# Introduction thiopia has made commendable progress in scaling up the health status of its population in the last one and half decades. However, the health services still need some improvement, and the shortage of healthcare workers is still well documented (1). Different factors could be responsible for the shortage of health work force in Ethiopia. One factor could be lack of job satisfaction. With this respect, the findings from the Second Wave of a Cohort Study of Young Doctors and Nurses of Ethiopia indicated job dissatisfaction is one of the factors that lead to international migration of health workers (2). Job satisfaction is an essential part of ensuring quality care, as dissatisfied healthcare providers are likely to give poor quality and less efficient care (3); its absence often leads to exhaustion and reduced organizational commitment (4); is also considered a strong predictor of overall individual well-being (5); and a good predictor of intentions or decisions of employees to leave a job (6). As many research findings indicated, employees' job satisfaction is sector dependent and inconsistent findings were reported in public and private sectors hospitals. With this regard, the finding obtained from a comparative study in Punjab showed that employees in private sector feel that their jobs are more comfortable and satisfaction level is quite high as compared to employees working in the public hospitals (7). Similarly, a research done in Turkish Health care staffs have found out that the job satisfaction level in private hospitals were higher compared to public hospitals (8). On the other hand, a study have revealed that the government healthcare workers were significantly more satisfied with their job than private counterparts (9). Still there is also a study that indicates no statistically significant difference on job satisfaction between government and private sector employees (10). However, after a review of the literature specific to health workers' job satisfaction, the researchers realized that most of the studies were done in developed countries while little research outputs found in developing countries including Ethiopia. Even if there were some local research on job satisfaction, they failed to address differences of job satisfaction in government and privates sector and among different professionals. Moreover, they emphasize on the overall level of job satisfaction rather than the various facet of the job satisfaction. These are serious gap as they failed to provide adequate information for the two sectors and various professionals and also failed to indicate the extent of the various facets of job satisfaction which ultimately affects the intervention process aimed at enhancing job satisfaction. This research, therefore, tried to address the above mentioned gaps. Thus, the general objective this research were to find out the overall job satisfaction and the extents of the various facets of job satisfaction among health workers of public and private sector hospitals in South-West Shoa Zone , Oromia Regional State. # II. # Methods and Materials Comparative cross-sectional survey was carried out from February 8 to March 6, 2015 among 220 health workers at public and private sector hospitals in South-West Shoa Zone, Oromia Regional State. There are only two hospitals in the South-West Shoa zone which: Tullu Bollo public hospital and St. Luke private hospital. The total population of the present study was 271 health workers, of which 187 health workers from St. Luke private hospital and the rest 84 were from Tullu Bollo public hospital. Accordingly, 232 health workers were the participants of the study using Cochran method of sample size determination method. In order to draw the representative sample, proportionate stratified sampling technique was applied. The stratification was based on fields of profession, which was Physician, Health Officer, Midwifery, Nurses, Lab technician, Anesthesia Expert, and Other which includes psychiatrists, Physiotherapy, Pharmacist, Ophthalmologist, X-ray technicians for both sectors, and Lab technicians for public sector. In order to collect data on job satisfaction, Job Satisfaction Scale (JSS) developed by Spector (1997) was used. The JSS allows the researchers to find out not only whether people are satisfied with their jobs but also, more importantly, which parts of the job facets is related to job satisfaction. Further, previous research has indicated that the JSS has high psychometric properties for example providing assurance that the data would be valid and reliable (11). The JSS