Rural health extension workers’ intention to leave their jobs and associated factors, North Wollo Zone, northeast Ethiopia


Background: The intention to leave primary jobs has risen in importance in the global dialogue on the health workforce. The related concept of staff turnover has also generated debate. This study was conducted to assess health extension workers’ intention to leave their jobs in North Wollo Zone, northeast Ethiopia. Methods: A cross-sectional study was conducted in North Wollo Zone from February to April 2016. Using a multi-stage stratified sampling technique, a total of 383 participants were selected. The data were entered into EpiData version 3.1 and exported to SPSS version 20 for analysis. Bivariable and multivariable logistic regression analyses were employed to identify significant factors. Odds ratios (ORs), 95% confidence intervals (CI), and p-values were used to measure the strength and presence of statistical associations. Results: The study showed that 64.1% (95% CI: 59.2, 69) of health extension workers had an intention to leave their jobs. Statistically significant factors were: low salary (AOR = 2.23; 95% CI: 1.98, 4.25); high workload (AOR = 2.78; 95% CI: 1.46, 5.31); dissatisfaction with educational opportunities (AOR = 3.74: 95% CI: 1.56, 8.27); dissatisfaction with payments and benefits (AOR = 3.32; 95% CI: 1.87, 6.68); dissatisfaction with the lack of recognition (AOR = 2.15; 95% CI: 1.18, 3.63); and dissatisfaction with working environments (AOR = 1.96; 95% CI: 1.18, 3.52). Conclusions: The proportion of participants who intended to leave their jobs was high. Hence, developing evidence-based retention strategies focusing on payments, educational opportunities, incentives, and work environment could help reduce the intention of health extension workers to leave their jobs. [Ethiop. J. Health Dev. 2020; 34(2):106-113] Keywords: Intention to leave, health extension workers, North Wollo Zone, Ethiopia