human resources management (hrm); what...
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HUMAN RESOURCES MANAGEMENT (HRM); WHAT EFFECT
DOES IT HAVE ON STAFF PERFORMANCE AND HEALTH
SERVICE DELIVERY IN NIGERIA – THE CASE STUDY OF
UNIVERSITY OF PORT-HARCOURT TEACHING HOSPITAL (UPTH),
RIVERS STATE, NIGERIA
Author:
Motunrayo Obajimi
Supervisor:
Jan Svanberg
Master’s Thesis in Business Administration, MBA programme
19 February 2011
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ACKNOWLEDGEMENT
I thank the Blekinge Institute of Technology (BTH) for offering such a wonderful MBA
program that allows geographically-scattered students to pursue a world class educational
program. I owe gratitude to the faculty and administrators of BTH MBA program who
have been kind enough to help me in their respective roles.
I am thankful to Dr. C.O. Omolase and Dr. Uneje for their advice in the course of this
work.
I am equally indebted to a number of respondents who contributed to this work by giving
their valuable response to the survey, and also to Dr. Ogonna Ogbonna, Dr. Uriah, Dr.
Ochuko, and Dr. Benson (all of UPTH), and Mr. Akingbade Akinola & Mrs. Chimatara
Chima-Nicholas, who were very helpful in the administration of the questionnaires.
My immense gratitude goes to my mum – Mrs. T.A. Tinuoye, sister – Kemi, brothers –
Femi & Segun, big sisters – Funmilola & Ebun, all for their support and love always.
Great appreciation goes to my in-laws – Daddy & Mummy Obajimi, Kfaj & Ronke –
who never stopped asking about the progress of this work. I am thankful for having them
with me.
I am so thankful to my charming & adorable sons – Eninlanimi and Ibuores’Oluwa – who
spared me the time for this work. My unquantifiable appreciation goes to my loving and
lovable heartthrob and crown – Adesina – who was there for me in every imaginable and
unimaginable way. Thank you my dearest one.
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To the One who first loved me before my being, who made of me a successful project
before I conceived of ever doing this programme – the immortal and only wise God, I
give all thanks, praise and appreciation. Abba Father, thank you for everything.
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DEDICATION
To all the medical practitioners who are hopeful for better days to come in the field of
medical practice in Nigeria.
To my ever loving and supporting husband- Adesina, charming and adorable sons-
Eninlanimi and Ibuores’Oluwa.
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ABSTRACT
The health care is a very important sector in Nigeria. Continuous observations of medical
practitioners changing to, and picking up employments in other field for example,
banking, insurance, oil and gas, marketing etc, pose a question if the problem has to do
with Human Resources Management in the health institution where majority of the
medical personnel get employed. This study was carried out to determine what effect this
would have on staff performance and in turn health service delivery.
This study adopted the simple random sampling technique to select one hundred and
twenty (120) medical practitioners. The Likert scale was used to assess the opinion of the
respondents. The data gathered through the questionnaires was analyzed using the
Statistical Package for Social Science (SPSS).
More than half of the respondents: 54 (52.9%) confirmed their uncomfortable office
conditions, 62 (60.4%) their insufficient benefits and allowances, 61 (59.8%) do not
agree that they were being paid fairly for their responsibility. A vast majority of the
respondents: 60 (58.8%) attested that employees are not recognized for good
performance. Most of the respondents: 69 (67.6%) agreed that they were growing as a
professional in the hospital. Quite a number of the respondents: 63(61.8%) confirmed that
there is no policy that covers hazard related to their jobs.
This study highlighted the overall Human resources management challenges in the health
sector and confirmed the relationship between poor pay structure, lack of facilities,
infrastructures, safety at work – and attitude to work. The Government and Health
managers should address those factors that affect attitude to work. Improving the work
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environment so that it provides a context congruent with the aspirations and values
systems of health workers is more likely to increase a better attitude to work and
consequently have a positive effect on individual, organizational and health outcomes.
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TABLE OF CONTENTS
CONTENT PAGE
Title page ........................................................................ 1
Acknowledgment ............................................................ 2
Dedication........................................................................ 4
Abstract ........................................................................... 5
Table of contents ............................................................. 7
List of Tables ..................................................................12
List of Figures.................................................................. 16
CHAPTER ONE: INTRODUCTION
1.1 Background of Research ........................................ 19
1.2 Statement of Problem ........................................... .20
1.3 Objective of Research ............................................ 21
1.4 Research Focus ...................................................... .21
8
1.5 Scope of the Thesis ................................................ 21
CHAPTER TWO: LITERATURE REVIEW
2.0 Introduction ............................................................ 22
2.1 The Evolution and Meaning of HRM.................... 23
2.2 Good Practice in HRM .......................................... 26
2.3 HRM in the Health Sector ..................................... 29
2.4 The HRM Challenges............................................ 31
2.4.1 Unsatisfactory Working Conditions................... 32
2.4.2 Poor Remuneration or Unfair pay ...................... 34
2.4.3 Job Dissatisfaction and Poor Motivation ............. 34
2.4.4 Unsafe Workplace (Safety and Security) ............. 35
2.4.5 Professional Autonomy....................................... 36
2.4.6 Workforce Training and Issues............................ 36
2.5 The Impact of HRM Practices on Perception of
Organizational Performance ................................. 37
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2.6 Employee Attitudes and Job Satisfaction............ 39
2.6.1 Dispositional Influences on Job Satisfaction ....... 40
2.6.2 Work Situation Influences .................................. 41
2.7 Job Satisfaction and Job Performance ............... 42
CHAPTER THREE: RESEARCH METHODOLOGY
3.0 Introduction .......................................................... 44
3.1 Research Instrument............................................ 44
3.2 Location and population of study....................... 45
3.3 Sample Size........................................................... 45
3.4 Method of Data Collection ....................................45
3.4.1 Structure of the Questionnaire................................. 45
CHAPTER FOUR: DATA ANALYSIS AND INTERPRETATION
4.0 Introduction ............................................................ 48
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4.1 Descriptive Statistics Results .............................. 48
4.1.1 Composition and Statistics of Respondents............ 48
4.1.2 Work and Work Conditions ....................................49
4.1.3 Compensation, Benefits, Rewards
and Recognition .................................................. 56
4.1.4 Career Development ........................................... 63
4.1.5 Safety and Security ............................................. 67
4.2 Correlation Analysis Results ........................... 71
4.2.1 Work and Work Conditions ................................ 71
4.2.2 Compensation, Benefits, Rewards
and Recognition .................................................. 73
4.2.3 Career Development ........................................... 76
4.2.4 Safety and Security ............................................. 77
CHAPTER FIVE: CONCLUSION AND RECOMMENDATIONS
5.0 Conclusion ............................................................. 79
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5.1 Recommendations ................................................. 79
5.1.1 The Government (Federal and State) .................. 80
5.1.2 The Hospital Management .................................. 81
References .................................................................. 83
Appendix ................................................................... 95
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LIST OF TABLES
CONTENT PAGE
Table 4.1.2a: Do you as an employee perceive that
your work is meaningful? ........................................ 49
Table 4.1.2b: Does your practice’s equipment work
properly? .................................................................. 50
Table 4.1.2c: Is the facility clean and up to date? ............. 51
Table 4.1.2d: Are office conditions comfortable? ............ 52
Table 4.1.2e: Do individuals have adequate personal
space? ....................................................................... 53
Table 4.1.2f: My physical working conditions are
good ....................................................................... .. 54
Table 4.1.2g: My workload is reasonable ......................... 55
Table 4.1.3a: The hospital maintains a competitive pay
and benefits package ................................................ 56
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Table 4.1.3b: The hospital pay policy helps attract and
retain high performing employees ........................... 57
Table 4.1.3c: Do you as an employee perceive that you
are being paid fairly? ............................................... 58
Table 4.1.3d: Do you as an employee perceive that
your benefits and allowances are sufficient? ........... 59
Table 4.1.3e: Does the practice have clear policies
related to salaries and allowances? .......................... 60
Table 4.1.3f: My salary is fair for my responsibilities ...... 61
Table 4.1.3g: Employees are recognized for good work
Performance ............................................................. 62
Table 4.1.4a: I receive adequate technical trainings as
per my job ................................................................ 63
Table 4.1.4b: I am growing as a professional in the
Hospital .................................................................... 64
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Table 4.1.4c: I have a clearly established career path with
the hospital ............................................................... 65
Table 4.1.4d: I have opportunities to learn and grow ........ 66
Table 4.1.4e: I am satisfied with the amount of training
offered for my advancement ..................................... 67
Table 4.1.5a: The hospital has a health, safety and
security policy .......................................................... 68
Table 4.1.5b: The policy assures me of my safety and
security at work ........................................................ 69
Table 4.1.5c: The policy covers me concerning hazards
related to my job ...................................................... 70
Table 4.2.1: Correlation Analysis of Work & Working
Conditions Variables versus other Variables ……… 71
Table 4.2.2: Correlation Analysis of Compensation,
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Benefits, Rewards, & Recognition Variables
versus other Variables ……………………………. 73
Table 4.2.3: Correlation Analysis of Career Development
Variables versus other Variables ………………… 76
Table 4.2.4: Correlation Analysis of Safety & Security
Variables versus other Variables ………………… 77
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LIST OF FIGURES
CONTENT PAGE
Figure 4.1.2a: Do you as an employee perceive
that your work is meaningful? ............................... 49
Figure 4.1.2b: Does your practice’s equipment
work properly? ....................................................... 50
Figure 4.1.2c: Is the facility clean and up to date? ........ 51
Figure 4.1.2d: Are office conditions comfortable? ........ 52
Figure 4.1.2e: Do individuals have adequate
personal space? ...................................................... 53
Figure 4.1.2f: My physical working conditions
are good .................................................................. 54
Figure 4.1.2g: My workload is reasonable ..................... 55
Figure 4.1.3a: The hospital maintains a competitive
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pay and benefits package ....................................... 56
Figure 4.1.3b: The hospital pay policy helps attract
and retain high performing employees .................. 57
Figure 4.1.3c: Do you as an employee perceive that
you are being paid fairly? ...................................... 58
Figure 4.1.3d: Do you as an employee perceive that
your benefits and allowances are sufficient? ........ 59
Figure 4.1.3e: Does the practice have clear policies
related to salaries and allowances? ........................ 60
Figure 4.1.3f: My salary is fair for my responsibilities... 61
Figure 4.1.3g: Employees are recognized for good
work performance .................................................. 62
Figure 4.1.4a: I receive adequate technical trainings as
per my job .............................................................. 63
Figure 4.1.4b: I am growing as a professional in
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the hospital ............................................................. 64
Figure 4.1.4c: I have a clearly established career
path with the hospital ............................................. 65
Figure 4.1.4d: I have opportunities to learn and grow.... 66
Figure 4.1.4e: I am satisfied with the amount of training
offered for my advancement .................................. 67
Figure 4.1.5a: The hospital has a health, safety and
security policy ........................................................ 68
Figure 4.1.5b: The policy assures me of my safety and
security at work ...................................................... 69
Figure 4.1.5c: The policy covers me concerning hazards
related to my job .................................................... 70
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CHAPTER ONE
INTRODUCTION
1.1 Background of Research
The Nigeria's health system is in a poor state and this is traceable to several factors
especially the gross under-funding of the health sector and shortage of skilled medical
personnel. Nigeria is one of the several major health staff-exporting countries in Africa.