contained 19 negatively and 17 positively worded items in which the respondents rate their level of agreement on 6 point scale ranging from 1 (disagree very much) to 6 (agree very much). A mean item response (after reverse scoring the negativelyworded items) of four or more represents satisfaction, whereas mean responses of three or less represents dissatisfaction. Mean scores between three and four was moderate. The data collected through JSS were analyzed with SPSS version 20 on the basis of their relevance for answering the research questions intended. Accordingly, descriptive statistical measures such as mean score were used for the sake of explaining the general pattern of job satisfaction. Independent sample T-test and one way ANOVA were also used in this study. Bonferroni Post-hoc test were used to explain what means were exactly significant when the statistically significant difference were obtained. Bonferroni test able to control Type-I error or fluctuation of alpha resulted from difference in sample size between comparative groups. Ethical clearance and approval to conduct this research was obtained from the Research and Post-Graduate Program Coordinator, College of Education and Behavioral Sciences, Jimma University. After getting permission from the administration, objectives of the study were clearly explained to the participants and oral informed consent was obtained. Confidentiality and anonymity were ensured throughout the execution of the study as participants were not required to disclose personal information on the questionnaire. Participants were informed that their participation was voluntary and that they could withdraw from the study at any time if they wished to do so. # III. # Results The purpose of this study was to examine job satisfaction among health workers of public and private sector hospitals at South-West Shoa Zone, Oromia Regional State. This chapter presents the results of the study based on the empirical analysis of the data collected from the research participants with respect to basic research questions. In addition, both descriptive and inferences on the data analysis are presented. # a) Sample characteristics i. Response rate In order to answer the aforementioned research questions, this comparative cross-sectional study was conducted at South-West Shoa Zone among health workers of public and private sector hospitals. The total population of the study was 271 health workers where 184 and 87 were taken from private and public sector hospital respectively. From this total population, 232 samples (156 health workers from private and 76 health workers from public sector hospitals) were drawn using a standard formula developed by Kurtz (1983). A total of 232 health workers were provided the self-administered questionnaire. A total of 232 questionnaires were distributed. 157 questionnaires were distributed to the private sector health workers and the other 75 questionnaires were distributed to the health workers in government sector hospital. Among the 232 questionnaires distributed, 220 completed questionnaires were returned, resulting in an overall response rate of 94.83%. Within these 220 questionnaires, 148 questionnaires were from private sector health workers, with a response rate of 94.27%; 72 questionnaires were from public hospital health workers, with a response rate of 96%. The overall response rate and the response rates of the two specific sectors of health workers are very much satisfactory. # ii. Description of general characteristics of respondents' The study solicited information from participants based on their sex, age, sector, experience, fields of profession and level of education. In aggregate, the study attracted a total of 220 respondents of which 148 (67%) were from private and 72 (33%) were from public sector hospitals. In terms of sex distribution, female health workers are made up 114 (51.82 %) while male health workers constituted 106 (48.18%). Slightly more than half of the participants 113 (51.36 %) were in the age group of less than 30 years, followed by the age group 30-40 were 75 (34.10 %), and 14.54 % above 40 years of age. The holders of at least first degree accounted for 92 (41.82 %), diploma accounts 91 (41.36%), and about 100 (45.45 %) of the respondents have a work experience of five and less, followed by 6-10 years of service 81 (36.81 %) and above 10 years, respectively. Regarding profession, it is clear that from both sector most of the respondents in the sample were Nurses 81 (36.81%) mostly due to the large number of nurses in both government and private sector hospitals, 