Keywords
nurses
rural health facilities
Ghana
structural equation modelling
Categories
How to Cite
Abstract
This study investigated the correlation between financial assistance, working circumstances, career chances, personal variables, and turnover intention amongst nurses employed in health centers in rural areas in the Western North Region of Ghana. A facility-based cross-sectional study was performed including 242 nurses employed in rural health facilities in the Western North Region. Data were gathered utilizing a standardized, self-administered questionnaire. Structural equation modeling (SEM) was utilized to evaluate the associations among financial assistance, working circumstances, career opportunities, personal characteristics, and turnover intention. The average age of respondents was primarily under 40 years, with females being the majority of participation. Financial assistance had a substantial negative correlation with turnover intention (β = −0.090, p < 0.05), suggesting that enhanced financial incentives diminished nurses' propensity to depart. The prospect of career progression was significantly correlated with turnover intention (β = 0.254, p < 0.001), indicating that restricted professional growth options in rural environments heightened the probability of turnover. Positive working conditions (β = −0.110, p < 0.001) and individual factors (β = −0.197, p < 0.001) were substantially correlated with decreased turnover intention. The intention to leave among nurses in rural Ghana is affected by financial, organizational, educational, and personal factors. Enhancing rewards and working circumstances, alongside resolving career development problems, may mitigate nurses' intentions to depart from rural positions. These findings offer empirical information to guide worker retention approaches in rural healthcare environments.
References
[1] Rajabi F, Esmailzadeh H, Rostamigooran N, Majdzadeh R, Doshmangir LJIjoph. Future of health care delivery in Iran, oppor-tunities and threats. 2013;42(Supple1):23.
[2] Kwansah J, Dzodzomenyo M, Mutumba M, Asabir K, Koomson E, Gyakobo M, et al. Policy talk: incentives for rural service among nurses in Ghana. 2012;27(8):669-76.
[3] Nkomazana O, Mash R, Shaibu S, Phaladze NJPo. Stakeholders’ perceptions on shortage of healthcare workers in primary healthcare in Botswana: focus group discussions. 2015;10(8):e0135846.
[4] Bossert TJ, Bossert T, Bärnighausen T, Bowser D, Mitchell A, Ged-ik G. Assessing financing, education, management and policy con-text for strategic planning of human resources for health: World Health Organization; 2007.
[5] Cosgrave C, Malatzky C, Gillespie JJIjoer, health p. Social deter-minants of rural health workforce retention: a scoping review. 2019;16(3):314.
[6] Tang SY, Browne AJ. ‘Race’matters: racialization and egalitarian discourses involving Aboriginal people in the Canadian health care context. 2008;13(2):109-27.
[7] Asamani JA, Ismaila H, Plange A, Ekey VF, Ahmed A-M, Chebere M, et al. The cost of health workforce gaps and inequitable distri-bution in the Ghana health service: an analysis towards evidence-based health workforce planning and management. 2021;19(1):1-15.
[8] Organization WH. Working together for health: the World health report 2006: policy briefs: World Health Organization; 2006.
[9] Zurn P, Codjia L, Sall FL, Braichet J-MJBotWHO. How to recruit and retain health workers in underserved areas: the Senegalese ex-perience. 2010;88(5):386-9.
[10] Ghana demographic and health survey G. key indicators. 2014 [Av--ailable from: https://www2.statsghana.gov.gh/docfiles/DHS_Repo-rt/Ghana_DHS_2014-KIR-21_May_2015.pdf.
[11] Ghana Statistical Service G. Ghana Maternal Health Survey 2017: Key Findings.Rockville, Maryland, USA: GSS, GHS, and ICF. 2018.
[12] MOH. Health sector medium term development plan (HSMTDP), 2018–2021. Ministry of Health, Ghana. 2017.
[13] MOH. Staffing Norms for the Health Sector. Ministry of Health, Ghana. 2018.
[14] Campbell J, Buchan J, Cometto G, David B, Dussault G, Fogstad H, et al. Human resources for health and universal health coverage: fostering equity and effective coverage. 2013;91:853-63.
[15] Dussault G, Franceschini MCJHrfh. Not enough there, too many here: understanding geographical imbalances in the distribution of the health workforce. 2006;4(1):1-16.
[16] Marsden P, Chirchir BJFU, pdf tCPOahwcoisfmee. Mid-Term Evaluation of the Kenya Emergency Hiring Plan. 2008.
[17] Kim C. Recruitment and retention in the Navajo area Indian health service. Western Journal of Medicine. 2000;173(4):240.
[18] Getzin A, Bobot BL, Simpson D. Sustaining family physicians in urban underserved settings. J Fam Med. 2016;48(10):809-13.
[19] Nasiripour AA, Maleki MR, Tabibi SJ, Chimeh EEJJoKUoMS. Factors influence on geographic distribution of physicians in se-lected countries: A Review Article. 2013;17(9).
[20] Glasser M, MacDowell M, Hunsaker M, Salafsky B, Nielsen K, Peters K, et al. Factors and outcomes in primary care physician re-tention in rural areas. South African Family Practice. 2010;52(4):336-40.
[21] Anderson JY, Gerbing DW. Structural equation modelling in prac-tice: a review and recommended two-step approach. Psychological Bulletin. 1988;103(3):411-23.
[22] Kline RB. Princeiples and Practice of of Structural Equation Mod-eling. second ed. New York: The Guilford Press; 2005.
[23] Malhotra N, Dash S. Marketing Research: An Applied Orientation (pp. 552–582). Prentice Hall; 2011.
[24] Nunnally J. C.(1978). Psychometric theory, 2nd ed McGraw-Hill, New York. 1978;2.
[25] Joreskog KG, Sorbom D. LISREL 8 user’s guide. Chicago: Scien-tific Software. 1993.
[26] Kline RB. Principles and practice of structural equation modeling. 4 ed. New York: Guilford Press; 2015.
[27] Hu LT, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal. 1999;6(1):1-55.
[28] Gaskin J, Lim J. Master validity tool. AMOS Plugin In: Gaskina-tion’s StatWiki. 2016.
[29] Mohammadiaghdam N, Doshmangir L, Babaie J, Khabiri R, Pon-net KJBfp. Determining factors in the retention of physicians in ru-ral and underdeveloped areas: a systematic review. 2020;21(1):1-23.
[30] Cosgrave C, Malatzky C, Gillespie J. Social determinants of rural health workforce retention: a scoping review. International journal of environmental research and public health. 2019;16(3):314.
[31] Ravaghi H, Taati E, Abdi Z, Meshkini A, Sarvarizadeh S. Factors influencing the geographic distribution of physicians in Iran: a qualitative study. Rural and Remote Health. 2015;15(1):29-39.
[32] Nkomazana O. Determining the causes for the shortage of human resources for primary health care in Botswana and developing a pilot intervention to address the problem: Stellenbosch: Stellen-bosch University; 2017.
[33] Chowdhary O. Comparative analysis on attrition and retention of employees in BPO sectors. Research Review International Journal of Multidisciplinary. 2019;4(2):869-74.
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