As a result of inadequate infrastructure and poor compensation packages, a sizeable
number of physicians, nurses and other medical professionals are lured away to
developed countries in search of fulfilling and lucrative positions.
With disability adjusted life expectancy (DALE) of 38.3 years and the rank of 187 in the
World Health Report 2000, the performance of the Nigerian health system is worse than
many sub-Saharan countries (WHO 2002-2007). There is thus an urgent need to support
the health system with adequately trained personnel in order to improve provision of the
health services. The poor state of Nigeria's health system is traceable to several factors:
organization, stewardship, financing and provision of health services (FMOH, 2007).
These have been compounded by other socioeconomic and political factors in the
environment. The overall availability, accessibility, quality and utilization of health
services decreased significantly or stagnated in the past decade. The proportion of
households residing within 10 kilometres of a health centre, clinic or hospital is 88% in
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the southwest, 87% in the southeast, 82% in the central, 73% in the northeast and 67% in
the northwest regions (WHO, 2002-2007)
1.2 Statement of Problem
Over the past few years, medical practices have advanced and are still advancing
globally. However, medical practice in Nigeria is still far from what it should be due to
some factors driving human resources challenges in the health sector which has been
identified as:
1. Insufficiently resourced and neglected health systems
2. Poor human resources planning and management practices and structures
3. Unsatisfactory working conditions characterized by: heavy workloads; lack of
professional autonomy; poor supervision and support; long working hours; unsafe
workplaces; inadequate career structures; poor remuneration/unfair pay; poor
access to needed supplies, tools and information; and limited or no access to
professional development opportunities
4. Internal and international migration of health workers. (Awofeso, 2008;
Nnamuchi, 2007; Adesanya, 2005; Chankova et al, 2007)
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1.3 Objective of Research
The ultimate goal of research in this realm is to assist organizations to succeed in their
performance improvement efforts. The purpose of this research is to empirically
investigate the relationship between poor pay structure, lack of facilities, infrastructures,
lack of facilities, infrastructures, safety at work and attitude to work.
1.4 Research Focus
This thesis addresses the human resources management problem in the medical sector,
focusing on the University of Port-Harcourt Teaching Hospital. The research includes
empirical analysis that involves gathering information through the administration of
questionnaires.
1.5 Scope of the Thesis
This thesis seeks to investigate the following questions:
1. Is there a relationship between the poor pay structure and attitude to work.
2. Is there a relationship between the working conditions – lack of facilities,
infrastructures, safety at work – and attitude to work.
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CHAPTER TWO
LITERATURE REVIEW
2.0 Introduction
In recent years, linking human resource management (HRM) to organizational
performance has been accentuated with the increasing adoption of a resource-based view
of the firm (Whicker and Andrews 2004; Datta, Guthrie and Wright 2005). Public health
systems require effective human resource management for quality health system
performance. How well providers deliver services to patients depends on the processes
that define, deploy and organize the workforce. In any sector, the workforce must be
motivated, well-staffed and appropriately skilled to do their job well.
The impact of HRM practices on organizational performance has been an important topic
in the field of HRM, industrial relations, as well as industrial and organizational
psychology. The increasing interest shown in this domain has been attributed to the idea
that human resources should be considered as a strategic factor, not only for the role it
plays in implementing managerial strategy, but also for its potential to become a source
of sustainable competitive advantage (Butler, Ferris and Napier 1991; Jackson and
Schuler 1995).
Health sector reform in several countries in the period of 1990s concentrated on structural
change, cost containment, the introduction of market mechanisms and consumer choice
but with little direct attempt to address Human Resources aspects.
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In current years, it has been increasingly identified that getting HR policy and
management right has to be at the centre of any sustainable solution to health system
performance. This is partly a result of the need to improve capacity in many countries’
health systems to meet the Millennium Development Goals. A well-motivated and
appropriately trained and organized workforce is crucial to the success of health system
delivery.
2.1 The Evolution and Meaning of Human Resources
Management (HRM)
One of the difficulties associated with the study of HRM is the broad range of ideas and
techniques encompassed within it, which has resulted in a failure to provide one common
interpretation of this study area. The terms welfare, personnel management, industrial
relations and employee relations have all been used to describe activities in this field of
study. Though human resources management have been part of business and
organizations since the first days of agriculture, in trying to answer the question, one
approach that can be taken is to trace back the various terms to their origin to a historical
perspective for clarity of their meanings. The various traditions are as follows:
1. The welfare tradition: This is the earliest tradition of what is now called HRM,
and originated in the early 20th
century. Before this period, many employees
suffered greatly if they were unable to work, and general health and safety
standards were much lower than those of today. In trying to improve the working
condition of employees, several organizations appointed welfare officers to take
up this responsibility.
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2. The employment management tradition: Another developing trend in the early
part of the century was the desire to improve work methods by studying the most
efficient ways to organize labour. Researchers attempted to introduce ―scientific
management‖ systems which made better use of working time. This tradition
created an interest in job definition, job design, workflow study and recruitment,
selection and training techniques. This ability to quantify and measure work and
provide effective guidelines for recruitment and training expanded the role of the
welfare officers, so the title of personnel manager replaced it. Personnel managers
were still closely allied to the workforce and the welfare role, but in addition they
had a responsibility to the management of the organization to utilize labour
effectively. This led to the role of personnel being seen as one which mediated
between managers and the workforce in general.
3. The industrial relations tradition: This view was also enhanced by the role
managers adopted in the relationship between trade unions and management.
Throughout the century membership of trade unions expanded, reaching a peak in
the late 1970’s. With this increased focus on trade unions, negotiation and
collective bargaining dominated the work of many personnel managers at the
time, eventually causing a new title to be coined, that of industrial relations
managers. Industrial relations tend to be associated with unionized activities, but
can also describe more general activities associated with the management groups
of employees. As the status and number of trade union members declined in the
1980’s and 90’s, and more organizations existed without unions at all, the term
employee relations began to replace the more traditional industrial relations title.
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Various writers have argued that industrial relations is about management of
groups of employees and their collective rights, whereas employee relations is
more concerned with matters relating to the individual. In practice, however, these
areas overlap to a large extent.
4. The specialist advisor tradition: Other roles associated with HRM developed to
fill the need to provide specialist advice to managers. The need for specialist is on
the increase in proportion with the increasing sophisticated range of selection
devices introduced in recent years. Statistical analysts may help with future
planning for employees using a wide range of computer techniques. Training and
management development programmes also require in-depth knowledge of
particular subjects. All these areas have their own job titles and responsibilities,
and many of these functions are filled by independent consultants rather than full-
time employees of the organization.
Bringing together these various strands, today the term HRM is used widely to
incorporate all the activities outlined above. As such it is an umbrella term for a
varied and specialist range of tasks associated with people management.
Consequently, Human Resources Management can be defined thus as:
―the careful selection and placement of new employees and the development and
effective utilization of existing ones with a view to attaining the potential of individual
employees and organizational goals and objective‖ (Aina, 2005)
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―the strategic and coherent approach to the management of an organization’s most valued
assets - the people working there who individually and collectively contribute to the
achievement of the objectives of the business‖ (Armstrong, 2006)
―The organizational function that deals with the people and issues related to people such
as compensation, hiring, performance management, and training‖ (Tracey, 2004). The
function within an organization that focuses on recruitment of, management of, and
providing direction for the people who work in the organization; or meaning employing
people, developing their resources, utilizing, maintaining and compensating their services
in tune with the job and organizational requirement.
The concept of Human Resources facilitates the recognition and aggregation of different
kinds of human inputs (Romer, 1992). The human inputs into an organization are the
skills and capabilities embodied in individuals or the workforce, which in parts, are
acquired through improved health and nutrition education and training (World Bank
1995). The importance of human resources management cannot therefore be over
emphasized.
2.2 Good Practice in Human Resources Management
In order to place the evidence base on HRM in health care in context, this section
considers how good practice in human resources management (HRM) has been defined
and evaluated in other sectors. So what is ―good‖ HRM?
There is a growing evidence based on these issue. Much of this evidence focuses on
organizational-level studies using large dataset analysis to consider the relationship
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between HR interventions and measures of organizational performance and output, where
the latter are defined in terms of private sector ―business‖ success – profits, returns on
sales, etc. a recent multi-sector review of research on the link between HRM and
organizational performance gave a result that over 30 studies done in the UK and USA
starting from the early ’90s leave no room to doubt that there exist a positive relationship
between people management (HRM) and business (organizational) performance, that is,
the more and more effective the practices, the better the result.
Richardson and Thompson (1999) noted that there are about 30 empirical studies that
have sought to tackle the correlation between HR practices and business performance.
Their studies corroborated the fact that the better the HR practices, the better the business
performance. These reviews established the fact that a good investment in development
and maintenance of effective HRM policy and practice makes a significant and
measureable positive contribution to organizational performance (West et al, 1997).