30 (13.63%) were physicians, 39 (17.72%) were Others, which includes psychiatrists, Physiotherapy, Pharmacist, Ophthalmologist, X-ray technicians for both sectors, and Lab technicians for public sector; 27 (12.72%) were midwifes, 21 (9.54%) were health officers, 11 (5%) were lab technicians and anesthesia expert each. One of the main objective of this study was to investigate whether or not there is significant difference on the level of job satisfaction between health workers in public and private sector hospitals. As such, the descriptive statistics and Independent Samples T-Test was computed, and results obtained are summarized in Table 5. According to these results, the mean score of overall job satisfaction in private sector hospital (M=3.29, SD=.56) was found to be higher than those in public sector hospital (M=2.94, SD=.41). In terms of the facets of job satisfaction, analysis result showed that except satisfaction with the nature of work and co-workers relationship the mean score of satisfaction with contingent reward (M=3.62, SD=.68), operating conditions (M=3.20, SD=98), communication (M=3.17, SD=.55), pay (M=3.11, SD=.82), Promotion (M=3.11, SD=1.00), fringe benefits (M=3.16, SD=.72), supervision (M=3.07, SD=.78) was found to be high in private sector hospital health workers. Also Table 5 indicates that there is a statistically significant difference on the level of overall job satisfaction between health workers at private and public sector hospital (t ( 219 ) = 5.292, p < 0.05). More specifically, Independent sample t-test revealed a statistically significant mean difference across sectors on seven facets of job satisfaction, namely pay (t ( 219 ) = 3.957, p < 0.05), promotion (t ( 219 ) = 6.814, p < 0.05), supervision (t ( 219 ) = 3.985, p < 0.05), fringe benefits (t ( 219 ) = 3.387, p < 0.05), co-workers relationship (t ( 219 ) = -5.235, p < 0.05), contingent reward (t ( 219 ) = 6.891, p < 0 . 05), and operating conditions (t (219) = 7.536, p < 0.05). However, no statistically significant difference was found regarding the nature of work (t ( 219 ) = -.628, p >0.05) and communication (t ( 219 ) = 1.577, p >0.05), between private and public sector hospitals' health workers. Analysis of variance (ANOVA) followed by post hoc test was carried out between job designations and overall job satisfaction. The finding from Table 13, indicates that there is statistically significant difference between job satisfaction and the various fields of profession F(6,214)=7.430, p <.05. Since the result was significant, post-hoc analysis by using Bonferroni test was then carried out. The post-hoc test showed significant difference between some fields of professions as shown in Table 14. The findings indicate that among health workers in South-West Shoa Zone Hospitals, the Physicians and Health officers tend to be moderately satisfied than other fields of professions. The Physicians are significantly more satisfied than all the other job designations except for Health Officers, Lab technicians, and others, which include psychiatrists, Physiotherapy, Pharmacist, Ophthalmologist, X-ray technicians for both sectors, and Lab technicians for public sector. The Health officers are significantly more satisfied than all the other fields of profession except for the Physicians and Lab Technicians. Table 14 # also indicates high level of dissatisfaction between Anesthesia experts and some fields of profession as indicated by the large mean difference between Anesthesia experts and Health Officers (mean difference -.77429); and Anesthesia experts and Physicians (mean difference -.65379). High level of dissatisfaction between Nurse and some fields of professions was also obtained by large mean difference between Nurses and Health Officers (mean difference -.53304); and Nurses and Physicians (mean difference -.41253). # e) Association of nine facets of job satisfaction with overall satisfaction Table 13 shows that there is statistically significant moderate positive relationship between overall job satisfaction and nine facets of job satisfaction (p <.05), which indicates that increases in dimension of satisfaction correspond to increases in the overall job satisfaction. Correlation result (table.12) shows except nature of work (r=.208**) and co-worker relationship (r=.359**), the rest seven dimensions have a strong association with satisfaction related to the job which is ranges from .622 to .733. Results also shows that fringe benefit (.733**) is the most associated dimension with job satisfaction. Where nature of work (.208**) is the least associated dimension