Level of Health professionals Commitment towards Increasing Uptake of Institutional Delivery Services and Associated Factors at Government Health Facilities in Jimma Zone, Southwest Ethiopia

Abstract

Background: Professional commitment is beyond a commitment for a particular organization and implies the individuals‟ perspective towards their profession and the motivation that they have to stay in their job which refers to one‟s loyalty to the profession and the willingness to strive and uphold the values and goals of the profession to maintain membership in that profession. There is a general conviction that professional commitment of health workforce has a positive and significant impact upon business performance and reform process of health system. The quality and effectiveness of health systems critically depends on the size, skills and commitment of the health workforce. In Ethiopia, the National, regional (Oromia) and Zonal (Jimma) level of family planning and ANC coverage were in good status but uptake of institutional delivery service (IDS) coverage was still low. In Oromia region, IDS utilization is about 13%, which is lower than the national level (16%). The health sector is struggling to bring change by exerting its effort on these constraints/determinants of IDS utilization from the client and service coverage perspective but the level of professional commitment and associated factors of health professionals‟ was not studied yet. Objective: To assess the level of professional commitment of health professionals‟ and associated factors in government health facilities of Jimma zone, Oromia, Southwest Ethiopia, 2016. Methods: A facility based cross-sectional study design employing both quantitative and qualitative methods was conducted from March 01-20, 2016. A sample of 442 health professionals were included from the randomly selected 7 Woredas and Jimma town within respective 47 health facilities that fulfill inclusion criteria, and 20 health managers were selected purposively from selected health facilities,woreda health offices and zonal health department for in-depth interview. All eligible health professionals from the health facilities were requested to fill self-administered questioner. Finally, after checking its completeness, the data was entered in to EPI data version 3.1 and exported to SPSS version 20 for statistical analysis. Factor analysis was conducted to identify the measurement scales and factor scores that were used in both simple (P<0.25) and multiple linear regressions (P<0.05). Finally, the finding was presented using graphs, tables, narratives and descriptive numerical summary. Qualitative data was collected using key-informant interviews to support the findings from the quantitative survey by thematic analysis technique. Results: The response rate of this study was 93.21%. The percentage mean score of professional commitment for health professionals working in government health facilities of Jimma zone was 72.71 % (SD21.88). The raw mean score of this scale was 39.08± 8.8 with a total rotated variance explained 61.22%. The percentages mean score for perceived maternal health goal scale was 68.37% with the total variance explained 69.68%. This study found that perceived staff interaction, perceived work-life balance, affective organizational commitment, normative organizational commitment, personal characteristics and perceived maternal health goal as independent predictors of professional commitment. Conclusion: In this investigation, the percentage mean score of professional commitment of health professionals working in government health facilities of Jimma zone was medium. Hence, we recommend health managers to communicate and update the new maternal health goal (SDG) as well as Professionals‟ should be committed to their organization and consider their personal characterstics having balanced worklife time to foster a more high level of professional commitment among health professionals in government health facilities of Jimma zone to increase uptake of institutional delivery services.