Richardson and Thompson (1999) noted three broad perspectives on how HR practices
contributes to business performance :
1. Best practice – this is a set of a HR practices, that when identified and
implemented, would improve business performance
2. Contingency – this means that business performance will be improved when the
best fit between business strategy and HR practices is achieved.
3. Bundles – this refers to specific collection/pack of HR practices that can be
identified to generate higher performance in organizations. The most effective
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composition of these bundles will vary in different organizational contexts
(MacDuffie 1995).
The last point is noteworthy because it highlights that there is no magic trick in HRM,
that is, no single intervention is likely to provide a permanent solution to all workforce
challenges facing an organization.
Richardson and Thompson (1999) went ahead to summarize 6 important points from their
reviews of the literature as follows:
1. The claim that there is a universal or complete best practice HR strategy is
premature.
2. Adoption of a specified group of HR policies will not in itself lead to
organizational success.
3. The same bundle of HR policies may not be universally valid.
4. Almost all current statistical analysis of HR strategies is based on adding up of a
mixture of items from a somewhat random list of HR policies and practices.
5. More evaluation attention needs to be dedicated to the examination of the
intermediary steps between the two end points of HR strategy and organizational
performance.
6. ―How something is done is often more important than what is done‖- but existing
empirical studies usually concentrate on the latter.
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2.3 Human Resource Management in the Health Sector
Within many health care systems worldwide, increased attention is being focused on
HRM. Specifically, human resources are one of the three principle health system inputs,
with the other two major inputs being physical capital and consumables (WHO Report,
2000).
Human resources, when pertaining to health care, can be defined as the different kinds of
clinical and non-clinical staff responsible for public and individual health intervention
(WHO). As arguably the most important of the health system inputs, the performance and
the benefits the system can deliver depend largely upon knowledge, skills and motivation
of those individuals responsible for delivering health services (WHO).
HRM in health has unique characteristics because the workforce is large, diverse and
comprises several separate occupations that are often represented by powerful
professional associations/unions. Some of these workers have sector-specific skills, while
others can readily move from the health sector to other sectors different from health.
While many health systems have been attempting to decentralize to improve efficiency,
they tend to be exemplified by a broad range of active stakeholders, a high level of direct
and indirect governmental and regulatory intervention, and recurrent top-down attempts
at reform. Health is very labour-intensive: the proportion of the total spent on staff is
higher in health than in most manufacturing industries and in many service industries.
The paradox is that while HR is under researched in health, partly because of its unique
context, the main business of health, which is clinical involvement is the subject of
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continuous and detailed research-based scrutiny, no other sector has the same level of
self-critical focus with use of sophisticated methods such as randomized control trials
(RCTs), systematic reviews and meta-analysis.
There have been a few attempts to look at HRM characteristics in the health sector. Eaton
(2000) examined issues related to high performance HRM in 20 nursing homes in the
USA. The result indicated that quality outcomes at some of the homes improved after
reorganization that included implementation of a new model of HRM based on job
enlargement and cross-training, but concluded that the business focus of the high
performance model made it inappropriate for the health care sector. Rondeau and Wagner
(2001) observed the impact of HR practices and the contingency theory on 283 Canadian
nursing homes. They discovered that the best performing homes were found to be more
likely to have implemented high performance HR practices and to have a workplace
climate that strongly values employee participation.
There is a broader and deeper evidence base that focuses on health sector-specific
measures of process, activity or outcome, and attempts to link these to HRM
interventions. One area that has experienced a momentous growth in research is large-
scale studies examining links between staffing levels, mix and outcome in the last two
years. Though these studies did not directly address specific HRM interventions, they
have made 2 contributions: adding to our understanding of the connection between
staffing and outcomes, and also providing a test bed for identifying and assessing the
appropriateness of outcome indicators in relation to staffing
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2.4 The Human Resources Management Challenges in the
Health Sector of Developing Countries
The study of the health workforce has gained prominence in recent years, as the dynamic
interconnections between human resource issues and health system effectiveness have
come into sharper focus (Fritzen, 2007). The workforce, arguably the most important
input to any health system, has a strong impact on overall health system performance.
Discipline-wise, Human Resources may be the most misunderstood of all corporate
departments, but it is also the most necessary, and likewise its management. It is true that
any individual who works in Human Resources must be a "people person." Since anyone
in this department deals with a number of employees, as well as outside individuals, on
any given day, a pleasant demeanour is a must.
WHO, in its World health report 2000, identified three principal health system inputs:
human resources (HR), physical capital and consumables. While each of these is
important to the delivery of health services, HR is critical to the success of any health
system. Put simply, the ultimate impact of any health programme hinges on whether
health care workers actually deliver those services. Not surprisingly, human resource is
one of the largest assets available within a health system and is frequently the single
greatest expense in any national health care budget. Developing countries are seeking
human resources solutions to address their lack of medically trained professional.
Shortage in these countries are prevalent due to the migration of their highly educated
and medically trained personnel. Therefore, the challenges of HRM are wide and
therefore not limited to the following.
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2.4.1 Unsatisfactory Working Conditions
The working conditions of health workers vary widely including the following heavy
workloads; lack of professional autonomy; poor supervision and support; long working
hours; unsafe workplaces; inadequate career structures; poor remuneration or unfair pay;
poor access to needed supplies, tools and information; and limited or no access to
professional development opportunities (Awofeso, 2008; Nnamuchi, 2007; Adesanya,
2005; Chankova et al, 2007)
Maternal and child mortality rates in Nigeria is one of the world’s highest despite oft
repeated claims by local and state governments that they have been providing free
medical care for women and children. In hospital wards, accident victims needing
emergency care are laid on the bare floor like beef while frantic efforts are made to look
for a doctor or attach them to life saving equipment that could barely function. Vice
President of the Nigerian Medical Association Dr. Bala Muhammed Audu says ―there is
need for a total overhaul of the health care delivery service in the country as there was a
complete erosion of the healthcare delivery service in the grassroots which is the entry
point of all preventable conditions.‖ While at home the grim statistics could give the
impression that Nigerian doctors lack what it takes to stand up to the challenge of saving
lives, abroad in foreign countries, notably in Europe and America the success of Nigerian
doctors is sometimes astounding. ―Nigeria has one of the best medical personnel in the
whole world,‖ says Dr Ibrahim Kana. ―Take a look around the world and you will be
amazed at the number of Nigerian doctors you see in foreign hospitals as consultants and
chief medical directors in these hospitals. So, what we need is the right working
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conditions, the necessary and modern equipment, strong and good political will by the
government; only then will there be a tremendous boost in the healthcare delivery service
in Nigeria.‖ (Hussain et al 2009).
The importance of investing in human resources, especially education and training is
recognized. This is reflected in an unprecedented global increase in school enrolment in
recent decades. However, the 1995 World Bank report laments that while schooling and
other forms of human resources have achieved rising levels, economic growth in most
countries (particularly the developing ones) has remained elusive.
Incentives for positive performance of the health workforce are reported to be very weak
across a range of developing countries’ health sectors, both from the 'daylight' and
'shadow' sides of the health facility environment (Fritzen). On the daylight side, workers
may feel they have little to gain from working hard or being responsive to either their
clients or superiors. Poor career paths and promotion opportunities lead to health workers
feeling 'stuck', while official salaries often cover only part of a worker's needs or overall
income (given alternative livelihood strategies, such as engaging in part-time private
sector health services or entirely different informal occupations) Manongi et al, 2006.
Also on the daylight side, a range of functions related to both performance management
(by which is meant the systematic communication of job expectations followed by
regular performance reviews) and strategic personnel planning (the creation of new types
of jobs, re-profiling of old ones or the addition or abolishing of staff positions in
accordance with need) – is found to be weak or typically non-existent (Fort & Voltero,
2004).
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2.4.2 Poor Remuneration or Unfair Pay
In terms of purchasing parity, Nigeria-based doctors typically earn about 25% of what
they would have earned if working in Europe, North America or Middle East. (Awofeso,
2004) Emigration is therefore viewed as the most effective strategy to address such salary
disparities (Awofeso). The following allowances have been frozen for up to two decades
without review: call duty, shift duty, hazards, transportation and housing. The federal
government of Nigeria in its efforts to review and improve salaries of other industries and
putting salaries in the tertiary institutions at par with the health changed the Consolidated
Tertiary Institutions Salary Scale (CONTISS), which, on the long run brought about in
the reduction in the take home pay of doctors while the other institutions experienced
increase in their allowances or pay. This CONTISS, in addition, collapsed some
allowances, thereby making them part of a lump sum, and eliminated some categories of
doctors from receiving call duty allowances (Unpublished Communiqué, 2008).
2.4.3 Job Dissatisfaction and Poor Motivation
Job satisfaction describes how content an individual is with his or her job. It is a
relatively recent term since in previous centuries jobs available to a particular person
were often predetermined by the occupation of that person’s parents. There are a variety
of factors that influence a person’s level of job satisfaction. These include income,
perceived fairness of promotion system, quality of working condition, social
relationships, leadership and the job itself. Job satisfaction or dissatisfaction of medical
practitioners affects their relationship with co-workers, administration and patients
(Kmietowicz, 2001).
35
It stands to reason that if medical practitioners are satisfied and happy with their job it
will enhance their productivity thereby increasing patients’ satisfaction with the services
rendered by the hospital (Omolase, 2008). "The quality of patient care may be related in
an important way to the quality of life experienced by staff at work" (West, 2004).
Research also showed that ―nurses were generally dissatisfied with their work with
remuneration being a key contributor to dissatisfaction‖ (Sims, 2003). In addition,
Excessive workload has been shown to significantly contribute to public- and private-
sector nurses' dissatisfaction in South Africa (Tzeng, 2002).
Health workers usually have motivational problems at work which may be reflected in a
variety of circumstances, but common manifestations include: lack of courtesy to
patients; failure to turn up at work on time and high levels of absenteeism; poor process
quality such as failure to conduct proper patient examinations and; failure to treat patients
in a timely manner (Nnamuchi, 2007; Hargreaves, 2002; Chankova et al, 2007). Recent
research has also highlighted Ability, Motivation and Opportunity as ―prime building
block‖ of HRM (CIPD, 2002).
