intention to quit and turnover: a longitudinal study in Senegal. Hum Resour Health. 2012;10: 1–14. doi: 10.1186/1478-4491-10-1
    1. Lu Y, Hu X-M, Huang X-L, Zhuang X-D, Guo P, Feng L-F, et al.. Job satisfaction and associated factors among healthcare staff: a cross-sectional study in Guangdong Province, China. BMJ Open. 2016;6: e011388. doi: 10.1136/bmjopen-2016-011388
    1. Toh SG, Ang E, Devi MK. Systematic review on the relationship between the nursing shortage and job satisfaction, stress and burnout levels among nurses in oncology/haematology settings. Int J Evid Based Healthc. 2012;10: 126–141. doi: 10.1111/j.1744-1609.2012.00271.x
    1. Salyers MP, Bonfils KA, Luther L, Firmin RL, White DA, Adams EL, et al.. The Relationship Between Professional Burnout and Quality and Safety in Healthcare: A Meta-Analysis. J Gen Intern Med. 2017;32: 475–482. doi: 10.1007/s11606-016-3886-9
    1. Salvagioni DAJ, Melanda FN, Mesas AE, González AD, Gabani FL, de Andrade SM. Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies. PLoS One. 2017;12. doi: 10.1371/journal.pone.0185781
    1. Adegoke AA, Atiyaye FB, Abubakar AS, Auta A, Aboda A. Job satisfaction and retention of midwives in rural Nigeria. Midwifery. 2015;31: 946–956. doi: 10.1016/j.midw.2015.06.010
    1. Tanzania M, Africa S. Global Health Action Comparing the job satisfaction and intention to leave of different categories of health workers in Tanzania, Malawi, and South Africa Comparing the job satisfaction and intention to leave of different categories of health workers in Tanzania, Malawi, and South Africa. Global Health Action. 1928;6: 19287. doi: 10.3402/gha.v6i0.19287
    1. Temesgen K, Aycheh MW, Leshargie CT. Job satisfaction and associated factors among health professionals working at Western Amhara Region, Ethiopia. Health and Quality of Life Outcomes. 2018;16: 65. doi: 10.1186/s12955-018-0898-7
    1. van der Doef M, Mbazzi FB, Verhoeven C. Job conditions, job satisfaction, somatic complaints and burnout among East African nurses. Journal of Clinical Nursing. 2012;21: 1763–1775. doi: 10.1111/j.1365-2702.2011.03995.x
    1. Aziri B. JOB SATISFACTION, A LITERATURE REVIEW. Management Research and Practice. 2011;3: 77–86.
    1. Pillay R. Work satisfaction of professional nurses in South Africa: a comparative analysis of the public and private sectors. Human Resources for Health. 2009;7: 15. doi: 10.1186/1478-4491-7-15
    1. Nguyen LH, Drew DA, Graham MS, Joshi AD, Guo C-G, Ma W, et al.. Risk of COVID-19 among front-line health-care workers and the general community: a prospective cohort study. The Lancet Public Health. 2020;5: e475–e483. doi: 10.1016/S2468-2667(20)30164-X
    1. Giannis D, Geropoulos G, Matenoglou E, Moris D. Impact of coronavirus disease 2019 on healthcare workers: beyond the risk of exposure. Postgraduate Medical Journal. 2021;97: 326–328. doi: 10.1136/postgradmedj-2020-137988
    1. Kumar J, Katto MS, Siddiqui AA, Sahito B, Ahmed B, Jamil M, et al.. Predictive Factors Associated With Fear Faced by Healthcare Workers During COVID-19 Pandemic: A Questionnaire-Based Study. Cureus. 12: e9741. doi: 10.7759/cureus.9741
    1. Zerbini G, Ebigbo A, Reicherts P, Kunz M, Messman H. Psychosocial burden of healthcare professionals in times of COVID-19—a survey conducted at the University Hospital Augsburg. Ger Med Sci. 2020;18: Doc05. doi: 10.3205/000281
    1. Wu Y, Wang J, Luo C, Hu S, Lin X, Anderson AE, et al.. A Comparison of Burnout Frequency Among Oncology Physicians and Nurses Working on the Frontline and Usual Wards During the COVID-19 Epidemic in Wuhan, China. J Pain Symptom Manage. 2020;60: e60–e65. doi: 10.1016/j.jpainsymman.2020.04.008
    1. Li X, Yu H, Bian G, Hu Z, Liu X, Zhou Q, et al.. Prevalence, risk factors, and clinical correlates of insomnia in volunteer and at home medical staff during the COVID-19. Brain Behav Immun. 2020;87: 140–141. doi: 10.1016/j.bbi.2020.05.008
    1. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al.. Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA network open. 2020;3: e203976. doi: 10.1001/jamanetworkopen.2020.3976
