Analysis of Job Satisfaction of Professional Nurses in Public and Private Sectors in Anambra State, Nigeria
Chapter One
Purpose of the Study
The main purpose of this study was to compare the job satisfaction of professional nurses in public and private health sectors in Anambra State. The study is also set to achieve the following specific purposes:
- To determine the level of satisfaction nurses derive from job security in public and private hospitals.
- To determine how recognition of nurses’ performances in public and private hospitals provide job satisfaction.
- To identify the extent to which opportunity for advancement guarantees job satisfaction to nurses in public and private hospitals
- To ascertain the level of satisfaction nurses derive from job control/responsibilities in public and private hospitals.
CHAPTER TWO
LITERATURE REVIEW
Introduction
This chapter generally, reviewed materials on job satisfaction as a prelude towards gaining both conceptual and theoretical insight and knowledge that formed the bedrock of the present study. To this end therefore, the study presents the review of related literature under the following headings: Overview of the Nigeria health care system, Theoretical review on job satisfaction, Conceptual framework on nurses’ job satisfaction, Empirical studies on professional nurses’ job satisfaction and Summary of literature review.
Overview of Nigeria’s Health System
The Nigerian health care sector is broad and comprises of public, private for-profit, Non-Governmental Organizations (NGOs), Community-Based Organizations (CBOs), Faith-Based Organizations (FBOs), and traditional health care providers. The health care sector is very heterogeneous, and includes unregistered and registered providers ranging from traditional birth attendants and individual medicine sellers to sophisticated hospitals. Thirty-eight percent of all registered facilities in the Federal Ministry of Health (FMOH) facilities database are privately owned, of which about 75% are primary care and 25% are secondary care facilities (WHO, 2008). Private facilities account for one-third of primary care facilities and could be a potentially important partner in expanding coverage of key health services.
Nigeria is a federation with three tiers of government – Federal, State, and Local. While the federal government develops policies that are relevant across all three levels, responsibility for health service provision in the public sector reflects the three-tier structure. According to the Department of Health Planning, Research and Statistics of the Federal Ministry of Health (FMOH), (2006) there were over 20,000 registered health facilities in the public sector across these three tiers in Nigeria in 2007. The levels of care in the public sector according to Nigeria Health System Assessment (NHSA) report in 2008 are as follows:
- Tertiary: Tertiary facilities form the highest level of health care in the country and include specialist and teaching hospitals and federal medical centers. These facilities have special expertise and full-fledged technological capacity that enable them to serve as referral centers for patients from the primary and secondary levels and act as resource centers for knowledge generation and diffusion. Each state has at least one tertiary facility. The responsibility for tertiary care and training falls under the mandate of the federal government.
- Secondary: Secondary care facilities include general hospitals, which provide general medical and laboratory services as well as specialized health services such as surgery, pediatrics, obstetrics and gynecology. General hospitals are typically staffed by medical officers (who are physicians), nurses, midwives, laboratory and pharmacy specialists, and Community Health Officers (CHOs). The facilities serve as referral centers for primary health care facilities. Each district, local government (LGA), or zone is expected to have at least one secondary-level facility. State governments are responsible for this level of care.
CHAPTER THREE
RESEARCH METHOD
This chapter presented the research design, area of study, population of the study, sample and sampling technique, instrument for data collection, validity and reliability of the study, ethical consideration, procedure for data collection and method of data analysis.
Research Design
This is a cross-sectional comparative study that sought to gain insight into the job satisfaction of professional nurses that work in both public and private health sectors of Anambra State. Comparison, as a fundamental research strategy helped us in this study to identify the basic job satisfaction variables of professional nurses in both health sectors of Anambra State. However, Survey research method was adopted for the study.
Area of Study
The study was conducted in Anambra State, South East of Nigeria. The State which has boundaries with Enugu, Abia, Imo, Delta and Kogi States has twenty one (21) local government areas. It has one Federal teaching hospital, good number of State hospitals, privately owned and Mission hospitals. The Federal teaching hospital is located at the commercial/ industrial town of Nnewi, while the State, Private and Mission hospitals are scattered within the twenty one (21) local government areas of the State. Professional nurses working in these hospitals were drawn from the civil servants that constitute the population.
Population of the Study
The population of the study was the professional nurses working in both Public and Private Health sectors of Anambra State. According to the data collected from Anambra State Ministry of Health Awka, there were 1,258 and 4,645 professional nurses working in Public and Private health sectors of Anambra State respectively. This therefore, gives a population of 5903 professional nurses at the time of the study. A sample size of 375 subjects was determined using the sample determination formula for a known population figure as developed by Yamane (1964) as follows;
CHAPTER FOUR
PRESENTATION OF RESULTS
This chapter discussed the presentation, analysis and interpretation of data from the study. A total of 375 copies of questionnaire were administered out of which 358 representing 95.47 percent copies were completed and returned. However among the returned questionnaire, eight (8) were wrongly filled and was subsequently rejected for the analysis. The researcher was therefore left with 350 (93.33 percent) questionnaires for the analysis which was adequate and enough representative of the population of the study (Eboh, 2009).
CHAPTER FIVE
DISCUSSION OF FINDINGS, CONCLUSIONS AND RECOMMENDATIONS
This chapter presented the discussion of findings on data presented in chapter four and inferences drawn therein, conclusion, implications of the study, limitations of the study, recommendation and suggestion for further study.