2.4.4 Unsafe Workplace (Safety and Security)
Unsafe workplace due to safety and security has posed a challenge to medical
practitioners executing their duties. The doctors, under the aegis Nigerian Association of
Resident Doctors (ARD), because of series of robbery attacks on doctors on call duties,
have had to urge the Federal Government of Nigeria to address the poor state of security
in the hospitals.
36
2.4.5 Professional Autonomy
There is the constant and persistent lack of professional autonomy for the medical
profession as the government at times tends to take every decision that affects healthcare
and at times put people who are not medically competent to oversee the affairs of the
sector. A sense of professionalism can be difficult to maintain because they are not
encouraged to practice to their full potentials, leaving medical practitioners to feel
undervalued (Hussain et al.)
2.4.6 Workforce Training and Issues
With more limited human resources and facilities, workforce training issues is becoming
a challenge. The growth and development of any organization depend on the availability
of an appropriate workforce, on it competence and level of effort in trying to perform the
task assigned to it ( Murray et al, 1978; Evans, 1984). HR are a strategic capital in any
organization, especially in service and health organizations, where the various clinical,
managerial, technical and other personnel are the principal input making it possible for
most health interventions to be performed. Staff diagnose problems and determine which
services will be provided and when, where and how. Health interventions are knowledge-
based and the providers are the ’guardians’ of this knowledge (PAHO, 2001).
37
2.5 The Impact of Human Resource Management Practices
on Perceptions of Organizational Performance
Research focusing on the firm-level impact of HRM practices has become popular in
recent years (for reviews, see (Appelbaum and Batt 1994); (Huselid 1995); and Wagner
(1994). Many studies have reported a positive association between various HRM
practices and objective and perceptual measures of firm performance, some authors
(Levine & Tyson, 1990; Wagner, 1994) have expressed concern that results may be
biased because of methodological problems. In addition, the absence of a widely accepted
measure of the ―progressive‖ or ―high performance‖ HRM practices construct makes it
difficult to compare findings across studies (for examples of different approaches, see
Appelbaum and Batt (1994); Cutcher-Gershenfeld (1991); Huselid (1995); Ichniowski et
al. (1994); and MacDuffie (1995). Scholars from different disciplines have suggested
various conceptual frameworks as explanations for the links between progressive HRM
practices and firm-level outcomes. Jackson and Schuler (1995) reviewed this literature
and reported that approaches as divergent as general systems theory, role behaviour
theory, institutional theory, resource dependence theory, human capital theory,
transaction cost economics, agency theory, and the resource-based theory of the firm
(Barney, 1991) have been used to study the potential role of human resources (and thus
HRM practices) in the determination of firm performance. Although a review of each of
these frameworks is beyond the scope of this study, the prior conceptual work generally
converges on the importance of HRM practices in the determination of both employee
and firm-level outcomes. Conceptually, such practices can be classified in terms of their
38
impact on employees’ skills and ability, motivation, and the way that work is structured
(Arthur, 1994; Bailey, 1993; Cutcher-Gershenfeld, 1991; Huselid, 1995; Ichniowski et
al., 1994; Kochan & Osterman, 1994).
Organizations can adopt various HRM practices to enhance employee skills. First, efforts
can focus on improving the quality of the individuals hired, or on raising the skills and
abilities of current employees, or on both. Employees can be hired via sophisticated
selection procedures designed to screen out all but the very best potential employees.
Indeed, research indicates that selectivity in staffing is positively related to firm
performance (Becker & Huselid, 1992). Second, organizations can improve the quality of
current employees by providing comprehensive training and development activities after
selection. Considerable evidence suggests that investments in training produce beneficial
organizational outcomes (Bartel, 1994; Knoke & Kalleberg, 1994).
The effectiveness of skilled employees will be limited, however, if they are not motivated
to perform their jobs. The form and structure of an organization’s HRM system can affect
employee motivation levels in several ways. First, organizations can implement merit pay
or incentive compensation systems that provide rewards to employees for meeting
specific goals. A substantial body of evidence has focused on the impact of incentive
compensation and performance management systems on firm performance (Gerhart &
Milkovich, 1992). In addition, protecting employees from arbitrary treatment, perhaps via
a formal grievance procedure, may also motivate them to work harder because they can
expect their efforts to be fairly rewarded (Ichniowski et al., 1994).
39
Finally, the way in which a workplace is structured should affect organizational
performance to the degree that skilled and motivated employees are directly involved in
determining what work is performed and how this work gets accomplished. Employee
participation systems (Wagner, 1994), internal labour markets that provide an opportunity
for employees to advance within a firm, and team-based production systems (Levine,
1995) are all forms of work organization that have been argued to positively affect firm
performance. In addition, it has been argued that the provision of job security encourages
employees to work harder. As Ichniowski and his associates noted, ―Workers will only
expend extra effort if they expect. a lower probability of future layoffs‖ . (Delaney &
Huselid 1996) in their research confirmed that progressive HRM practices, including
selectivity in staffing, training, and incentive compensation, are positively related to
perceptual measures of organizational performance.
2.6 Employee Attitudes and Job Satisfaction
Employees have attitudes or viewpoints about many aspects of their jobs, their careers,
and their organizations. However, from the perspective of research and practice, the most
focal employee attitude is job satisfaction.
The most-used research definition of job satisfaction is by Locke (1976), who defined it
as ―. .. a pleasurable or positive emotional state resulting from the appraisal of one’s job
or job experiences‖. Implicit in Locke’s definition is the importance of both affect, or
feeling, and cognition, or thinking. When we think, we have feelings about what we
think. Conversely, when we have feelings, we think about what we feel. Cognition and
affect are thus inextricably linked, in our psychology and even in our biology. Thus,
40
when evaluating our jobs, as when we assess most anything important to us, both
thinking and feeling are involved.
In general, HR practitioners understand the importance of the work situation as a cause of
employee attitudes, and it is an area HR can help influence through organizational
programs and management practices. One of the most important areas of the work
situation to influence job satisfaction—the work itself—is often overlooked by
practitioners when addressing job satisfaction.
2.6.1 Dispositional Influences on Job Satisfaction
Several innovative studies have shown the influences of a person’s disposition on job
satisfaction. One of the first studies in this area (Staw & Ross, 1985) demonstrated that a
person’s job satisfaction scores have stability over time, even when he or she changes
jobs or companies. In a related study, childhood temperament was found to be
statistically related to adult job satisfaction up to 40 years later (Staw, Bell, & Clausen,
1986). Evidence even indicates that the job satisfaction of identical twins reared apart is
statistically similar (Arvey, Bouchard, Segal, & Abraham, 1989). Although this literature
has had its critics (e.g., Davis-Blake & Pfeffer, 1989), an accumulating body of evidence
indicates that differences in job satisfaction across employees can be traced, in part, to
differences in their disposition or temperament (House, Shane, & Herold, 1996).
Similarly, Brief (1998) and Motowidlo (1996) have developed theoretical models in an
attempt to better understand the relationship between dispositions and job satisfaction.
Continuing this theoretical development, Judge and his colleagues (Judge & Bono, 2001;
Judge, Locke, Durham, & Kluger, 1998) found that a key personality trait, core self-
41
evaluation, correlates with (is statistically related to) employee job satisfaction. They also
found that one of the primary causes of the relationship was through the perception of the
job itself. Thus, it appears that the most important situational effect on job satisfaction—
the job itself—is linked to what may be the most important personality trait to predict job
satisfaction—core self evaluation.
2.6.2 Work Situation Influences
The work situation also matters in terms of job satisfaction and organization
impact. Contrary to some commonly held practitioner beliefs, the most notable situational
influence on job satisfaction is the nature of the work itself—often called ―intrinsic job
characteristics.‖
Research studies across many years, organizations, and types of jobs show that when
employees are asked to evaluate different facets of their job such as supervision, pay,
promotion opportunities, co-workers, and so forth, the nature of the work itself generally
emerges as the most important job facet (Judge & Church, 2000; Jurgensen, 1978). This
is not to say that well-designed compensation programs or effective supervision are
unimportant; rather, it is that much can be done to influence job satisfaction by ensuring
work is as interesting and challenging as possible.
Unfortunately, some managers think employees are most desirous of pay to the exclusion
of other job attributes such as interesting work. For example, in a study examining the
importance of job attributes, employees ranked interesting work as the most important
job attribute and good wages ranked fifth, whereas when it came to what managers
42
thought employees wanted, good wages ranked first while interesting work ranked fifth
(Kovach,1995).
Of all the major job satisfaction areas, satisfaction with the nature of the work itself—
which includes job challenge, autonomy, variety, and scope—best predicts overall job
satisfaction, as well as other important outcomes like employee retention (e.g., Fried &
Ferris, 1987; Parisi & Weiner, 1999; Weiner, 2000). Thus, to understand what causes
people to be satisfied with their jobs, the nature of the work itself is one of the first places
for practitioners to focus on.
2.7 Job Satisfaction and Job Performance
The study of the relationship between job satisfaction and job performance has a
controversial history. The Hawthorne studies, conducted in the 1930s, are often credited
with making researchers aware of the effects of employee attitudes on performance.
Shortly after the Hawthorne studies, researchers began taking a critical look at the notion
that a ―happy worker is a productive worker.‖ Most of the earlier reviews of the literature
suggested a weak and somewhat inconsistent relationship between job satisfaction and
performance.
A review of the literature in 1985 suggested that the statistical correlation between job
satisfaction and performance was about .17 (Iaffaldano & Muchinsky, 1985). Thus, these
authors concluded that the presumed relationship between job satisfaction and
performance was a ―management fad‖ and ―illusory.‖ This study had an important impact
on researchers, and in some cases on organizations, with some managers and HR
43
practitioners concluding that the relationship between job satisfaction and performance
was trivial. However, further research does not agree with this conclusion. Organ (1988)
suggests that the failure to find a strong relationship between job satisfaction and
performance is due to the narrow means often used to define job performance. Organ
argued that when performance is defined to include important behaviours not generally
reflected in performance appraisals, such as organizational citizenship behaviours, its
relationship with job satisfaction improves. Research tends to support Organ’s
proposition in that job satisfaction correlates with organizational citizenship behaviours
(Organ & Ryan, 1995).
