Primary Health Care Workers Turnover intention and Organizational behavior: Systematic Review and Meta-analysis

Abstract

Primary healthcare workers (PHC) are a vital component of healthcare delivery worldwide. Primary healthcare centers important pillars at all levels of the global health system with PHC worker turnover being a major cause of low coverage for PHC. Organizational behavior has been linked to PHC worker turnover. This study aimed to examine the determinants of turnover intention and its relationship between organizational behavior by key research issues, and key research trends. The study employed a systematic literature review and met analysis approach. Different electronic databases were used to obtain literature. These included PubMed/MEDLINE, Web of Science, and Scopus. The literature search was conducted using the Boolean operators “organizational behavior” AND “Primary health care workers” AND “turnover intentions” OR “turnover behavior” OR turnover. In addition, the medical subject heading is used in PubMed/MEDLINE. Studies were eligible for any study design, turnover among PHC workers and its determinants had to be explicitly reported in each included study. Data extraction and synthesis article extracted and reviewed by independent author. Factorial analysis through meta-analysis, all studies had the same factor, which was included in the review. Newcastle–Ottawa Scale was used for the quality of studies and I² was used to determine the heterogeneity. The study found that the prevalence of PHC health workers turnover was 42.5% and male [OR = 2.59 (95% CI 1.05, 5.20)], Physicians [OR = 2.31(95% CI 1.12, 6.82)], unsatisfied with the working environment [OR = 3.72 (95% CI 2.26, 8.65)], no motivations [OR = 3.76 (95% CI 2.10, 6.21)] and displeased with the management [OR = 4.71 (95% CI 2.37, 5.38)] and having no learning [OR = 5.16 (95% CI 3.48, 8.16)] were significantly related with turnover intention of the health professionals. This study found that different determinants were associated with high turnover of PHC workers and low quality of organizational behavior among them. From these findings, methodological, contextual, theoretical, and issue gaps were identified, together with gaps in the level of analysis and publication outlets.