with overall job satisfaction among health workers. A significant association also found within some dimensions of the job satisfaction. IV. # Discussion This is a comparative cross-sectional study that aimed at comparing job satisfaction between private and public sector hospital health workers in South-West Shoa Zone, Oromia Regional State. This section presents the results of the statistical analysis in relation to the previous research and literature. The findings of this study show that health workers working in hospitals at South-West Shoa Zone were moderately satisfied with their job. Interestingly, this finding is similar to that of several other studies conducted on job satisfaction among health workers in Kigali University Teaching Hispital (D'amour, 2012), Malaysia (Roslan, et al, 2014), Iran (Ali-Mohammed, 2004), Rwanda (Nkomeje, 2008). Of the factors that were investigated in this study, satisfactions with 'co-workers', supervision, 'nature of work', 'contingent reward' and 'communication' had the moderate mean satisfaction rate. However, the mean score of satisfaction with operating conditions pay and promotion showed low level of satisfactions. Dissatisfaction with regard to salaries in this study finding seems to be a common issue that is also evident in a very recent study conducted in West Shoa Zone, Ethiopia (Mengistu & Bali, 2015). Again, this result is partly similar with the result obtained in Bahrain (Jahrami et al., 2011). With regard to sector differences, the present study indicate that the health workers in private sector feel that their jobs are more comfortable and satisfaction level is quite high as compared to employees working in the public hospitals. In line with these results, consistent findings were obtained. For example, Rana (2014) reported that in Punjab private sector health workers were more satisfied than public sector health workers. Likewise, Pala, et al (2008) also reported that a significant difference in job satisfaction in which private hospitals workers were having higher job satisfaction levels compared to public hospitals. Contrary to this study, Rao & Malik (2012) found out that government healthcare workers are more satisfied with their job as compared to private health workers. With regard to facets of job satisfaction in the two sectors , the finding of this study divulge that the health workers who were worked in private sector hospital had comparatively better satisfaction than those in public hospital in all dimension of job satisfaction except satisfaction with co-workers. This result partially inconsistent with the result reported by Pillay (2008) which reported private sector health workers were dissatisfied with pay and promotion while health workers from public sector were moderately satisfied with such facets of job satisfaction. Generally, a statistically significant differences between private and public sector hospital healthcare workers and were obtained for the overall job satisfaction scores and for seven out of the nine dimensions; the only exception was the dimension of nature of work and communication. Several previous researches suggest that job satisfaction can be influenced by a variety of factors such as personal variables like fields of profession. In line with this, the findings of this study indicated a statistically significant difference on job satisfaction between different fields of profession. Thus, physicians and health officers were significantly more satisfied as compared to other fields of professions. The difference that exists in this study on job satisfaction among fields of profession were similar with the study in Serbia by Aleksandra (2007) which reported a significant difference on job satisfaction between health workers with varied fields of profession, in which physicians were most satisfied with their job than Nurses. Similar findings were also reported by Roslan et al (2014) indicates in Malaysia Physicians were found to be significantly more satisfied than other fields of profession. The result of present study also agrees with Alemishet, et al. (2011), have found out that nurses were less satisfied than physicians and other fields of professions. V. # Conclusion This study examined the level of job satisfaction among health workers of government and private hospitals at South-West Shoa Zone, Oromia Regional State. The findings of this study can provide the basis for further research so that valuable insight can be taken in identifying factors to focus on in order to improve job satisfaction. However, the present study has some limitations. First, the