In addition, in a more recent and comprehensive review of 301 studies, Judge, Thoresen,
Bono, and Patton (2001) found that when the correlations are appropriately corrected (for
sampling and measurement errors), the average correlation between job satisfaction and
job performance is a higher .30. In addition, the relationship between job satisfaction and
performance was found to be even higher for complex (e.g., professional) jobs than for
less complex jobs. Thus, contrary to earlier reviews, it does appear that job satisfaction is,
in fact, predictive of performance, and the relationship is even stronger for professional
jobs.
44
CHAPTER THREE
RESEARCH METHODOLOGY
3.0 Introduction
This chapter describes the general approach and techniques that were used in this study.
These include the instruments of data collection, the sampling procedure and the method
of data analysis.
True research involves a systematic quest for knowledge (Aina 2002). According to Best
and Khan (1998) in Aina (2002), ―research is the systematic and objective analysis and
recording of controlled observations that may lead to the development of generalizations,
principles, theories resulting in prediction and ultimate control of many events that may
be consequences or causes of specific activities‖.
3.1 Research Instrument
According to Onyango, (2002), data collection involves measuring some research
phenomenon, whether it is a process, an object or a human subject’s behaviour. Usually
data collection instrument consists of set of questions to a number of persons or
respondents in order to gather data. Object of measurement differ from one research
project to another, depending on the purpose of enquiry.
45
3.2 Location and population of study
Population refers to the total aggregate number of respondents in the area from which the
data was gathered. The target population for this study comprise medical practitioners &
health workers of the University Teaching Hospital of Port Harcourt.
3.3 Sample Size
The impossibility of studying the whole population often leads to the selection and study
of a sample that is representative of the population. In most cases, only a reasonable
approximation is possible which generally produces a rough estimate of the required
sample size (Aina, 2002). Sabot (1992) is of the view that the greater the accuracy and/or
confidence level required for results, the larger the absolute size of the sample must be.
The decided sample size was one hundred and twenty.
3.4 Method of Data Collection
The survey method for this study is the Questionnaire. The questionnaire items are drawn
based on the two research questions earlier stated in the introduction chapter of this work.
3.4.1 Structure of the Questionnaire
The questionnaire was developed into parts – the bio-data part to show the profession and
educational level of the respondent and the core part that described the questions that
bothered on attitude to work and working conditions of the sampled respondents.
46
The variables of the questionnaires were divided into six groups. Each of the sub-
variables – questions – helped to assess staff’s performance in delivering health care
service in the chosen hospital – UPTH.
The core questions were of six groups - namely - About the Hospital; Corporate Culture;
Work & Working Conditions; Compensations, Benefits, Rewards and Recognition;
Career Development; Safety and Security.
The first and second groups of the questionnaire – About the Hospital and Corporate
Culture – seeks to measure the respondents’ perception of the public image of the
hospital.
The third group – Work & Working Conditions – sampled opinion on workplace
structure; workload and perception of work delivered by these employees. These
questions are to measure the respondents’ feeling on the work equipment, and how
valuable their work contribute to the overall goal of serving sick people.
The fourth group – Compensations, Benefits, Rewards and Recognition – bothered on
pay, recognition and benefit packages. These questions measure respondents’ perception
of how well they paid and rewarded compared to their deliverables.
The Career development questions were specific on trainings on the job; career path;
learning and growth opportunities. These questions measure the existence of career
development initiative in the work.
The last group- Safety and Security – seeks to measure whether the hospital has a safety,
health and security policy and the effectiveness of such.
47
The response of each item of these questions would be rated on a five-point Likert scale
anchored with the statements: Strongly Agree, Agree, Neutral, Disagree &Strongly
Disagree.
The assumption here is that the responses from the respondent would indicate and help to
infer from these Human Resources variables how they in turn affect the staff’s
performance in the delivery of health care service in their hospital.
48
CHAPTER FOUR
DATA ANALYSIS AND INTERPRETATION
4.0 Introduction
This chapter presents the analysis and interpretation of the data that were collected. The
tool employed in gathering the data is the questionnaire, which consisted of twenty-
eight questions discussed under six sections. However, the result would focus on the
most relevant questions addressing the research questions of the thesis.
4.1 Descriptive Statistics Results
The data collection was made through 102 filled and returned questionnaire out of 120
opinions sought, that is, the total questionnaires that were distributed.
4.1.1 Composition and Statistics of Respondents
One hundred and twenty questionnaires were distributed to members of staff of the
University of Port Harcourt Teaching Hospital, of which one hundred and two were
returned. The questionnaires were distributed randomly to staffs of the hospital. The
analysis of the respondents showed the largest of them – 65.7% - to be Doctors,
Pharmacists ranking next – 10.8%, Nurses: 7.8%, Biochemist and Pathologist are both
3.9% each, Physiologists: 2.9%, and Radiologists being least with 1%. Out of the 102
respondents, 52 (51%) are females while 50 (49%) are males. The ages of the
49
respondents ranged from 25 years to above 55 years with the age 25 – 35 years making
up the largest group – 60.8%, 35 – 45 years being 29.4%, 45 – 55 years being 8.8% and
55 – 100 accounting for 1%. The education qualification of the respondents revealed 5
% as diploma, 47% having first degree and 49% are at post graduate level.
4.1.2 Work and Work Conditions
Table 4.1.2a: Do you as an employee perceive that your work is meaningful?
Response Frequency Percent
Strongly Agree 52 51
Agree 34 33.3
Neutral 9 8.8
Disagree 6 5.9
Strongly Disagree 1 1
Total 102 100
Figure 4.1.2a: Do you as an employee perceive that your work is meaningful?
50
As shown in the table and figure 4.1.2a above, out of the 102 respondents, 86 (84.3%) of
them perceived their work to be meaningful while 7 (6.9%) respondents differ in the
opinion. The remaining 9 (8.8%) respondents are neutral in their opinion.
Table 4.1.2b: Does your practice’s equipment work properly?
Response Frequency Percent
Strongly Agree 6 5.9
Agree 43 42.2
Neutral 23 22.5
Disagree 20 19.6
Strongly Disagree 10 9.8
Total 102 100
Figure 4.1.2b: Does your practice’s equipment work properly?
51
Table and figure 4.1.2b both show that 49 respondents (48.1%) agree that their practice’s
equipment serve them properly. 30 (29.4%) respondents indicated that their equipment do
not serve them properly, while the remaining 23 (22.5%) do not differ or agree.
Table 4.1.2c: Is the facility clean and up to date?
Response Frequency Percent
Strongly Agree 5 4.9
Agree 35 34.3
Neutral 21 20.6
Disagree 30 29.4
Strongly Disagree 11 10.8
Total 102 100
Figure 4.1.2c: Is the facility clean and up to date?
52
From the table and figure 4.1.2c, a total of 40 (39.2%) respondents attest that the facility
is clean and up to date. Some 21 (20.6%) respondents were neutral in opinion while 41
(40.2%) did not agree on the cleanliness and up to date of the facility.
Table 4.1.2d: Are office conditions comfortable?
Response Frequency Percent
Strongly Agree 3 2.9
Agree 17 16.7
Neutral 28 27.5
Disagree 34 33.3
Strongly Disagree 20 19.6
Total 102 100
Figure 4.1.2d: Are office conditions comfortable?
53
As illustrated in table and figure. 4.1.2d, out of the 102 respondents, 54 (52.9%) do not
agree that their office conditions are comfortable while 20 (19.6%) respondents differ in
the opinion. The remaining 28 (27.5%) respondents are neutral in their opinion.
Table 4.1.2e: Do individuals have adequate personal space?
Response Frequency Percent
Strongly Agree 2 2.0
Agree 9 8.8
Neutral 26 25.5
Disagree 33 32.4
Strongly Disagree 32 31.4
Total 102 100
Figure 4.1.2e: Do individuals have adequate personal space?
54
As shown in the table and figure 4.1.2e above, out of the 102 respondents, 11 (10.8%)
agreed to having adequate personal space while 65 (63.8%) respondents differ in the
opinion. The remaining 26 (25.5%) respondents are neutral in their opinion.
Table 4.1.2f: My physical working conditions are good
Response Frequency Percent
Strongly Agree 6 5.9
Agree 31 30.4
Neutral 27 26.5
Disagree 24 23.5
Strongly Disagree 14 13.7
Total 102 100
Figure 4.1.1f: My physical working conditions are good
55
As illustrated in table and figure 4.1.2f, 37 (36.3%) attest that their working conditions
are good, 38 (37.2%) did not agree and the remaining 27 (26.5%) respondent were
neutral in their opinion.
Table 4.1.2g: My workload is reasonable
Response Frequency Percent
Strongly Agree 3 2.9
Agree 27 26.5
Neutral 26 25.5
Disagree 18 17.6
Strongly Disagree 28 27.5
Total 102 100
Figure 4.1.2g: My workload is reasonable
56
It is evident from table and figure 4.1.2g, that the majority of the respondents 46 (45.1%)
does not consider their workload has been reasonable while 30 (29.4%) of the
respondents believe that their workload is reasonable. The remaining 26 (25.5%) had
neutral opinion.
4.1.3 Compensation, Benefits, Rewards and Recognition
Table 4.1.3a: The hospital maintains a competitive pay and benefits package
Response Frequency Percent
Strongly Agree 3 2.9
Agree 15 14.7
Neutral 32 31.4
Disagree 31 30.4
Strongly Disagree 21 20.6
Total 102 100
Figure 4.1.3a: The hospital maintains a competitive pay and benefits package
57
Results presented in table and figure 4.1.3a shows that 52 (51%) of the respondents
disagree on the competitiveness of pay and benefits, 18 (17.6%) agree that the hospital
maintains a competitive pay and benefits package, the remaining 32 (30.4%) were neutral
in their opinion.
