ArticleHuman resources for health2018
'We are planning to leave, all of us'-a realist study of mechanisms explaining healthcare employee turnover in rural Ethiopia.
Article in Human resources for health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Reconfiguring retention: a qualitative exploration of the lived experiences of female nurses in an arid rural setting in Turkana County, Kenya.Global health action · 2026Article
- Radiographers' turnover in Tanzania: a mixed-methods protocol on predictors, intentions and retention strategies.BMJ open · 2026Article
- Exploring long-term retention intention and influencing factors among rural-oriented medical students in primary care in Guangxi, China: a qualitative study.BMC health services research · 2026Article
- Mapping facility-based tuberculosis preventive treatment provision in Ethiopia: a geospatial analysis.BMC health services research · 2026Article
- The impact of team functioning on the quality of care in rural hospitals: a cross-sectional survey study on similarity and multidisciplinarity.BMC health services research · 2025Article
- Do generational diversity and perceived similarity improve team functioning in rural Chinese hospitals? A cross-sectional survey study.BMJ open · 2024Article
- Impact of COVID-19 on the neglected tropical diseases: a scoping review.Infectious diseases of poverty · 2024Article
- Article
- Organizational culture and barriers to change in University of Gondar Comprehensive Specialized Hospital Cardiac Unit.BMC health services research · 2023Article
- Factors Affecting the Successful Implementation of a Digital Intervention for Health Financing in a Low-Resource Setting at Scale: Semistructured Interview Study With Health Care Workers and Management Staff.Journal of medical Internet research · 2023Article
- What Factors Explain Low Adoption of Digital Technologies for Health Financing in an Insurance Setting? Novel Evidence From a Quantitative Panel Study on IMIS in Tanzania.International journal of health policy and management · 2023Article
- Human resource management in Ethiopian public hospitals.BMC health services research · 2022Article
- Strategic human resource management and performance in public hospitals in Ethiopia.Frontiers in public health · 2022Article
- Which mechanisms explain motivation the of primary health workers? Insights from the realist evaluation of a maternal and child health programme in Nigeria.BMJ global health · 2020Article
- Article
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5 authors.
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Abstract
backgroundWe study healthcare employees' turnover intentions in the Afar National Regional State of Ethiopia. This rural region is experiencing the globally felt crisis in human resources, which is inhibiting its ability to meet health-related sustainable development goals.
methodsRealist case study which combines literature study and qualitative analysis of interview and focus group discussion data, following a realist case study protocol.
resultsA large majority of employees has turnover intentions. Building on Herzberg's two-factor theory, person-environment fit theory, as well as recent sub-Saharan evidence, analysis of the collected data yields four turnover mechanisms: (1) lack of social and personal opportunities in the region, (2) dissonance between management logic and professional logic, (3) standards of service operations are hard to accept, and (4) lack of financial improvement opportunities.
conclusionsWhile the first and fourth mechanisms may be out of reach for local (human resource) management interventions, the second and third mechanisms proposed to explain health workforce turnover appear to be amenable to local (human resource) management interventions to strengthen healthcare. These mechanisms are likely to play a role in other remote sub-Saharan regions as well.
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