    1. Luo M, Guo L, Yu M, Jiang W, Wang H. The psychological and mental impact of coronavirus disease 2019 (COVID-19) on medical staff and general public–A systematic review and meta-analysis. Psychiatry Res. 2020;291: 113190. doi: 10.1016/j.psychres.2020.113190
    1. Blanco-Donoso LM, Moreno-Jiménez J, Gallego-Alberto L, Amutio A, Moreno-Jiménez B, Garrosa E. Satisfied as professionals, but also exhausted and worried‼: The role of job demands, resources and emotional experiences of Spanish nursing home workers during the COVID-19 pandemic. Health & Social Care in the Community. n/a. doi: 10.1111/hsc.13422
    1. Volmer G. Nurse burnout in the wake of COVID-19 can cost up to $137B | Feedtrail. [cited 13 Aug 2021]. Available:
    1. Kok MC, Dieleman M, Taegtmeyer M, Broerse JEW, Kane SS, Ormel H, et al.. Which intervention design factors influence performance of community health workers in low- and middle-income countries? A systematic review. Health Policy and Planning. Oxford University Press; 2015. pp. 1207–1227. doi: 10.1093/heapol/czu126
    1. Rosenthal EL, Brownstein JN, Rush CH, Hirsch GR, Willaert AM, Scott JR, et al.. Community health workers: Part of the solution. Health Affairs. Health Affairs; 2010. pp. 1338–1342. doi: 10.1377/hlthaff.2010.0081
    1. Afulani PA, Gyamerah AO, Aborigo RA, Nutor JJ, Malechi H, Laar A, et al.. Perceived preparedness to respond to the COVID-19 pandemic: a study with healthcare workers in Ghana. Journal of Global Health Science. 2020;2. doi: 10.35500/jghs.2020.2.e24
    1. Afulani PA, Gyamerah AO, Nutor JJ, Laar A, Aborigo RA, Malechi H, et al.. Inadequate preparedness for response to COVID-19 is associated with stress and burnout among healthcare workers in Ghana. PLoS One. 2021;16: e0250294. doi: 10.1371/journal.pone.0250294
    1. World Health Organization. COVID-19 Situation update for the WHO African Region. World Health Organization; 2021.
    1. World Health Organization. WHO Coronavirus (COVID-19) Dashboard With Vaccination Data. 2021 [cited 9 Jun 2021]. Available:
    1. Craig J, Kalanxhi E, Hauck S. National estimates of critical care capacity in 54 African countries. medRxiv. 2020; 2020.05.13.20100727. doi: 10.1101/2020.05.13.20100727
    1. World Health Organization. Nursing and midwifery personnel (per 10 000 population). 2020 [cited 28 Jun 2020]. Available:
    1. World Health Organization. Density of physicians (total number per 1000 population). World Health Organization; 2019. Available:
    1. Barasa EW, Ouma PO, Okiro EA. Assessing the hospital surge capacity of the Kenyan health system in the face of the COVID-19 pandemic. PLOS ONE. 2020;15: e0236308. doi: 10.1371/journal.pone.0236308
    1. Kenya Ministry of Health. Kenya Health Workforce Report: The Status of Healthcare Professionals in Kenya, 2015. Kenya Ministry of Health; 2015.
    1. Brian Ngugi. Matiang’i extends night curfew by 60 days to curb Covid-19 spread. In: Business Daily [Internet]. 31 May 2021 [cited 9 Jun 2021]. Available:
    1. Ghanaweb. Korle-Bu nurses stage sit-home strike after one tested positive for coronavirus. In: GhanaWeb [Internet]. 4 Apr 2020 [cited 17 Jun 2021]. Available:
    1. Prentice A. Ghana health workers warn of potential COVID-19 calamity. Reuters. 9 Jul 2020. Available: . Accessed 17 Jun 2021.
    1. Shah J, Monroe-Wise A, Talib Z, Nabiswa A, Said M, Abeid A, et al.. Mental health disorders among healthcare workers during the COVID-19 pandemic: a cross-sectional survey from three major hospitals in Kenya. BMJ Open. 2021;11: e050316. doi: 10.1136/bmjopen-2021-050316
    1. John Mbati. Kenya’s Frontline Health Workers Are Dying From COVID-19. In: COVID-19 Africa Watch [Internet]. 24 Nov 2020 [cited 9 Jun 2021]. Available:
    1. Wasike A. Kenya faces crisis as healthcare workers strike. 8 Dec 2020 [cited 9 Jun 2021]. Available:
    1. Cohen S, Kamarck T, Mermelstein R. A global measure on perceived stress. A Global Measure of Perceived Stress. 1983; 385–396.