Table 4.1.3b: The hospital pay policy helps attract and retain high performing
employees.
Response Frequency Percent
Strongly Agree 2 2.0
Agree 10 9.8
Neutral 38 37.3
Disagree 27 26.5
Strongly Disagree 25 24.5
Total 102 100
58
Figure 4.1.3b: The hospital pay policy helps attract and retain high performing
employees.
Observation summarized in table and figure 4.1.3b above reveals that 52 (51%) of the
respondents attested to the fact that the hospital pay policy does not attract and retain
high performing employees. 38 (37.3%) were neutral in their opinion while the remaining
12 (11.8%) agreed that hospital pay policy does attract and retain high performing
employees.
Table 4.1.3c: Do you as an employee perceive that you are being paid fairly?
Response Frequency Percent
Strongly Agree 2 2.0
Agree 19 18.6
Neutral 29 28.4
Disagree 30 29.4
Strongly Disagree 22 21.6
59
Total 102 100
Figure 4.1.3c: Do you as an employee perceive that you are being paid fairly?
As illustrated in table and figure 4.1.3c, 52 (51%) of the respondents perceived that they
are not being paid fairly, 29 (28.4%) were neutral in their opinion while the remaining 22
(21.6%) agreed that they were paid fairly.
Table 4.1.3d: Do you as an employee perceive that your benefits and allowances are
sufficient?
Response Frequency Percent
Strongly Agree 3 2.9
Agree 14 13.7
Neutral 23 22.5
Disagree 29 28.4
Strongly Disagree 33 32.4
60
Total 102 100
Figure 4.1.3d: Do you as an employee perceive that your benefits and allowances are
sufficient?
As shown in table and figure 4.1.3d above, 62 (60.4%) of the respondents perceived that
their benefits and allowances are not sufficient, 17 (16.6%) of the respondents perceived
that their benefits and allowances are sufficient. The remaining 23 (22.5%) were neutral
in their opinion.
Table 4.1.3e: Does the practice have clear policies related to salaries and allowances?
Response Frequency Percent
Strongly Agree 4 3.9
Agree 25 24.5
Neutral 40 39.2
61
Disagree 19 18.6
Strongly Disagree 14 13.7
Total 102 100
Figure 4.1.2e: Does the practice have clear policies related to salaries and allowances?
Result presented in table and figure 4.1.3e above shows that 29 (28.4%) of the
respondents attested that the practice does have clear policies related to salaries and
allowances, 33 (32.3%) of the respondents did not agree that the practice does have
clear policies related to salaries and allowances. The remaining 40 (39.2%) were neutral
in their opinion.
Table 4.1.3f: My salary is fair for my responsibilities
Response Frequency Percent
Strongly Agree 2 2.0
Agree 17 16.7
Neutral 22 21.6
62
Disagree 30 29.4
Strongly Disagree 31 30.4
Total 102 100
Figure 4.1.3f: My salary is fair for my responsibilities
As illustrated in table and figure 4.1.3f above, 19 (18.7%) of the respondents attested
that they were being paid fairly for their responsibilities, 61 (59.8%) do not agree that
they were being paid fairly for their responsibility. The remaining 22 (21.6%) were
neutral in their opinion.
Table 4.1.3g: Employees are recognized for good work performance
Response Frequency Percent
Strongly Agree 4 3.9
Agree 13 12.7
Neutral 25 24.5
Disagree 35 34.3
63
Strongly Disagree 25 24.5
Total 102 100
Figure 4.1.3g: Employees are recognized for good work performance
Observation summarized in table and figure 4.1.3g reveals that 17 (16.6%) of the
respondents attested that employees are recognized for good performance, 60 (58.8%) of
the respondents did not. The remaining 25 (24.5%) were neutral in their opinion.
4.1.4 Career Development
Table 4.1.4a: I receive adequate technical trainings as per my job.
Response Frequency Percent
Strongly Agree 10 9.8
Agree 23 22.5
64
Neutral 29 28.4
Disagree 22 21.6
Strongly Disagree 18 17.6
Total 102 100
Figure 4.1.4a: I receive adequate technical trainings as per my job.
As illustrated in table and figure 4.1.4a above 33 (32.3%) %) of the respondents agreed
that they receive adequate technical trainings as per their job, 40 (39.2%) differed in
their opinion, while the remaining 29 (28.4%) were neutral in their opinion.
Table 4.1.4b: I am growing as a professional in the hospital
Response Frequency Percent
Strongly Agree 14 13.7
Agree 55 53.9
Neutral 22 21.6
Disagree 8 7.8
65
Strongly Disagree 3 2.9
Total 102 100
Figure 4.1.4b: I am growing as a professional in the hospital
Result presented in table and figure 4.1.4b reveals that 69 (67.6%) of the respondents
agreed that they are growing as a professional in the hospital, 11 (10.7%) of the
respondents indicated that they are not growing as a professional in the hospital. The
remaining 22 (21.6%) were neutral in their opinion.
Table 4.1.4c: I have a clearly established career path with the hospital
Response Frequency Percent
Strongly Agree 13 12.7
Agree 44 43.1
Neutral 29 28.4
Disagree 13 12.7
Strongly Disagree 3 2.9
66
Total 102 100
Figure 4.1.4c: I have a clearly established career path with the hospital
Observation summarized in table and figure 4.1.4c reveals that 57 (55.8%) of the
respondents indicated that they have clearly established career path with the hospital, 11
(10.7%) differed in their opinion while the remaining 29 (28.4%) were neutral in their
opinion.
Table 4.1.4d: I have opportunities to learn and grow
Response Frequency Percent
Strongly Agree 16 15.7
Agree 46 45.1
Neutral 29 28.4
Disagree 5 4.9
67
Strongly Disagree 6 5.9
Total 102 100
Figure 4.1.4d: I have opportunities to learn and grow
As shown in table and figure 4.1.4d above 62 (60.8%) of the respondents agreed that t
hey have opportunities to learn and grow, (10.8%) of the respondents indicated that they
do not have opportunities to learn and grow. The remaining (28.4%) were neutral in
their opinion.
Table 4.1.4e: I am satisfied with the amount of training offered for my advancement.
Response Frequency Percent
Strongly Agree 2 2.0
Agree 24 23.5
Neutral 30 29.4
68
Disagree 24 23.5
Strongly Disagree 22 21.6
Total 102 100
Figure 4.1.4e: I am satisfied with the amount of training offered for my advancement
Result presented in table and figure 4.1.4e shows that 26 ( 25.5%)of the respondents
were satisfied with the amount of training offered for their advancement, 46 (45.1%) of
the respondents were not satisfied with the amount of training offered for their
advancement while the remaining 30 (29.4%) were neutral in their opinion.
4.1.5 Safety and Security
Table 4.1.5a: The hospital has a health, safety and security policy
69
Response Frequency Percent
Strongly Agree 10 9.8
Agree 15 14.7
Neutral 33 32.4
Disagree 22 21.6
Strongly Disagree 22 21.6
Total 102 100
Figure 4.1.5a: The hospital has a health, safety and security policy
As illustrated in the table and figure 4.1.5a, above 25 (24.5%), of the respondents do not
agree, 44 (43.2%) did not agree the that hospital has a health, safety and security policy.
The remaining 33 (32.4%) were neutral in their opinion.
Table 4.1.5b: The policy assures me of my safety and security at work
70
Response Frequency Percent
Strongly Agree 4 3.9
Agree 11 10.8
Neutral 30 29.4
Disagree 32 31.4
Strongly Disagree 25 24.5
Total 102 100
Figure 4.1.5b: The policy assures me of my safety and security at work
Results presented in table and figure 4.1.5b above reveals that 15 (14.7%) of the
respondents attested that the policy assures them of their safety and security at work, 55
(54.9%) of the respondents did not agree that the policy assures them of their safety
and security at work. The remaining 30 (29.4%) were neutral in their opinion.
Table 4.1.5c: The policy covers me concerning hazards related to my job
71
Response Frequency Percent
Strongly Agree 2 2.0
Agree 6 5.9
Neutral 31 30.4
Disagree 31 30.4
Strongly Disagree 32 31.4
Total 102 100
Figure 4.1.5c: The policy covers me concerning hazards related to my job
As shown in table and figure 4.1.5c above, 8 (7.9%) of the respondents attested that the
policy covers them concerning hazards related to their job, 63 (61.8%) of the respondents
did not agree while the remaining 31 (30.4%) were neutral in their opinion.
4.2 Correlation Analysis Results
72
The questionnaire data were analysed using correlation analysis, i.e. the Pearson
Correlation. This revealed the relationship between the variables.
