Intention to leave a job among public health workers

  • Katica Tripković Gradski zavod za javno zdravlje Beograd
  • Milena Šantrić- Milićević Medical Faculty, University in Belgrade, Institute for Social Medicine
Keywords: health workforce, public health, intention to leave a job, retention

Abstract


A particularly important issue in healthcare settings is public health professionals’ intention to leave their job, which may exacerbate both existing and forecasted public health workforce shortage and jeopardize the health system’s performance. The rate of intention to leave a job varies across countries and among different profiles of health workers. It is well documented that job dissatisfaction facilitates the intention to leave. Organizational factors (such as job- related stress, interpersonal relationships with colleagues and supervisors, opportunities for professional development, nature of work, and organizational culture) are considered to have the most significant impact on public health workers’ intention to leave a job. However, the relevance of individual factors (gender, age, marital status) and other factors (e.g., number of family members, community satisfaction, and family responsibilities) is less clear. It is of great importance that policymakers and managers in health facilities implement effective retention strategies in order to reduce public health workers’ turnover and ensure continued delivery of both health care and public health services, and prepare for response to future crises. Retention strategies should be oriented towards ensuring public health workers’ health and safety, increasing job satisfaction, recognizing their value and achievements, and creating supportive and productive work environments.

References


  1. Foldspang A. From potential to action. Public health core competencies for essential public health operations. A manual. Brussels: Association of Schools of Public Health in the European Region; 2016.

  2. Yeager VA, Wisniewski JW, Amos K, Bialek R. Why Do People Work in Public Health? Exploring Recruitment and Retention Among Public Health Workers. J. Public Health Manag. Pract. 2016; 00(00):1–8.

  3. Milicevic MS, Vasic M, Edwards M, Sanchez C, Fellows J. Strengthening the public health workforce: An estimation of the long‐term requirements for public health specialists in Serbia. Health Policy. 2018; 122:674–680, https://doi.org/10.1016/j.healthpol.2018.03.012.

  4. Tripković K, Milićević M, Miladinović MM, Kovačević L, Mikanović VB, Vuković D. Implementation of the Workload Indicators of Staffing Need (WISN) method in determining staff requirements in public health laboratories in Serbia. Disaster Med. Public Health Prep. 2020; 1–9. https://doi.org/10.1017/dmp.2020.133.

  5. World Health Organization. Global strategy on human resources for health workforce 2030. [Internet]. 69th World Health Assembly. 2016 May 20-28; Geneva, Switzerland. Geneva: WHO; 2016.

  6. Sun T, Zhao XW, Yang LB, Fan LH. The impact of psychological capital on job embeddedness and job performance among nurses: a structural equation approach. J. Adv. Nurs. 2011; 68(1):69–79.

  7. Zaheer S , Ginsburg L, Wong HJ, Thomson K, Bain L and Wulffhart Z. Turnover intention of hospital staff in Ontario, Canada: exploring the role of frontline supervisors, teamwork, and mindful organizing. Hum. Resour. Health. 2019; 17:66. https://doi.org/10.1186/s12960-019-0404-2.

  8. Shen X, Jiang H, Xu H, Ye J, Lv C, Lu Z, Gan Y. The global prevalence of turnover intention among general practitioners: a systematic review and meta-analysis. BMC Fam. Pract. 2020;21:246.

  9. Gebregziabher D, Berhanie E, Berihu H, Belstie A and Teklay G. The relationship between job satisfaction and turnover intention among nurses in Axum comprehensive and specialized hospital Tigray, Ethiopia. BMC Nurs. 2020; 19:79. https://doi.org/10.1186/s12912-020-00468-0

  10. Chegini Z, AsghariJafarabadi M, Kakemam E. Occupational stress, quality of working life and turnover intention amongst nurses. Nurs. Crit. Care. 2019; 24(5):283-289 https://doi.org/10.1111/nicc.12419.

  11. El-Jardali F, Dimassi H, Dumit N, Jamal D, Mouro G. A national cross sectional study on nurses’ intent to leave and job satisfaction in Lebanon: implications for policy and practice. BMC Nurs. 2009; 8(3):1–13.

  12. Heinen MM, van Achterberg T, Schwendimann R, Zander B, Matthews A, Kozka M et al. Nurses’ intention to leave their profession: A cross sectional observational study in 10 European countries. Int. J. Nurs. Stud. 2013; 50:174–184.

  13. Stewart NJ, D'Arcy C, Kosteniuk J, Andrews ME, Morgan D, Forbes D, et al. Moving on? Predictors of intent to leave among rural and remote RNs in Canada. J Rural Health. 201; 27(1):103-13. doi: 10.1111/j.1748-0361.2010.00308.x.

  14. Peter KA, Meier-Kaeppeli B, Pehlke-Milde J and Grylka-Baeschlin S. Work-related stress and intention to leave among midwives working in Swiss maternity hospitals – a cross-sectional study. BMC Health Serv. Res. 2021; 21:671. https://doi.org/10.1186/s12913-021-06706-8.

