Work satisfaction of professional nurses in South Africa: a comparative analysis of the public and private sectors Rubin Pillay
Address: School of Business and Finance, University of Western Cape, Bellville, Cape Town, South Africa Email: Rubin Pillay - firstname.lastname@example.org
Published: 20 February 2009 Human Resources for Health 2009, 7:15 doi:10.1186/1478-4491-7-15
Received: 25 February 2008 Accepted: 20 February 2009
This article is available from: http://www.human-resources-health.com/content/7/1/15 © 2009 Pillay; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: Work satisfaction of nurses is important, as there is sufficient empirical evidence to show that it tends to affect individual, organizational and greater health and social outcomes. Although there have been several studies of job satisfaction among nurses in South Africa, these are limited because they relate to studies of individual organizations or regions, use small samples or are dated. This paper presents a national study that compares and contrasts satisfaction levels of nurses in both public and private sectors. Methods: This was a cross-sectional survey of professional nurses conducted throughout South Africa using a pretested and self-administered questionnaire. Univariate and bivariate statistical models were used to evaluate levels of satisfaction with various facets of work and to elicit the differences in satisfaction levels between different groups of nurses. A total of 569 professional nurses participated in the study. Results: Private-sector nurses were generally satisfied, while public-sector nurses were generally dissatisfied. Public-sector nurses were most dissatisfied with their pay, the workload and the resources available to them. They were satisfied only with the social context of the work. Privatesector nurses were dissatisfied only with their pay and career development opportunities. Professional nurses in the more rural provinces, those intending to change sectors and those more likely not to be in their current positions within the next five years were also more likely to be dissatisfied with all facets of their work. Conclusion: This study highlighted the overall dissatisfaction among South African nurses and confirmed the disparity between the levels of job satisfaction between the public and private sectors. Health managers should address those factors that affect job satisfaction, and therefore retention, of nurses in South Africa. Improving the work environment so that it provides a context congruent with the aspirations and values systems of nurses is more likely to increase the satisfaction of nurses and consequently have a positive effect on individual, organizational and health outcomes.
South Africa has a dual health system. The public sector, comprising government health institutions, serves pre-
dominantly the indigent population, while the private sector, comprising for-profit organizations and individuals, serves the insured population or those who can afford
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care on an out-of-pocket basis. Although the public sector is responsible for the well-being of 82% of the population, it accounts for only 40% of the total health expenditure in South Africa. In contrast, the private sector consumes 60% of the health expenditure and is responsible for less than 20% of the population . The public sector, which is underresourced and overused, is often characterized as being inefficient and ineffective in...