Discussion of Findings
Discussion was based on the research questions and the tested Null hypotheses. The findings of this study were also compared with empirical studies done previously by other researchers.
Nurses’ Satisfaction from Job Security
The result of the study indicated that nurses in the public hospitals were satisfied with job security while nurses in the private hospitals were not. This finding is supported by Rao & Malik (2012) who found that more number of government hospital nurses have job security as such they are more satisfied with their job whereas most of the private hospital nurses do not have security with their job as such they seemed to be less satisfied. Chimanikire et al., (2007) also supported that even though most employees indicate that their jobs were relatively secure, most of them expressed overall lack of satisfaction.
Nurses’ Satisfaction from Recognition
Result showed that nurses in the public hospitals were satisfied with recognition while nurses in the private hospitals were not satisfied with recognition. To this end, Barker & Guzman (2012) supported that the use of recognition is a very effective tool to assist facilities in the promotion of job satisfaction and nurse retention. Barker & Guzman also observed that many nurses do not feel their work is rewarded or appreciated while some do. Lephalala, (2006) also agreed that recognition was low in private hospitals as nurses’ opinions were undervalued by medical staff (mostly the medical doctors). Danish & Usman (2010) reported that there was a significant relationship between recognition and work motivation and satisfaction.
Effect of Job Control on Job Satisfaction
The Null hypothesis showed that job control does not have significant effect on job satisfaction between nurses in public and private hospitals. This finding is in line with Shimazu et al., (2004) who observed that job satisfaction does not depend on job control and Robertson, Birch and Cooper (2012) who noted that there is no positive relationship between variety of job responsibilities and job satisfaction.
In this study, nurses in public health care settings were more satisfied with their job than private nurses. This could be attributed to structural and functional differences between public and private hospitals. It was based on the fact that government hospitals offer better facilities, more incentives and superior service conditions to nurses compared with private hospitals, which usually have limited financial and human resources to offer to employees. The disparity between government and private health care settings continues to be an issue of debate and warrants more in-depth investigation.
Conclusion
From the findings of this study, it was obvious that job satisfaction was high among nurses in public hospitals than nurses in private hospitals. The study equally shows that government guarantees job security to its employees more than private individuals. Finally, nurses in both public and private hospitals were satisfied with job control in their career.
Implications of the Study
The findings of the study have far reaching implication for stakeholders in the health sector. Nurses in private hospitals as the study reveals are less satisfied with their jobs. Consequently, since low level satisfaction leads to absenteeism, labour turnover and negative publicity of the organization, management of private hospitals would be faced with these vices because an unsatisfied worker can prove to be a liability to the organization just as Igbal (2012) submits that a higher job satisfaction is associated with increased productivity, lower absenteeism, and lower employee turnover. Conclusively therefore, happy and satisfied worker is always a productive worker and this to a reasonable extent was the case in public hospitals but not so in the privately owned hospitals in Anambra State.
Limitations of the Study
This study had some limitations that must be acknowledged though they did not affect the final outcome and results. Firstly, the distribution of the questionnaire was a hectic task because of the spatial geographical location of the hospitals. This almost affected the distribution and collection of the copies of questionnaire on-the-spot.
Secondly, the study employed the survey method of generating information from the respondents through questionnaires relied on subjective or qualitative responses which were somehow difficult to quantitatively validate.
Recommendations
Based on the findings of this study, the following recommendations were proffered:
- Management should encourage employees to take responsibility for their own job satisfaction by developing an environment that allows them the scope to perform well. In this environment, employees need to accept that responsibility and take steps to build on their own satisfaction.
- Because career opportunities and further training afford professional nurses the prospect of further developing themselves, and growing within the ranks of their career. Health managers in both sectors should provide nurses with the enabling facilities to actualize their desires in this respect.
- Effective strategies for motivation and retention of professional nurses in both sectors should be centered on creating a stimulating, challenging and friendly working environment by health managers.
- Health managers should recognize the needs of nurses and work towards improving them to address the cases of increasing migration of nurses from private sector to public sector and from both sectors to outside the country.
- Management of private hospitals should strive to create enabling environment similar to what is obtained in public hospital in terms of job security to discourage staff turnover.
Contribution to knowledge
This study highlighted the obvious disparity on the level of job satisfaction of professional nurses working in the public and private health sectors of Anambra State. Giving the pivotal roles nurses’ play in the effective and efficient health care delivery in Anambra State, it therefore becomes imperative for health managers especially those in private sector to address holistically the four core variable identified in this study namely: job security, performance recognition, opportunity for advancement and job control as antidotes to professional nurses job satisfaction and retention. Furthermore, improving the private sectors working environment to be congruent with the aspirations, expectations and values system of professional nurses is more likely to increase satisfaction of nurses working in this sector. This consequently will have positive and endearing effects on both professional nurses and Anambra State health sector.
Suggestion for further studies
Job satisfaction no doubt represents one of the most complex areas facing managers under human resources management. Despite thousands of papers and researches conducted on job satisfaction all over the world, the area is still inexhaustive. While the changing work environment portends new research interest, the need to revisit past research finding in line with the modern trends became obvious hence making it necessary for further and more studies on job satisfaction. On this note therefore, the researcher suggested for further studies in the following areas;
- Comparative study of job satisfaction variables among professional nurses and other health workers e.g. Pharmacist, Laboratory Scientists, Doctors, etc.
- Gender issues, female dominance and job satisfaction in Nursing Profession and career.
- Job satisfaction levels of professional nurses based on their area of specialization and practice, among others.
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