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      Job satisfaction and turnover intention among Iraqi doctors - a descriptive cross-sectional multicentre study

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          Abstract

          Background

          During the last two decades, the Iraqi human resources for health was exposed to an unprecedented turnover of trained and experienced medical professionals. This study aimed to explore prominent factors affecting turnover intentions among Iraqi doctors.

          Methods

          A descriptive cross-sectional multicentre study was carried out among 576 doctors across 20 hospitals in Iraq using multistage sampling technique. Participants completed a self-administered questionnaire, which included socio-demographic information, work characteristics, the 10-item Warr-Cook-Wall job satisfaction scale, and one question on turnover intention. Descriptive and bivariate and multiple logistic regression analyses were conducted to identify significant factors affecting turnover intentions.

          Results

          More than one half of Iraqi doctors (55.2%) were actively seeking alternative employment. Factors associated with turnover intentions among doctors were low job satisfaction score (odds ratio (OR) = 0.97; 95% confidence interval (CI): 0.95, 0.99), aged 40 years old or less (OR = 2.9; 95% CI: 1.74, 4.75), being male (OR = 4.2; 95% CI: 2.54, 7.03), being single (OR = 5.0; 95% CI: 2.61, 9.75), being threatened (OR = 3.5; 95% CI: 1.80, 6.69), internally displaced (OR = 3.1; 95% CI: 1.43, 6.57), having a perception of unsafe medical practice (OR = 4.1; 95% CI: 1.86, 9.21), working more than 40 h per week, (OR = 2.3; 95% CI: 1.27, 4.03), disagreement with the way manager handles staff (OR = 2.2; 95% CI: 1.19, 4.03), being non-specialist, (OR = 3.9, 95% CI: 2.08, 7.13), and being employed in the government sector only (OR = 2.0; 95% CI: 1.09, 3.82).

          Conclusion

          The high-turnover intention among Iraqi doctors is significantly associated with working and security conditions. An urgent and effective strategy is required to prevent doctors’ exodus.

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          Most cited references54

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          An evaluation of precursors of hospital employee turnover.

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            Structural equations modeling test of a turnover theory: Cross-sectional and longitudinal analyses.

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              The effects of health worker motivation and job satisfaction on turnover intention in Ghana: a cross-sectional study

              Background Motivation and job satisfaction have been identified as key factors for health worker retention and turnover in low- and middle-income countries. District health managers in decentralized health systems usually have a broadened ‘decision space’ that enables them to positively influence health worker motivation and job satisfaction, which in turn impacts on retention and performance at district-level. The study explored the effects of motivation and job satisfaction on turnover intention and how motivation and satisfaction can be improved by district health managers in order to increase retention of health workers. Methods We conducted a cross-sectional survey in three districts of the Eastern Region in Ghana and interviewed 256 health workers from several staff categories (doctors, nursing professionals, allied health workers and pharmacists) on their intentions to leave their current health facilities as well as their perceptions on various aspects of motivation and job satisfaction. The effects of motivation and job satisfaction on turnover intention were explored through logistic regression analysis. Results Overall, 69% of the respondents reported to have turnover intentions. Motivation (OR = 0.74, 95% CI: 0.60 to 0.92) and job satisfaction (OR = 0.74, 95% CI: 0.57 to 0.96) were significantly associated with turnover intention and higher levels of both reduced the risk of health workers having this intention. The dimensions of motivation and job satisfaction significantly associated with turnover intention included career development (OR = 0.56, 95% CI: 0.36 to 0.86), workload (OR = 0.58, 95% CI: 0.34 to 0.99), management (OR = 0.51. 95% CI: 0.30 to 0.84), organizational commitment (OR = 0.36, 95% CI: 0.19 to 0.66), and burnout (OR = 0.59, 95% CI: 0.39 to 0.91). Conclusions Our findings indicate that effective human resource management practices at district level influence health worker motivation and job satisfaction, thereby reducing the likelihood for turnover. Therefore, it is worth strengthening human resource management skills at district level and supporting district health managers to implement retention strategies.
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                Author and article information

                Contributors
                drsaadalezzi@gmail.com
                saljunid@gmail.com
                ilker.dastan@izmirekonomi.edu.tr
                ruqiyaalomer@yahoo.com
                ma_m776@yahoo.com
                medkuru@yahoo.com
                samidobaie@yahoo.com
                Journal
                Hum Resour Health
                Hum Resour Health
                Human Resources for Health
                BioMed Central (London )
                1478-4491
                19 April 2015
                19 April 2015
                2015
                : 13
                : 21
                Affiliations
                [ ]United Nations University-International Institute of Global Health (UNU-IIGH), International Centre for Case-Mix and Clinical Coding (ITCC), National University of Malaysia Medical Centre (UKMMC), Jalan Yaacob Latiff, 56000 Cheras Kuala Lumpur, Malaysia
                [ ]International Centre for Case-Mix and Clinical Coding (ITCC), National University of Malaysia Medical Centre (UKMMC), Jalan Yaacob Latiff, 56000 Cheras Kuala Lumpur, Malaysia
                [ ]Department of Economics, Izmir University of Economics, Izmir, Turkey
                [ ]Department of Public Health, Faculty of Medicine, Tiqrit University, Tiqrit, Iraq
                [ ]Medical Department, Tengku Ampuan Rahimah Hospital (HTAR), Jalan Langat, Klang, Selangor Malaysia
                [ ]Department of Community Medicine, International Medical University (IMU), Bukit Jalil, Kuala Lumpur, Malaysia
                Article
                14
                10.1186/s12960-015-0014-6
                4407309
                25903757
                393d5b40-77fa-4a19-9158-17be3fc6aad3
                © Ali Jadoo et al.; licensee BioMed Central. 2015

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 12 January 2015
                : 9 April 2015
                Categories
                Research
                Custom metadata
                © The Author(s) 2015

                Health & Social care
                iraqi doctors,health human resources migration,turnover intention,job satisfaction

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