cross-sectional study design did not allow determination of the causal relationships among variables. Second, even with the high level of participation in this study, there is a possibility that responses of individuals who did not participate may have differed in some manner from those who did in fact participate. Lastly, the conclusions of this study cannot be generalized to all health workers across Ethiopia, as the different environment and circumstances prevailing in other hospitals may impact on job satisfaction. In spite of these limitations, the following conclusions are drawn on the basis of results obtained: The level of job satisfaction among health workers in hospitals at South-West Shoa Zone was moderate in general. Regarding facets, they were moderately satisfied with contingent reward, co-worker relationship nature of work, and communication in their workplace. However, they are dissatisfied with the rest six facets of job satisfaction, namely pay, promotion, supervision, fringe benefits, and operating condition. If health workers are not satisfied with their job the tendency to turnover would be very high and even if they are in their job they could not deliver quality service. Comparatively, the findings of current study showed a significant difference in the level of job satisfaction among health workers in government and private sector. Though private sector hospital's health workers were moderately satisfied with their work but overall the government health workers are poorly satisfied with their work. Further, this study was also found a statistically significant difference among fields of Similarly, Jahrami et al. (2011) reported that health workers in psychiatric hospitals in Bahrain were moderately satisfied with their job. Regarding facets, their finding have found out that health workers had better level of job satisfaction with regard to nature of work, supervision, co-workers and communications as compared to other dimensions of job satisfaction such as pay, promotion, fringe benefits, contingent reward and operating conditions. As this study revealed, the most important factors for health workers' job satisfaction were co-worker relationship and nature of work. Health workers in this survey saw that the tasks and duties of helping others were the major sources of satisfaction. profession on job satisfaction. Thus, Physicians and Health Officers are more satisfied than Midwifes, Nurses, Anesthesia expert, Lab technicians and others (psychiatrists, Physiotherapy, Pharmacist, Ophthalmologist, X-ray technicians for both sectors, and Lab technicians for public sector). # VI. # Recommendations The purpose of this section is to lay emphasis on several recommendations drawn from the present study. The aim of these recommendations is to discover new ideas to enhance job satisfaction there by describing factors associated to job satisfaction among healthcare employees at South-West Shoa Zone. Thus, the federal government and administrating bodies of private sector should improve such factors on the way satisfies health workers. Moreover, Since health workers in private and public sector hospitals at South-West Shoa Zone were dissatisfied with their pay, promotion, supervision, fringe benefits, and operating procedures, the government of Ethiopia specifically Ministry of Health and the administrative bodies of the private sector hospital should understand the importance of implementing appropriate salaries, supervision, fringe benefits, operating procedures and fair promotion. VII. 3Demographic variablesPublic Hospital F %Private Hospital F %FTotal%S ex Male Female Total33 39 7215 17.72 32.7273 75 14833.18 34.10 67.28106 114 22048.18 51.82 100Age <30 years 30 -40 years Above 40 years Total30 35 7 7213.63 15.91 3.18 32.7283 40 25 14837.73 18.19 11.36 67.28113 75 32 22051.36 34.10 14.54 100Level of Education Diploma Bsc. Degree Above Bsc. Degree Total31 30 11 7214.09 13.64 5.00 32.7260 62 26 14827.27 28.18 11.82 67.2891 92 37 22041.36 41.82 16.82 100Service year 5 year and less 6 -10 years Above 10 years Total33 28 11 7215.00 12.72 5.00 32.7267 53 28 14840.45 24.09 12.727 67.28100 81 39 22045.45 36.81 17.72 100Profession Physicians Health Officer Nurses (Bsc. & Diploma) Midwifes12 9 27 115.45 4.09 12.27 5.0018 12 54 168.18 5.45 24.54 7.2730 21 81 2713.63 9.54 36.81 12.27 4Facets of job satisfactionMeanSD.MinimumMaximumPay2.78.881.004.50Promotion2.59.871.004.50Supervision2.78.781.504.75Fringe benefits2.94.691.254.75Contingent reward3.21.671.754.75Operating procedures2.61.921.004.50Co-workers3.89.902.006.00Nature of