  15. He R, Liu J, Zhang W-H, Zhu B, Zhang N, Mao Y. Turnover intention among primary health workers in China: a systematic review and meta-analysis. BMJ Open. 2020; 10:e037117. doi:10.1136/bmjopen-2020-037117.

  16. Al-Muallem N, Al- Surimi KM. Job satisfaction, work commitment and intention to leave among pharmacists: a cross-sectional study. BMJ Open. 2019; 9:e024448. doi:10.1136/bmjopen-2018-024448.

  17. Gacevic M, Milicevic MS, Vasic M, Horozovic V, Milicevic M, Milic N. The relationship between dual practice, intention to work abroad and job satisfaction: A population‐based study in the Serbian public healthcare sector. Health Policy. 2018; 122:1132–1139. https://doi.org/10.1016/j.healthpol.2018.09.004.

  18. Santric‐Milicevic M, Terzic‐Supic ZJ, Matejic BR, Vasic V, Ricketts TC. First‐ and fifth‐year medical students’ intention for emigration and practice abroad: A case study of Serbia. Health Policy. 2014; 118:173–183. https://doi.org/10.1016/j.healthpol.2014.09.018.

  19. Santric‐Milicevic M, Matejic B, Terzic‐Supic Z, Vasic V, Babic U, Vukovic V. Determinants of intention to work abroad of college and specialist nursing graduates in Serbia. Nurse Educ. Today. 2015; 35:590–596. https://doi.org/10.1016/j.nedt.2014.12.022.

  20. Sellers K, Leider JP, Harper E, Castrucci BC, Bharthapudi K, Liss-Levinson R, et al. The Public Health Workforce Interests and Needs Survey: The First National Survey of State Health Agency Employees. J Public Health Manag Pract. 2015; 21(Suppl 6):S13-27. doi: 10.1097/PHH.0000000000000331

  21. Liss-Levinson R, Bharthapudi K, Leider JP, Sellers K. Loving and Leaving Public Health: Predictors of Intentions to Quit Among State Health Agency Workers. J Public Health Manag Pract. 2015, 21(6 Supp), S91–S101

  22. Leider JP, Harper E, Shon JW, Sellers K, Castrucci BC. Job Satisfaction and Expected Turnover Among Federal, State, and Local Public Health Practitioners. Am J Public Health. 2016, 106:1782–1788. doi:10.2105/AJPH.2016.303305

  23. Juliano C, Castrucci BC, Leider JP, McGinty MD, Bogaert K. The Governmental Public HealthWorkforce in 26 Cities: PH WINS Results From Big Cities Health Coalition Members. J Public Health Manag Pract. 2019; 25(Suppl 2):S38-S48. doi:10.1097/PHH.0000000000000929.

  24. Sellers K, Leider JP, Gould E, Castrucci BC, Beck A, Bogaert K, et al. The State of the US Governmental Public Health Workforce, 2014–2017. Am J Public Health. 2019; 109:674–680. doi: 10.2105/AJPH.2019.305011

  25. Bogaert K, Castrucci BC, Gould E, Sellers K, Leider JP, Whang C, et al. The Public Health Workforce Interests and Needs Survey (PH WINS 2017): An Expanded Perspective on the State Health Agency Workforce. J Public Health Manag Pract. 2019; 25:S16-S25 doi: 10.1097/PHH.0000000000000932

  26. Sellers K, Leider JP, Lamprecht L, Liss-Levinson R, Castrucci BC. Using Public Health Workforce Surveillance Data to Prioritize Retention Efforts for Younger Staff. Am J Prev Med. 2020; 59(4):562−569.

  27. Peru Yanez JA, Jahanshahi AA, Alvarez-Risco A, Li J, Zhang SX. Anxiety, Distress, and Turnover Intention of Healthcare Workers in Peru by Their Distance to the Epicenter during the COVID-19 Crisis. Am. J. Trop. Med. Hyg. 2020; 103(4):1614–1620. doi:10.4269/ajtmh.20-0800

  28. Nashwan AJ, Abujaber AA, Villar RC, Nazarene A, Al-Jabry MM and Fradelos EC. J. Pers. Med. 2021; 11:456. https://doi.org/10.3390/jpm11060456.

  29. Al-Mansour K. Stress and turnover intention among healthcare workers in Saudi Arabia during the time of COVID-19: Can social support play a role? PLoS ONE. 2021;16(10): e0258101. https://doi.org/10.1371/journal.pone.0258101

  30. Mirzaei A, Rezakhani Moghaddam H, Habibi Soola A. Identifying the predictors of turnover intention based on psychosocial factors of nurses during the COVID-19 outbreak. Nurs Open. 2021; 00:1–8. https://doi.org/10.1002/nop2.896.

  31. Royal College of Nursing. Employment Survey 2021.RCN, London. https://www.rcn.org.uk/professional-development/publications/employment-survey-2021-uk-pub-010 075

  32. Astin C, Haneen A, Abdulaziz A, Hamasha M, Soren J. Identifying Patterns of Turnover Intention Among Alabama Frontline Nurses in Hospital Settings During the COVID-19 Pandemic. J. Multidiscip. Healthc. 2021; 14: 1783–1794.

