Vol. 2, Issue 1, Part A (2020)

Background: Health extension workers (HEWs) are the frontline health workers for Ethiopia’s primary health care system. The Health Extension Program (HEP) is one of the most innovative community- based health programs launched by the Ethiopian Federal Ministry of Health (FMOH) to make health services accessible to rural communities by setting out women health extension workers (HEWs) in rural health posts. Ethiopia has initiated a nationwide community health program (referred to as Health Extension Program) that is primarily staffed with health extension workers; however, data on their satisfaction and motivation and related factors were not studied and scanty in the country. Thus, this study was aimed to assess measure the satisfaction of health extension workers and to identify factors affecting their satisfaction in the study setting in particular and the country in general. Materials and Methods: A cross-sectional descriptive study analysis was conducted to collect relevant data on satisfaction from health extension workers who had been from three districts in Southwest Ethiopia. Items included in the questionnaires include values, organizational cultures, work place conditions, personality, motivating and satisfaction. They also included reasons for satisfaction and dissatisfaction; motivating and de-motivating from future perspectives using Likert scale. Mean and standard deviation were used to describe satisfaction level. Multiple linear regression model was used for identifying associated factors. Result: The overall mean satisfaction score was 43.0 out of the 60 total score. Organizational culture, personal recognition and appreciation, job descriptions and criteria career structure and for promotion salary have been identified by rural HEWs as major were mentioned as a reason for satisfaction and motivating; while low salaries, insufficient training and lack of capacity among others, absence of transportation, poor supervision, and absence of housing living conditions were mentioned as reasons for dissatisfaction and de-motivating. Conclusion: HEWs play a pivotal role in Ethiopia’s HEP. As such, their motivations require special consideration to support them to continue doing their health care activities in a productive way. The HEWs were least satisfied with Salary pay, education, and benefits which require high level decision for strategies to improve the pay and benefits, and opportunities for education. They were also least satisfied with management and working conditions that can be addressed at organization level by supportive supervision and management, participatory decision making, clear job descriptions, merit based recognition and appreciation and balanced workload.