4.2.1 Work & Working Conditions
Table 4.2.1: Correlation Analysis of Work & Working Conditions Variables versus other
Variables
VAR
01 –
Q3A
VAR
02 –
Q3B
VAR
03 –
Q3C
VAR
04 –
Q3D
VAR
05 –
Q3E
VAR
06 –
Q3F
VAR
07 –
Q3G
VAR
08 –
Q4A
VAR
09 –
Q4B
VAR
10 –
Q4C
VAR
11 –
Q4D
VAR
12 –
Q4E
VAR
13 –
Q4F
VAR 1
– Q3A Sig. (2-
tailed)
,180 ,045 ,111 ,913 ,044 ,777 ,240 ,778 ,922 ,021 ,220 ,032
VAR 2
– Q3B
Sig. (2-
tailed)
,180
,000 ,005 ,043 ,003 ,080 ,255 ,042 ,235 ,310 ,129 ,458
VAR3
– Q3C
Sig. (2-
tailed)
,045 ,000
,000 ,000 ,000 ,311 ,035 ,000 ,008 ,031 ,281 ,015
VAR4
– Q3D
Sig. (2-
tailed)
,111 ,005 ,000
,000 ,000 ,000 ,038 ,000 ,015 ,047 ,300 ,016
VAR5
– Q3E
Sig. (2-
tailed)
,913 ,043 ,000 ,000
,000 ,000 ,003 ,000 ,001 ,000 ,065 ,000
VAR6
– Q3F
Sig. (2-
tailed)
,044 ,003 ,000 ,000 ,000
,000 ,011 ,031 ,012 ,686 ,150 ,070
VAR7
– Q3G
Sig. (2-
tailed)
,777 ,080 ,311 ,000 ,000 ,000
,057 ,028 ,008 ,008 ,013 ,000
VAR
14 –
Q4G
VAR
15 –
Q5A
VAR
16 –
Q5B
VAR
17 –
Q5C
VAR
18 –
Q5D
VAR
19 –
Q5E
VAR
20 –
Q6A
VAR
21 –
Q6B
VAR
22 –
Q6C
VAR 1
– Q3A Sig. (2-
tailed)
,408 ,054 ,238 ,000 ,003 ,775 ,191 ,191 ,697
VAR 2
– Q3B
Sig. (2-
tailed)
,003 ,013 ,247 ,000 ,000 ,003 ,000 ,000 ,000
VAR3
– Q3C
Sig. (2-
tailed)
,041 ,015 ,027 ,299 ,006 ,096 ,000 ,000 ,001
73
VAR4
– Q3D
Sig. (2-
tailed)
,320 ,194 ,007 ,170 ,001 ,416 ,293 ,293 ,068
VAR5
– Q3E
Sig. (2-
tailed)
,053 ,664 ,544 ,769 ,210 ,444 ,216 ,216 ,028
VAR6
– Q3F
Sig. (2-
tailed)
,177 ,379 ,017 ,453 ,002 ,382 ,145 ,145 ,001
VAR7
– Q3G
Sig. (2-
tailed)
,005 ,297 ,677 ,710 ,718 ,172 ,960 ,960 ,066
Variable Q3A has a 95% significant relationship with variables Q3C, Q3F, Q4D, Q4F
and Q5D.
There is a 99% significant relationship between variable Q3A and Q5C, i.e. p=0.000.
Variable Q3B has a 95% significant relationship with variables Q3E, Q4B & Q5A.
The variable Q3B has a 99% significant relationship with variables Q3C, Q3D, Q3F,
Q4G, Q5C, Q5D, Q5E, Q6A, Q6B & Q6C.
The variable Q3C has 95% significant relationship to variables Q3A, Q4A, Q4D, Q4F,
Q4G, Q5A & Q5B.
Variable Q3C has 99% significant relationship to variables Q3B, Q3D, Q3E, Q3F, Q4B,
Q4C, Q5D, Q6A, Q6B & Q6C.
The variable Q3D has 95% significant relationship to variables Q4A, Q4C, Q4D & Q4F.
Variable Q3D has 99% significant relationship to variables Q3 B, Q3C, Q3E Q3F, Q3G,
Q4B, Q5B & Q5D.
The variable Q3E has 95% significant relationship to variables Q3B & Q6C.
74
Variable Q3E has 99% significant relationship to variables Q3C, Q3D, Q3F, Q3G, Q4A,
Q4B, Q4C, Q4D and Q4F.
The variable Q3F has 95% significant relationship to variables Q3A, Q4A, Q4B & Q4C.
Variable Q3F has 99% significant relationship to variables Q3B, Q3C, Q3D, Q3E, Q3G
and Q6C.
Variable Q3G has 95% significant relationship to variables Q4B and Q4D.
The variable Q3G has 99% significant relationship to variables Q3D, Q3E, Q3F, Q4C,
Q4E, Q4F and Q4G.
4.2.2 Compensation, Benefits, Rewards & Recognition
Table 4.2.2: Correlation Analysis of Compensation, Benefits, Rewards & Recognition
Variables versus other Variables
VAR
01 –
Q3A
VAR
02 –
Q3B
VAR
03 –
Q3C
VAR
04 –
Q3D
VAR
05 –
Q3E
VAR
06 –
Q3F
VAR
07 –
Q3G
VAR
08 –
Q4A
VAR
09 –
Q4B
VAR
10 –
Q4C
VAR
11 –
Q4D
VAR
12 –
Q4E
VAR
13 –
Q4F
VAR8
– Q4A
Sig. (2-
tailed)
,240 ,255 ,035 ,038 ,003 ,011 ,057
,000 ,000 ,000 ,023 ,002
VAR9
– Q4B
Sig. (2-
tailed)
,778 ,042 ,000 ,000 ,000 ,031 ,028 ,000
,000 ,000 ,000 ,000
VAR10
– Q4C
Sig. (2-
tailed)
,922 ,235 ,008 ,015 ,001 ,012 ,008 ,000 ,000
,000 ,058 ,000
VAR11
– Q4D
Sig. (2-
tailed)
,021 ,310 ,031 ,047 ,000 ,686 ,008 ,000 ,000 ,000
,000 ,000
VAR12
– Q4E
Sig. (2-
tailed)
,220 ,129 ,281 ,300 ,065 ,150 ,013 ,023 ,000 ,058 ,000
,000
VAR13
– Q4F
Sig. (2-
tailed)
,032 ,458 ,015 ,016 ,000 ,070 ,000 ,002 ,000 ,000 ,000 ,000
75
VAR14
– Q4G
Sig. (2-
tailed)
,408 ,003 ,041 ,320 ,053 ,177 ,005 ,040 ,003 ,138 ,027 ,003 ,001
VAR
14 –
Q4G
VAR
15 –
Q5A
VAR
16 –
Q5B
VAR
17 –
Q5C
VAR
18 –
Q5D
VAR
19 –
Q5E
VAR
20 –
Q6A
VAR
21 –
Q6B
VAR
22 –
Q6C
VAR8
– Q4A
Sig. (2-
tailed)
,040 ,426 ,748 ,704 ,934 ,384 ,026 ,026 ,000
VAR9
– Q4B
Sig. (2-
tailed)
,003 ,104 ,261 ,014 ,028 ,023 ,003 ,003 ,000
VAR10
– Q4C
Sig. (2-
tailed)
,138 ,633 ,121 ,544 ,189 1,000 ,013 ,013 ,000
VAR11
– Q4D
Sig. (2-
tailed)
,027 ,443 ,905 ,824 ,990 ,152 ,159 ,159 ,000
VAR12
– Q4E
Sig. (2-
tailed)
,003 ,230 ,802 ,033 ,899 ,089 ,080 ,080 ,010
VAR13
– Q4F
Sig. (2-
tailed)
,001 ,059 ,998 ,301 ,209 ,034 ,007 ,007 ,000
VAR14
– Q4G
Sig. (2-
tailed)
,045 ,021 ,033 ,037 ,002 ,000 ,000 ,000
The Q4A has a 95% significant relationship with variables Q3C, Q3D, Q3F, Q4E, Q4F,
Q4G and Q6B.
Variable Q4A has 99% significant relationship to variables Q3E, Q4B, Q4C, Q4D and
Q6C.
The variable Q4B has 95% significant relationship to variables Q3B, Q3F, Q3G, Q5C,
Q5D and Q5E.
Variable Q4B has 99% significant relationship to variables Q3C, Q3D, Q3E, Q4A, Q4C,
Q4D, Q4E, Q4F, Q4G, Q6B and Q6C.
Variable Q4C has 95% significant relationship to variables Q3D and Q3F.
76
The variable Q4C has 99% significant relationship to variables Q3C, Q3E, Q3G, Q4A,
Q4B, Q4D, Q4F, Q6B and Q6C.
Variable Q4D has 95% significant relationship to variables Q3A, Q3C, Q3D and Q4G.
The variable Q4D has 99% significant relationship to variables Q3E, Q3G, Q4A, Q4B,
Q4C, Q4E, Q4F and Q6C.
The variable Q4E has 95% significant relationship to variables Q3G, Q4A, Q5C & Q6C.
Variable Q4E has 99% significant relationship to variables Q4B, Q4D, Q4F and Q4G.
The variable Q4F has 95% significant relationship to variables Q3A, Q3C, Q3D & Q5E.
Variable Q4F has 99% significant relationship to variables Q3E, Q3G, Q4A, Q4B, Q4C,
Q4D, Q4E, Q4G, Q6B and Q6C.
Variable Q4G has 95% significant relationship to variables Q3C, Q4A, Q4D, Q5A, Q5B,
Q5C and Q5D.
The variable Q4G has 99% significant relationship to variables Q3B, Q3G, Q4B, Q4E,
Q4F, Q5E, Q5F, Q6A, Q6B and Q6C.
4.2.3 Career Development
Table 4.2.3: Correlation Analysis of Career Development Variables versus other
Variables
77
VAR
01 –
Q3A
VAR
02 –
Q3B
VAR
03 –
Q3C
VAR
04 –
Q3D
VAR
05 –
Q3E
VAR
06 –
Q3F
VAR
07 –
Q3G
VAR
08 –
Q4A
VAR
09 –
Q4B
VAR
10 –
Q4C
VAR
11 –
Q4D
VAR
12 –
Q4E
VAR
13 –
Q4F
VAR15
– Q5A
Sig. (2-
tailed)
,054 ,013 ,015 ,194 ,664 ,379 ,297 ,426 ,104 ,633 ,443 ,230 ,059
VAR16
– Q5B
Sig. (2-
tailed)
,238 ,247 ,027 ,007 ,544 ,017 ,677 ,748 ,261 ,121 ,905 ,802 ,998
VAR17
– Q5C
Sig. (2-
tailed)
,000 ,000 ,299 ,170 ,769 ,453 ,710 ,704 ,014 ,544 ,824 ,033 ,301
VAR18
– Q5D
Sig. (2-
tailed)
,003 ,000 ,006 ,001 ,210 ,002 ,718 ,934 ,028 ,189 ,990 ,899 ,209
VAR19
– Q5E
Sig. (2-
tailed)
,775 ,003 ,096 ,416 ,444 ,382 ,172 ,384 ,023 1,000 ,152 ,089 ,034
VAR
14 –
Q4G
VAR
15 –
Q5A
VAR
16 –
Q5B
VAR
17 –
Q5C
VAR
18 –
Q5D
VAR
19 –
Q5E
VAR
20 –
Q6A
VAR
21 –
Q6B
VAR
22 –
Q6C
VAR15
– Q5A
Sig. (2-
tailed)
,045
,000 ,001 ,000 ,000 ,000 ,000 ,060
VAR16
– Q5B
Sig. (2-
tailed)
,021 ,000
,000 ,000 ,011 ,003 ,003 ,872
VAR17
– Q5C
Sig. (2-
tailed)
,033 ,001 ,000
,000 ,001 ,016 ,016 ,511
VAR18
– Q5D
Sig. (2-
tailed)
,037 ,000 ,000 ,000
,000 ,000 ,000 ,290
VAR19
– Q5E
Sig. (2-
tailed)
,002 ,000 ,011 ,001 ,000
,000 ,000 ,000
The variable Q5A has 95% significant relationship to variables Q3B, Q3C and Q4G.
