Background
Study setting
Methods
Sampling and data collection
District | Total number of eligible institutions (N) | Number of institutions sampled (n) | Percentage of eligible institutions sampled |
---|---|---|---|
Dailekh | 58 | 16 | 28 % |
Banke | 47 | 15 | 32 % |
Kailali | 44 | 22 | 50 % |
Qualitative data collection and management
Tool development, quantitative data collection and management
Validation methodology
Type of validity | Data source | Analytical approach |
---|---|---|
Construct validity | • Qualitative interviews with maternal and newborn health workers (MNHWs) • Quantitative survey with MNHWs | • 10 qualitative interviews with MNHWs who appeared satisfied with their jobs, and five qualitative interviews with MNHWs who appeared dissatisfied. • Comparison of job satisfaction scores with the qualitative data. |
Content validity | • Qualitative interviews with MNHWs • Quantitative survey with MNHWs | • 10 qualitative interviews with MNHWs who appeared satisfied with their jobs, and five qualitative interviews with MNHWs who appeared dissatisfied. • Calculating the degree to which the items in each of the dimensions of the Job Satisfaction Survey were related to each other, using the Spearman’s rank correlation |
Reliability and internal consistency | • Quantitative survey with MNHWs | Calculating: • Cronbach’s alpha (α) coefficient of internal consistency • Theta (θ) coefficient (special case of Cronbach’s alpha) to specifically account for multidimensionality in an item set |
Sensitivity | • Created quartiles of the JSI to distinguish between different degrees of job satisfaction. • Tabulated the average JSI by socio-demographic characteristics of the MNHWs to see how this average score varied by different characteristics. |
Results
Qualitative validation: definitions and concepts of job satisfaction in Nepal
Content validity
Construct validity
ID number | Job Satisfaction Index (JSI) (quartile category) | Interpretation of qualitative interview | Maternal and Newborn Health Worker (MNHW) interview quotes |
---|---|---|---|
1013 | 4.65 most satisfied | Satisfied | “Community members and my relatives … recognize me as a good person when I support them in their health related problems and during pregnancy and delivery. I really love that.” “There are no problems as the equipment are enough ” “I feel satisfied because I feel capable of doing things like immunization, conducting outreach clinics, giving antenatal and postnatal check-ups, assisting deliveries, managing medicine etc.” |
1026 | 2.31 most satisfied | Satisfied | “But here, because of transportation facility, it is easier to go from one place to another. Because of availability of facilities here, it is difficult for me to leave this place.” “Compared to other places, [the community] is quite supportive. They come to the health facility and are friendly with the health workers and they are interested in getting information.” |
2023 | 2.12 more satisfied | Satisfied | “I feel satisfied because this is my place and my office is near my house. When I am on duty for 24 h, it is easy to go home and then my friends inform me if there is a case.” “Everything is good. All my friends, sisters and sirs are cooperative and friendly. They teach me the things that I don't know. So everything is nice.” |
