Job satisfaction of urban community health workers after the 2009 healthcare reform in China: a systematic review

Int J Qual Health Care. 2016 Feb;28(1):14-21. doi: 10.1093/intqhc/mzv111. Epub 2015 Dec 17.


Purpose: In 2009 China introduced a new round of healthcare reform to strengthen primary care networks through the development of Community Health Services (CHS). This study aimed to measure the degree of overall job satisfaction and also satisfaction dimensions and then find common causes of dissatisfaction among Community Health Workers (CHWs) in urban China by conducting a systematic review of relevant studies on CHWs' job satisfaction.

Data sources: Web of Science, PubMed, Google scholar, Wanfangdata and CNKI were searched.

Study selection: Publications about job satisfaction of CHWs were screened and assessed. Finally 18 Chinese articles and 4 English articles were included.

Data extraction: Quantitative and qualitative data were extracted for nine themes concerning job satisfaction. Narrative synthesis was employed to analyze the data.

Results of data synthesis: CHWs were generally neither satisfied nor dissatisfied with their work after 2009. Financial rewards and opportunities for professional development were the most important determinants of job dissatisfaction. Workers were generally satisfied with interpersonal relationships in the workplace. The expanded public health services package and human-resources related regulations, e.g. the professional rank promotion system, government-controlled staffing policy (i.e. staff-quota system) and government-controlled budgetary planning (i.e. the Separation of Revenue and Expenditure), were policies that had an effect on job satisfaction.

Conclusion: Financial rewards and professional development were the two main predictors of job satisfaction. To improve CHS in China, policy-makers (especially the central government) need to consider the impact of current policies on job satisfaction in order to reduce job dissatisfaction.

Keywords: china; community health; healthcare reform; job satisfaction; systematic review.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • China
  • Community Health Workers / psychology*
  • Health Care Reform*
  • Humans
  • Job Satisfaction*
  • Primary Health Care*