Variable Q5A has 99% significant relationship to variables Q5B, Q5C, Q5D, Q5E, Q6A
and Q6B.
The variable Q5B has 95% significant relationship to variables Q3C, Q3F, Q5E & Q6A.
Variable Q5B has 99% significant relationship to variables Q3D, Q5A, Q5C, Q5D and
Q6B.
78
Variable Q5C has 95% significant relationship to variables Q4B, Q4E, Q4G, Q6A and
Q6B.
The variable Q5C has 99% significant relationship to variables Q3A, Q3B, Q5A, Q5B,
Q5D and Q5E.
Variable Q5D has 95% significant relationship to variables Q4B and Q4G.
The variable Q5D has 99% significant relationship to variables Q3A, Q3B, Q3C, Q3D,
Q3G, Q5A, Q5B, Q5C, Q5E, Q6Aand Q6B.
The variable Q5E has 95% significant relationship to variables Q4B, Q4F and Q5B.
Variable Q5E has 99% significant relationship to variables Q3B, Q4G, Q5A, Q5C, Q5E,
Q6A, Q6B and Q6C.
4.2.4 Safety and Security
Table 4.2.1: Correlation Analysis of Safety and Security Variables versus other
Variables
VAR
01 –
Q3A
VAR
02 –
Q3B
VAR
03 –
Q3C
VAR
04 –
Q3D
VAR
05 –
Q3E
VAR
06 –
Q3F
VAR
07 –
Q3G
VAR
08 –
Q4A
VAR
09 –
Q4B
VAR
10 –
Q4C
VAR
11 –
Q4D
VAR
12 –
Q4E
VAR
13 –
Q4F
VAR20
– Q6A
Sig. (2-
tailed)
,153 ,000 ,000 ,796 ,846 ,106 ,540 ,592 ,121 ,097 ,901 ,339 ,382
VAR21
– Q6B
Sig. (2-
tailed)
,191 ,000 ,000 ,293 ,216 ,145 ,960 ,026 ,003 ,013 ,159 ,080 ,007
VAR22
– Q6C
Sig. (2-
tailed)
,697 ,000 ,001 ,494 ,028 ,001 ,066 ,000 ,000 ,000 ,000 ,010 ,000
79
VAR
14 –
Q4G
VAR
15 –
Q5A
VAR
16 –
Q5B
VAR
17 –
Q5C
VAR
18 –
Q5D
VAR
19 –
Q5E
VAR
20 –
Q6A
VAR
21 –
Q6B
VAR
22 –
Q6C
VAR20
– Q6A
Sig. (2-
tailed)
,006 ,000 ,013 ,043 ,000 ,000 ,000 ,000 ,000
VAR21
– Q6B
Sig. (2-
tailed)
,000 ,000 ,003 ,016 ,000 ,000
,000
VAR22
– Q6C
Sig. (2-
tailed)
,000 ,060 ,872 ,511 ,290 ,000 ,000 ,000
The variable Q6A has 95% significant relationship to variables Q5C and Q5D.
Variable Q6A has 99% significant relationship to variables Q3B, Q3C, Q4G, Q5A, Q5B,
Q5E, Q6B and Q6E.
Variable Q6B has 95% significant relationship to variables Q4A, Q4C and Q5C.
The variable Q6B has 99% significant relationship to variables Q3B, Q3C, Q4B, Q4F,
Q4G, Q5A, Q5B, Q5D, Q5E, Q6A and Q6C.
The variable Q6C has 95% significant relationship to variables Q3E and Q4E.
Variable Q6C has 99% significant relationship to variables Q3B, Q3C, Q3F, Q4A, Q4B,
Q4C, Q4D, Q4F, Q4G, Q5E, Q6A and Q6B.
80
CHAPTER FIVE
CONCLUSION AND RECOMMENDATIONS
5.0 Conclusion
This study has illustrated clearly that a vast majority of the health workers perceived that
they are not being paid fairly for their responsibility and do not have comfortable
working conditions. This is alarming because "the quality of patient care may be related
in an important way to the quality of life experienced by staff at work" (West, 2004).
The findings indicate that the Human resources available at the hospital are not
adequately managed in relation to the objectives of the hospital. Job satisfaction or
dissatisfaction of medical practitioners affects their relationship with co-workers,
administration and patients (Kmietowicz, 2001).
It stands to reason that if medical practitioners are satisfied and happy with their job it
will enhance their productivity thereby increasing patients’ satisfaction with the services
rendered by the hospital (Omolase, 2008).
5.1 Recommendations
Based on the findings and conclusion of this study, the following recommendations are
made for the various bodies concerned.
81
5.1.1 The Government (Federal and State)
1. Government should provide necessary infrastructure, good communication,
adequate power supply, and state-of- the art facilities for promotion and
sustenance of knowledge networks in research, teaching, training, and service
delivery.
2. Government should provide special salary and allowance package for health
workers. (Medical Special Salary Scale/Medical Salary Scale-MSSS/MSS) as
clamoured for by medical practitioners.
3. There is urgent need for creation of Directorate of Human resources at the
Federal ministry of health for a better coordination of activities revolving around
human resources functions, and this should be headed by a professional human
resources expert.
4. The ministry of health in collaboration with the federal government should
ensure that health workers in the public service are competitively paid.
5. A competitive and transparent system for civil service recruitment.
6. A Leadership Development Program should be put in place by the Government
under the auspices of the federal ministry of health to train health managers
(Chief Medical Directors) in HR management and leadership skills.
7. A national HRM information/record system in the health sector should be
developed.
82
8. Government should make provisions for maximum security of life and properties
of health workers.
The goal in the health sector should be the welfare of all stakeholders such as the health
workers and the patients. The Governments’ duty should be to place the interest of the
people above their personal interest.
5.1.2 The Hospital Management
1. There is urgent need for creation of Human resources department in the hospital
for better coordination of activities revolving around human resources functions.
This department should be headed by a professional human resources expert. An
alternative is to outsource the HR functions.
2. High quality and regular training should be provided to refresh the skills of
health workers so that they could improve and meet up with the growing medical
trends in the world.
3. A Leadership Development Program should be put in place to train health
managers (Heads of departments) in HR management and leadership skills.
4. Hospital management should provide workshops on how to achieve job
satisfaction.
5. Hospital management should provide friendly working environment for their
staff, (fully and functional air conditioned offices with internet ready desktop
computers) and adequate office space .
83
6. HR policy should be developed.
7. HR information/record system should be developed
Improving the work environment so that it provides a context congruent with the
aspirations and values systems of health workers is more likely to increase a bettter
attitude to work and consequently have a positive effect on individual, organizational
and health outcomes.
84
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APPENDIX
School of Management
Blekinge Institute of Technology, Sweden
HUMAN RESOURCES MANAGEMENT (HRM); WHAT EFFECT
DOES IT HAVE ON STAFF PERFORMANCE AND HEALTH
SERVICE DELIVERY IN NIGERIA – THE CASE STUDY OF
UNIVERSITY OF PORT-HARCOURT TEACHING HOSPITAL (UPTH),
RIVERS STATE, NIGERIA
Hello,
My name is Motunrayo Obajimi. I am a Master in Business Administration student of
Blekinge Institute of Technology Sweden. I am undertaking a thesis that seeks to
study how Human Resources Management can be used to help improve the quality of
service delivered by medical practitioners. Please be kind to give 10 minutes of your
time to answer these questions. The information obtained would be solely for
research purpose and would be handled with utmost confidentiality. Thank you very
much for your time.
Kind regards.
PART A
BIO-DATA 1.Sex – a. Male b. Female
2.Age bracket
25-35
35-45
97
45-55
≥ 60
3. Educational Attainment:
Diploma
First degree
Post-graduate
Others (Please indicate) .............................
4. Profession:
a. Doctor b. Nurse c. Laboratory Scientist d. Microbiologist e
Radiologist f. Biochemist g. Pharmacist h. Others (Please
indicate) ..........................
PART B Legend:
SA = Strongly Agree
A = Agree
N = Neutral
D = Disagree
SD = Strongly Disagree
Questions/Opinions Responses
SA A N D SD
1. About the Hospital Our hospital is a good place to work
Our hospital is an aggressive competitor in the marketplace
The top management communicates about changes or decisions
that affect employees
Our hospital is concerned with the long term welfare of the
employees.
2. Corporate Culture Organization values the individual worker
Management is flexible and understands the importance of
balancing my work and personal life.
3. Work & Working Conditions Do you as an employee perceive that your work is meaningful?
Does your practice’s equipment work properly?
Is the facility clean and up to date?
Are office conditions comfortable?
Do individuals have adequate personal space?
My physical working conditions are good
My workload is reasonable
98
4. Compensation, Benefits, Rewards and
Recognition
The hospital maintains a competitive pay and benefits package
The hospital pay policy helps attract and retain high performing
employees.
Do you as an employee perceive that you are being paid fairly?
Do you as an employee perceive that your benefits and
allowances are sufficient?
Does the practice have clear policies related to salaries and
allowances?
My salary is fair for my responsibilities
Employees are recognized for good work performance
5. Career Development I receive adequate technical trainings as per my job.
I am growing as a professional in the hospital
I have a clearly established career path with the hospital
I have opportunities to learn and grow
I am satisfied with the amount of training offered for my
advancement.
6. Safety and Security The hospital has health, safety and security policy
The policy assures me of my safety and security at work
The policy covers me concerning hazards related to my job