1040 | −1.69 less satisfied | Dissatisfied | “The HMC said that they would increase my salary after 1 year, but it has been 4 years already and nobody cares about it.” “Because there is a shortage of drinking water – it only comes every 10–15 days - I don’t feel like staying here. Sometimes I feel sad living alone here and being responsible for everything all by myself.” “We keep on talking (about the lack of rooms), time and time again to our in-charge…he says that it will be done, but nothing has been done so far.” |
2032 | −2.29 least satisfied | Dissatisfied | “I don't feel that the staff have been mutually working here. However, you still have to work even if you are not satisfied with it. There hasn’t been any situation when all the staff have agreed to work together with their heart.” “Actually, I don’t feel safe. While doing delivery, we don’t have anything besides gloves. We don’t have boots and masks so we have to be careful.” |
ID number | Job Satisfaction Index (JSI) (quartile category) | Interpretation of qualitative interview | Maternal and Newborn Health Worker (MNHW) interview quotes |
---|---|---|---|
2008 | −0.12 less satisfied | Satisfied | “The society over here is good. We have no problem when they come here to take service. I feel good. We have never faced problem even in night shifts. I feel good.” “I enjoy it here. Everyone has their section and their own responsibility. They work in their time and if there is any problem then we work together.” “There are delivery sets and equipment needed for Medical Abortion and check up. We have everything.” |
1032 | −0.65 Less satisfied | Satisfied | “People ask for me to conduct their delivery, even though it is another person’s duty. They trust me a lot and I am happy that everybody likes me. I do whatever I can. I feel confident while working and I am happy by myself.” “Nothing is easy here. There is not enough equipment, and there is no cleaner so it is difficult to clean the health facility.” |
2029 | −1.78 least satisfied | Satisfied | “I have an identity here. Everyone is familiar and I have made close personal friends too. After I came here, I started knowing my neighbours, sisters, and because of their love and care, it is difficult to leave this place.” “It is enjoyable when everyone does their work with mutual understanding. Because everyone is helpful and close, it is enjoyable.” |
2007 | −2.1 least satisfied | Satisfied | “We have access to public transport. There are Tharu (ethnic group) communities here…. they trust us. It is easy to work where we are trusted.” “There are many close friends of mine here. The other staff are my close friends.” |
Quantitative validation: validity, reliability and internal consistency
Variable |
n
| % | Mean job satisfaction index (JSI) | Standard deviation |
---|---|---|---|---|
District
| ||||
Dailekh | 40 | 29.20 | 1.02 | 2.34 |
Kailali | 59 | 43.07 | −0.75 | 2.36 |
Banke | 38 | 27.74 | 0.09 | 1.32 |
Gender
| ||||
Female | 137 | 100 | 0.00b
| 2.23 |
Age group
| ||||
18–19 years | 6 | 4.38 | 1.41 | 2.99 |
20–29 years | 60 | 43.8 | −0.18 | 2.38 |
30–39 years | 43 | 31.39 | −0.06 | 2.16 |
40–49 years | 25 | 18.25 | 0.34 | 1.79 |
50 years or older | 3 | 2.19 | −1.05 | 1.36 |
Ethnicity
| ||||
Dalit Hill | 4 | 2.92 | 0.3 | 1.6 |
Dalit TeraiƗ | 1 | 0.73 | 1.4 | . |