work3.52.771.255.75Communication3.10.541.754.75Overall Job satisfaction3.05.492.064.86c) Job satisfaction across sector (public and private) 5Facets of jobPrivate hospitalPublic hospitalt-test for Equality of MeanssatisfactionMeanSD.MeanSD.Tdfp-valuePay3.11.822.62.873.957219.000Promotion3.111.002.33.666.814219.000Supervision3.07.782.63.753.985219.000FB3.16.722.83.663.387.001CR3.62.683.01.586.891219.000OC3.20.982.32.727.536219.000Coworkers3.46.834.10.86-5.235219.000NW3.47.693.54.81-.628219.530Com3.17.553.05.531.577219.116Overall JS3.29.562.94.415.292219.000**. Difference is significant at 0.05 alpha levels (2-tailed), p < 0.05d) Job satisfaction across fields of professions. Table 9 indicates some mean score differenceSD=.54), midwifes (M=3.07, SD=.36), others (M=3.05, SD=.48), and anesthesia expert (M=3.02, SD=.53),were observed between different fields of profession, health officers had better mean score of job satisfactionrespectively. However, low mean score was observed among nurses (M=2.94, SD=.41), and lab technicians(M=3.48, SD=.63), followed by physicians (M=3.35,(M=2.70, SD=.09). 7VariablesGroupNMeanSD.MinMaxProfessionPhysicians303.35.542.254.47Health officers213.48.632.504.86Nurses822.94.412.063.50Midwifes273.07.362.443.89Lab technicians112.70.093.003.19Anesthesia expert113.02.532.063.44Others393.05.482.03.89 13VariablesGroupSum of squareDfMean squarefSig.ProfessionPhysiciansBetween groups9.39661.5667.430.000Health officersWithin groups45.102214.211NursesTotal54.498220MidwifesLab techniciansAnesthesia expertOthers**. Difference is significant at 0.05 alpha levels (2-tailed), p < 0.05 10Year 2017Mean(I-J)Std. ErrorSig.95% Confidence Interval Lower Bound Upper BoundHealth officer-.12050.130621.000-.5221.2811Nurses.41253 *.09796.001.1113.7137PhysiciansMidwifes Lab technician.43755 * .28763.12178 .16182.009 1.000.0631 -.2099.8120 .7852Anesthesia expert.65379 *.16182.002.15621.1513Others.33768.11149.058-.0051.6805Physician.12050.130621.000-.2811.5221Health offNurses Midwifes.53304 * .55805 *.11228 .13357.000 .001.1878 .1473.8783 .9688Lab technician.40813.17087.373-.1173.9335Anesthesia expert.77429 *.17087.000.24891.2997Others.45818 *.12426.006.0761.8402Physician-.41253 *.09796.001-.7137-.1113( A )NursesHealth officer Midwifes-.53304 * .02502.11228 .10186.000 1.000-.8783 -.2882-.1878 .3382-Global Journal of Human Social ScienceMidwifes Lab techLab technician Anesthesia expert Others Physician Health officer Nurses Lab technician Anesthesia expert Others Physician Health officer Nurses Midwifes Anesthesia expert Others Physician Health officer-.12491 .24125 -.07486 -.43755 * -.55805 * -.02502 -.14993 .21624 -.09987 -.28763 -.40813 .12491 .14993 .36616 .05005 -.65379 * -.77429 *.14741 .14741 .08930 .12178 .13357 .10186 .16421 .16421 .11493 .16182 .17087 .14741 .16421 .19575 .15673 .16182 .170871.000 1.000 1.000 .009 .001 1.000 1.000 1.000 1.000 1.000 .373 1.000 1.000 1.000 1.000 .002 .000-.5782 -.2120 -.3494 -.8120 -.9688 -.3382 -.6548 -.2887 -.4533 -.7852 -.9335 -.3283 -.3550 -.2357 -.4319 -1.1513 -1.2997.3283 .6945 .1997 -.0631 -.1473 .2882 .3550 .7212 .2535 .2099 .1173 .5782 .6548 .9681 .5320 -.1562 -.2489AnesthesiaNurses Midwifes-.24125 -.21624.14741 .164211.000 1.000-.6945 -.7212.2120 .2887Lab technician-.36616.195751.000-.9681.2357Others-.31611.15673.944-.7980.1658Physician-.33768.11149.058-.6805.0051Health officer-.45818 *.12426.006-.8402-.0761OthersNurses Midwifes.07486 .09987.08930 .114931.000 1.000-.1997 -.2535.3494 .4533Lab technician-.05005.156731.000-.5320.4319Anesthesia expert.31611.15673.944-.1658.7980* 12PayProSupFBCROCNWCowCOOJSProPC.574 **1Sig.(2-tailed).000SupPC.328 **.362 **1Sig.(2-tailed).000.000FBPC.515 **.567 **.563 **1Sig.(2-tailed).000.000.000CRPC.480 **.589 **.502 **.575 **1Sig.(2-tailed).000.000.000.000OPPC.378 **.530 **.546 **.437 **.515 **1Sig.(2-tailed).000.000.000.000.000CowPC.135 *-.190 **-.091.019-.054-.243 **1Sig.(2-tailed).044.005.177.776.426.000NWPC.000-.011.364 **.081.142 *-.042.346 **1Sig.(2-tailed).998.876.000.230.034.535.000COPC.342 **.352 **.403 **.516 **.420 **.234 **.212 **.241 **1Sig.(2-tailed).000.000.000.000.000.000.001.000OJSPC.682 **.693 **.705 **.733 **.732 **.622 **.208 **.359 **.638 **1Sig.(2-tailed).000.000.000.000.000.000.002.000.000* Correlation is significant at the 0.05 level (2-tailed).** Correlation is significant at the 0.01 level (2-tailed).** PC=Pearson Correlation, Pro=Promotion, Sup=Supervisor, FB=Fringe benefits, CR=Contingent reward, OP=Operatingprocedures, Cow=Co-workers, NW=Nature of work, CO=Communication, OJS=Overall Job satisfaction. 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