Impact of primary care system interventions on healthcare worker satisfaction and intention to stay in the Philippines: a follow-up study

Carol Stephanie Chua Tan-Lim; Mark Anthony U Javelosa; Josephine T Sanchez; Leonila F Dans; Mia P Rey; Anton G Elepano; Regine Ynez H De Mesa; Antonio L Dans

doi:10.1136/bmjoq-2024-002788

Impact of primary care system interventions on healthcare worker satisfaction and intention to stay in the Philippines: a follow-up study

BMJ Open Qual. 2024 May 20;13(2):e002788. doi: 10.1136/bmjoq-2024-002788.

Authors

Carol Stephanie Chua Tan-Lim^{1

2}, Mark Anthony U Javelosa³, Josephine T Sanchez², Leonila F Dans^{3

2}, Mia P Rey^{2

4}, Anton G Elepano², Regine Ynez H De Mesa², Antonio L Dans²

Affiliations

¹ Department of Clinical Epidemiology, University of the Philippines Manila College of Medicine, Manila, Philippines cctan7@up.edu.ph.
² Program on Health Systems Development - Philippine Primary Care Studies, Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines.
³ Department of Clinical Epidemiology, University of the Philippines Manila College of Medicine, Manila, Philippines.
⁴ Department of Accounting and Finance, Cesar E A Virata School of Business, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines.

Abstract

Background: The Philippines has a shortage and uneven distribution of healthcare workers (HCWs). Job satisfaction is an important element to HCW retention and attracting new HCWs into the health system.

Objective: This study measured HCWs' intent to stay and HCWs' satisfaction after implementation of multiple interventions intended to strengthen the primary care system, and determine factors significantly associated with HCWs' intent to stay.

Methodology: This is a serial cross-sectional study in urban, rural and remote primary care sites in the Philippines. All physicians, nurses, midwives, dentists, community health workers and support staff were invited to participate. Baseline HCWs' intent to stay and satisfaction were obtained using a self-administered questionnaire prior to implementation of interventions. The same survey was again conducted in the years 2021 and 2022, corresponding to 5 and 6 years after initial implementation for the urban site, and 2 and 3 years for the rural and remote sites. We used multiple logistic regression to determine factors associated with intent to stay.

Results: There were 430 survey respondents (89.4% response rate) for year 2021, and 417 survey respondents (97.4% response rate) for year 2022. The urban and rural sites had significant increase in several HCW satisfaction domains, while the remote site had significant decrease in several HCW satisfaction domains. There was no significant difference in the intent to stay in the three sites. Factors that decreased intent to stay included length of employment, job involvement and employment as a nurse, while factors that increased intent to stay included job satisfaction, enjoyment and working in the urban site.

Conclusion: HCW satisfaction improved in the urban site and rural site, while HCW satisfaction declined in the remote site. Intention to stay of primary care HCWs did not significantly change.

Keywords: Health services research; PRIMARY CARE; Quality improvement.

MeSH terms

Adult
Cross-Sectional Studies
Female
Follow-Up Studies
Health Personnel* / psychology
Health Personnel* / statistics & numerical data
Humans
Intention
Job Satisfaction*
Male
Middle Aged
Personnel Turnover / statistics & numerical data
Philippines
Primary Health Care* / standards
Primary Health Care* / statistics & numerical data
Surveys and Questionnaires