Disadvantaged Janajati Hill | 14 | 10.22 | −0.6 | 2.7 |
Disadvantaged Janajati Terai | 16 | 11.68 | −1.2 | 2.0 |
Relatively advantaged Janajati | 9 | 6.57 | 1.4 | 2.9 |
Upper caste | 93 | 67.88 | 0.1 | 2.1 |
Job title
| ||||
Auxiliary Nurse Midwife | 88 | 64.23 | −0.16 | 2.12 |
Senior Auxiliary Nurse Midwife | 23 | 16.79 | 0.25 | 1.36 |
Staff Nurse | 13 | 9.49 | −0.04 | 4.05 |
Senior Staff Nurse | 5 | 3.65 | −0.44 | 1.40 |
Up-graded Maternal and Child Health Worker | 8 | 5.84 | 1.44 | 1.63 |
Type of current health facility
| ||||
Zonal hospital | 13 | 9.49 | −0.55 | 2.08 |
District hospital | 13 | 9.49 | −0.61 | 4.55 |
Primary health centre | 24 | 17.52 | 0.16 | 1.45 |
Health post | 64 | 46.72 | 0.02 | 1.94 |
Sub health post | 23 | 16.79 | 0.44 | 1.82 |
Time spent in current post
| ||||
Less than 1 month | 12 | 8.76 | 2.52 | 2.12 |
1–6 months | 23 | 16.79 | −0.62 | 2.09 |
7–12 months | 6 | 4.38 | −0.55 | 1.57 |
1–2 years | 22 | 16.06 | 0.02 | 2.07 |
2 years or more | 74 | 54.01 | −0.18 | 2.15 |
Salary after tax (Nepali Rupees)
a
| ||||
Less than 5,000 | 4 | 2.92 | −1.93 | 0.99 |
5,000–9,999 | 39 | 28.47 | −0.26 | 2.22 |
10,000–14,999 | 72 | 52.55 | 0.15 | 2.05 |
15,000–19,999 | 21 | 15.33 | 0.21 | 2.84 |
More than 20,000 | 1 | 0.73 | 2.29 | . |
PB1 | PB2 | PB3 | PB4 | PB5 | PB6 | PB7 | PB8 | |
---|---|---|---|---|---|---|---|---|
PB1 | 1 | |||||||
PB2 | 0.49 | 1 | ||||||
PB3 | −0.03 | −0.01 | 1 | |||||
PB4 | 0.21 | 0.22 | 0.14 | 1 | ||||
PB5 | 0.52 | 0.38 | −0.03 | 0.26 | 1 | |||
PB6 | 0.05 | 0.03 | 0.05 | 0.01 | 0.12 | 1 | ||
PB7 | 0.34 | 0.22 | −0.02 | 0.37 | 0.45 | 0.05 | 1 | |
PB8 | 0.35 | 0.31 | 0.20 | 0.08 | 0.8 | 0.08 | 0.13 | 1 |
CS1 | CS2 | CS3 | CS4 | CS5 | CS6 | CS7 | |
---|---|---|---|---|---|---|---|
CS1 | 1 | ||||||
CS2 | 0.59 | 1 | |||||
CS3 | 0.27 | 0.42 | 1 | ||||
CS4 | 0.43 | 0.53 | 0.37 | 1 | |||
CS5 | 0.13 | 0.17 | −0.02 | 0.30 | 1 | ||
CS6 | 0.07 | 0.08 | 0.02 | 0.1 | 0.04 | 1 | |
CS7 | 0.19 | 0.29 | −0.02 | 0.27 | 0.61 | 0.12 | 1 |
PR1 | PR2 | PR3 | PR4 | PR5 | |
---|---|---|---|---|---|
PR1 | 1 | ||||
PR2 | 0.14 | 1 | |||
PR3 | 0.23 | 0.05 | 1 | ||
PR4 | 0.08 | 0.12 | 0.09 | 1 | |
PR5 | 0.30 | 0.17 | 0.18 | 0.38 | 1 |
WE1 | WE2 | WE3 | WE4 | WE5 | WE6 | WE7 | WE8 | |
---|---|---|---|---|---|---|---|---|
WE1 | 1 | |||||||
WE2 | 0.19 | 1 | ||||||
WE3 | 0.167 | 0.23 | 1 | |||||
WE4 | 0.00 | 0.30 | 0.40 | 1 | ||||
WE5 | 0.00 | 0.20 | 0.35 | 0.49 | 1 | |||
WE6 | 0.11 | 0.21 | 0.31 | 0.15 | 0.12 | 1 | ||
WE7 | −0.01 | 0.23 | 0.25 | 0.12 | 0.26 | 0.21 | 1 | |
WE8 | 0.12 | 0.08 | 0.07 | −0.00 | 0.10 | −0.04 | 0.12 | 1 |
GS1 | GS2 | GS3 | GS4 | GS5 | GS6 | GS7 | GS8 | |
---|---|---|---|---|---|---|---|---|
GS1 | 1 | |||||||
GS2 | 0.27 | 1 | ||||||
GS3 | 0.25 | 0.16 | 1 | |||||
GS4 | 0.10 | 0.04 | −0.07 | 1 | ||||
GS5 | −0.13 | 0.36 | −0.18 | 0.17 | 1 | |||
GS6 | 0.19 | 0.24 | 0.49 | −0.11 | −0.04 | 1 | ||
GS7 | 0.13 | 0.06 | −0.04 | 0.09 | 0.06 | −0.25 | 1 | |
GS8 | 0.02 | −0.16 | 0.23 | −0.05 | −0.22 | 0.10 | −0.04 | 1 |
Dimension | Cronbach's alpha (α) |
---|---|
Overall JSI | 0.78 |
Pay and benefits | 0.66 |
Co-workers and supervisors | 0.64 |
Promotion | 0.52 |
Work environment | 0.65 |
General | 0.42 |
Quartile | Mean JSI |
---|---|
Least satisfied | −2.83 |
Less satisfied | −0.42 |
More satisfied | 0.82 |
Most satisfied | 2.51 |