    1. Shirom A, Melamed S. A comparison of the construct validity of two burnout measures in two groups of professionals. International Journal of Stress Management. 2006;13: 176–200. doi: 10.1037/1072-5245.13.2.176
    1. Afulani PA, Ongeri L, Kinyua J, Temmerman M, Mendes WB, Weiss SJ. Psychological and physiological stress and burnout among maternity providers in a rural county in Kenya: individual and situational predictors. BMC Public Health. 2021;21: 453. doi: 10.1186/s12889-021-10453-0
    1. Grossi G, Perski A, Osika W, Savic I. Stress-related exhaustion disorder–clinical manifestation of burnout? A review of assessment methods, sleep impairments, cognitive disturbances, and neuro-biological and physiological changes in clinical burnout. Scandinavian Journal of Psychology. 2015;56: 626–636. doi: 10.1111/sjop.12251
    1. Kohler U, Karlson KB, Holm A. Comparing coefficients between nested nonlinear probability models. The Stata Journal. 2011;11: 420–438.
    1. Algunmeeyn A, El-Dahiyat F, Altakhineh MM, Azab M, Babar Z-U-D. Understanding the factors influencing healthcare providers’ burnout during the outbreak of COVID-19 in Jordanian hospitals. Journal of Pharmaceutical Policy and Practice. 2020;13: 53. doi: 10.1186/s40545-020-00262-y
    1. Giusti EM, Pedroli E, D’Aniello GE, Stramba Badiale C, Pietrabissa G, Manna C, et al.. The Psychological Impact of the COVID-19 Outbreak on Health Professionals: A Cross-Sectional Study. Front Psychol. 2020;11. doi: 10.3389/fpsyg.2020.01684
    1. Shanafelt T, Ripp J, Trockel M. Understanding and Addressing Sources of Anxiety Among Health Care Professionals During the COVID-19 Pandemic. JAMA. 2020;323: 2133–2134. doi: 10.1001/jama.2020.5893
    1. Urooj U, Ansari A, Siraj A, Khan S, Tariq H. Expectations, Fears and Perceptions of doctors during Covid-19 Pandemic. Pak J Med Sci. 2020;36: S37–S42. doi: 10.12669/pjms.36.COVID19-S4.2643
    1. Abdelghani M, El-Gohary HM, Fouad E, Hassan MS. Addressing the relationship between perceived fear of COVID-19 virus infection and emergence of burnout symptoms in a sample of Egyptian physicians during COVID-19 pandemic: a cross-sectional study. Middle East Current Psychiatry, Ain Shams University. 2020;27. doi: 10.1186/s43045-020-00079-0
    1. Gedif G, Sisay Y, Alebel A, Belay Y. Level of job satisfaction and associated factors among health care professionals working at University of Gondar Referral Hospital, Northwest Ethiopia: a cross-sectional study. BMC Research Notes. 2018;11. doi: 10.1186/s13104-017-3119-2
    1. Khadka D, Chaulagain N. Factors Influencing Job Satisfaction among Healthcare Professionals at Tilganga Eye Centre, Nepal. International Journal of Scientific & Technology Research. 2018;1: 32–36.
    1. Khamlub S, Harun-Or-Rashid M, Sarker MAB, Hirosawa T, Outavong P, Sakamoto J. Job satisfaction of health-care workers at health centers in Vientiane Capital and Bolikhamsai Province, Lao PDR. Nagoya J Med Sci. 2013;75: 233–241.
    1. Giménez-Espert MDC, Prado-Gascó V, Soto-Rubio A. Psychosocial Risks, Work Engagement, and Job Satisfaction of Nurses During COVID-19 Pandemic. Front Public Health. 2020;8: 566896. doi: 10.3389/fpubh.2020.566896
    1. Alrawashdeh HM, Al-Tammemi AB, Alzawahreh MKh, Al-Tamimi A, Elkholy M, Al Sarireh F, et al.. Occupational burnout and job satisfaction among physicians in times of COVID-19 crisis: a convergent parallel mixed-method study. BMC Public Health. 2021;21: 811. doi: 10.1186/s12889-021-10897-4
    1. Zou M. Gender, work orientations and job satisfaction. Work, Employment and Society. 2015;29: 3–22. doi: 10.1177/0950017014559267
    1. Miao Y, Li L, Bian Y. Gender differences in job quality and job satisfaction among doctors in rural western China. BMC Health Services Research. 2017;17: 848. doi: 10.1186/s12913-017-2786-y
    1. West CP, Dyrbye LN, Erwin PJ, Shanafelt TD. Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. The Lancet. 2016;388: 2272–2281. doi: 10.1016/S0140-6736(16)31279-X

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