  33. Balicer RD, Omer SB, Barnett DJ, Everly Jr GS. Local public health workers' perceptions toward responding to an influenza pandemic. BMC Public Health. 2006; 6:99. https://doi.org/10.1186/1471-2458-6-99.

  34. Stone KW, Kintziger KW, Jagger MA, Horney JA. Public Health Workforce Burnout in the COVID-19 Response in the U.S. Int. J. Environ. Res. Public Health. 2021; 18:4369. https://doi.org/10.3390/ijerph18084369.

  35. Tripković K, Šantrić‐Milićević M, Vasić M, Šulović MZ, Odalović M, Jovanović VM, et al. Factors Associated with Intention of Serbian Public Health Workers to Leave their Job: A Cross‐Sectional, Population‐Based Study. Int. J. Environ. Res. Public Health. 2021; 18:10652. https://doi.org/10.3390/ijerph182010652.

  36. Jadoo SAA, 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. Hum. Resour. Health. 2015, 13:21. doi: 10.1186/s12960-015-0014-6.

  37. Chen G, Tang Y, Su Y. The Effect of Perceived Over-Qualification on Turnover Intention From a Cognition Perspective. Front. Psychol. 2021; 12:699715. doi: 10.3389/fpsyg.2021.699715

  38. González R, Cockburn W, Irastorza X, Houtman I, Bakhuys Roozeboom M. European Survey of Enterprises on New and Emerging Risks Managing Safety and Health at Work; European Agency for Safety and Health at Work, Esener, European Union: Brussels, Belgium, 2010.

  39. Ajzen I. The theory of planned behaviour. Organ. Behav. Hum. Decis. Process. 1991;50(2):179-211.

  40. Price JL, Mueller CW. A causal model of turnover for nurses. Acad Manag J. 1981; 24:543–565.

  41. Mobley WH. Employee turnover: causes, consequences, and control. New York, New York: Addison- Wesley Publishing Company Inc, 1982.

  42. Tett RP, Meyer JP. Job satisfaction, organizational commitment, turnover intention and turnover: path analysis based on analytic findings. Pers. Psychol. 1993; (46):259-293.

  43. Vandenberg RJ, Nelson JB . Disaggregating the motives underlying turnover intentions: When do intentions predict turnover behaviour? Hum Relat. 1999; (52):1313-1336.

  44. Regts G, Molleman E. To leave or not to leave: When receiving interpersonal citizenship behavior influences an employee’s turnover intention. Hum Relat. 2012; 66(193): 192-218.

  45. Singh N, Sharma LS. Process Models of Employee Turnover during 1975-1995: A Review, European academic research. 2015; III(2).

  46. March JG, Simon HA. Organizations. New York: John Wiley, 1958.

  47. Mobley WH. Intermediate linkages in the relationship between job satisfaction and employee turnover. J. Appl. Psychol. 1977; 62:237–240.

  48. Jackofsky EF. Turnover and job performance: An integrated process model. Acad Manage Rev. 1984; 9:74–83.

  49. Mitchell TR, Holtom BC, Lee TW, Sablynski C, Erez M. Why people stay: Using job embeddedness to predict voluntary turnover. Acad Manage J. 2001; 44:1102–1121.

  50. Shweta J. Determinants of employee turnover intentions: A review. Management Today. 2009; 9(2):26-33.

  51. Halawi AH. Stimuli and Effect of the Intention to Leave the Organization. Eur. Sci. J. 2014; e - ISSN 1857- 7431.

  52. Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Department of health and human services. Exposure to stress. Occupational Hazards in Hospitals. DHHS (NIOSH) Publication No. 2008–136, July 2008.

  53. Mobley WH, Griffeth RW, Hand HH, Meglino BM. Review and conceptual analysis of the employee turnover process. Psychol. Bull. 1979; 86:493–522.

  54. Bayarçelik EB, Findikli MA. The Mediating Effect of Job Satisfaction On The Relation Between Organizational Justice Perception And Intention To Leave. Procedia Soc Behav Sci 235. 2016; 403-411.

  55. The European Observatory on Health Systems and Policies. Observatory Studies Series No. 24. Public Health in Austria. An analysis of the status of public health. The European Observatory on Health Systems and Policies, 2011. ISBN 978 92 890 0249 3.

  56. Søvold LE, Naslund JA, Kousoulis AA, Saxena S, Qoronfleh MW, Grobler C, et al. Prioritizing the Mental Health and Well-Being of Healthcare Workers: An Urgent Global Public Health Priority. Front. Public Health. 2021; 9:679397. doi: 10.3389/fpubh.2021.679397

  57. Warden DH, Hughes RG, Probst JC, Warden DN, Adams SA. Current turnover intention among nurse managers, directors, and executives. Nurs Outlook. 2021; 69(5):875-885. doi:10.1016/j.outlook.2021.04.006.


58. Council on Linkages Between Academia and Public Health Practice. Recruitment and Retention: What’s Influencing the Decisions of Public Health Workers? Public Health Foundation: Washington, DC, USA, 2016.

Published
2022/10/19
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