Motivation and Associated Factors among health Professionals at Public Hospitals of Ethiopia

Motivation and Associated Factors among health Professionals at Public Hospitals of Ethiopia | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Motivation and Associated Factors among health Professionals at Public Hospitals of Ethiopia Adane Etore, Tekle Ejajo, Dawit Sullamo, Demeke Daselegn Lendebo, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9073720/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Healthcare professional motivation is basically related to job satisfaction, remuneration, hospital work environments, educational attainment, and resource availability. Conversely, low motivation adversely affects the performance of individual healthcare institutions, health workers, and the health system as a whole. This study aims to assess the motivation levels and associated factors among healthcare professionals in public hospitals of Ethiopia. Methods An institution based cross- sectional study was conducted from October 1, to November 1, 2023. A total of 407 healthcare professionals were included in the study by using simple random sampling. Data was collected by using a pretested structured self-administered questionnaire. Binary logistic regression analyses were used to determine the association between the dependent variable and independent variable. Variable with p-value < 0.05 was declared as statistically significant. Result A total of 407 health professionals participated in this study, yielding a 96.4% response rate. Of these, 31.7% (95% CI: 27.0%–36.6%) were motivated. Multivariable analysis revealed that job satisfaction (AOR = 1.29 (95% CI: 1.12–2.70), justice and fairness (AOR = 1.38 ( 95% CI: 1.21–2.21), remuneration (AOR = 2.48 (95% CI: 1.14–5.4), educational level (AOR = 2.41(95% CI: 1.13–5.13), and resource availability (AOR = 2.14 (95% CI: 1.20–3.81) were significantly associated with the participants' motivational status. Additionally, the specific hospital where they worked (AOR = 5.6) was also a significant factor Conclusion finding of this study showed that most of the health professionals were not motivated. The presence of job satisfaction, justice and fairness, remuneration, working hospitals, educational level, and resource availability were significantly associated with motivational status. Motivation Associated Factors Health Professionals Public Hospitals Figures Figure 1 Background An individual's willingness to work effectively and efficiently to accomplish personal and organizational goals is referred to as motivation. It is the individual emotion and process by which an individual responds to determine stimulus that the environment challenges the worker to boost performance and energized to establish positively( [ 1 ], [ 2 ]). Additionally, both internal and external pressures act as a catalyst for work behavior and as the force that shapes the direction, intensity, and length of work behavior ([ 3 ]).Without enough desire to achieve their work objectives, workers would not complete tasks, even if they have clear work objectives, and the appropriate abilities, in a supportive work environment[ 4 ]. Given that providing healthcare requires a lot of labor, the motivational concern is especially powerful in the health sector [ 5 ]. Extrinsic motivation (EM) refers to external factors that can be assessed through rewards, benefits, the workplace, working circumstances, and management[ 6 ]. The work itself cannot fully satisfy extrinsic motivations. According to Jung, the fulfillment of needs is also influenced by the impacts of employment and its contributing variables [ 7 ]. The impact of intrinsic incentives, which are motivated by the quality of one's working life, is likely to be more profound and long lasting. It is impossible to separate these two distinct motivational facets from one another due to their interconnectedness [ 8 ]. The interactions between employees and their workplace are reflected in the motivation of healthcare practitioners. Policies at the local, organizational, and overall sector levels can positively or negatively affect health workers, and as a result, influence the functioning of the health system. This is due to the interactive nature of motivation. Yet little is understood about the essential components and outcomes of motivation in emerging and transitional countries like Ethiopia[ 5 ]. The act of being motivated by one's job insofar as it meets their individual needs is known as intrinsic motivation. Self-generated intrinsic motivation is theorized to lead people to search for employment in the field they believe will best meet their needs. Responsibility, autonomy, the courage to use and develop one's own skills, engaging tasks, and opportunities for advancement are some of the factors affecting intrinsic motivation[ 9 ]. Extrinsic and intrinsic motivation (IM) is two categories under Herzberg's two-factor theory of motivation. The urge for someone to do their job successfully to satisfy their intrinsic needs is known as intrinsic motivation [ 10 ]. A task's completion or other psychological benefits are examples of intrinsic motivation [ 6 ]. It includes components that are related to internal considerations, such as job satisfaction, accomplishment, acknowledgment, and possibilities for growth (advancement) [ 8 ]. The importance of health professionals' motivation for the efficiency of the healthcare system is being recognized by policymakers. The quality, efficiency, and equity of the healthcare system's service delivery depend on how motivated healthcare employees are to put effort into their work. Although resources and the skills of health workers are important, managers and decision-makers in the field should be aware that these factors alone will not cause health workers to perform to the standards expected of them. Instead, health workers are willing to show up for work regularly, work hard, be adaptable, and be willing to perform the necessary tasks [ 1 , 3 , and 4 ]. In the workplace, motivational processes take place at the individual level and consist of two parallel elements: the degree to which employees adopt organizational goals (their "will do") and the degree to which they successfully use their resources to accomplish shared objectives (their "can do") [ 11 ]. Inadequate health systems with insufficient tools, supplies, and management structures result in low output, a narrow range of competencies, and inadequate reactivity. The linked complexity of these aspects is the core reason for unsatisfactory performance in various domains. These difficulties can lead to work discontent and low motivation among healthcare personnel, as can the complexity and difficulties involved in providing and juggling competing needs for patient care [ 12 ]. The motivation of healthcare workers may have an impact on how well services are delivered. It has repeatedly been mentioned as a significant hindrance to the delivery of efficient health services [ 13 ]. It is generally known that there is a shortage of healthcare workers in the majority of the world. As a result, certain medical facilities are enticing potential employees with bonuses. The healthcare system depends on each healthcare professional, and any shortage affects other occupational groups. There is a chance that patients could receive subpar care or possibly be put in danger due to industry-wide shortages. Additionally, these shortages produce a setting that is unfriendly to employee retention[ 14 ]. According to a study done in Africa, a lot of Human Resources are demotivated and frustrated because they are unable to satisfy their professional consciences and are hindered from pursuing their vocations due to a lack of resources and supplies, as well as insufficient or improperly applied Human Resource Management techniques. Health workers' motivation may suffer as a result.[ 15 ] In Ethiopia, the government included the creation of a CRC (compassionate, respectful, and caring health workforce) in its GTP2 strategy. To do this, the government undertook training of health professionals based on research to significantly increase their number. A clear promotion ladder was developed for healthcare workers at the entry level and mid-level. In the health industry, human resources serve as a strategic asset and are a crucial resource for maintaining employee motivation. As a result, the provision of healthcare services depends heavily on qualified employees[ 16 ]. According to research from Ethiopia, the health system has been making efforts to raise the quality of healthcare services by implementing significant healthcare reforms, such as business processing and re-engineering, healthcare funding, and health information systems. The Ethiopian FMOH acknowledged the issue as a component of a sector-wide reform program intended to improve the quality and accessibility of healthcare through a decentralized system and put importance on developing hospitals' management capabilities through trailblazing blueprint standards[ 17 , 18 ]. However, none of these approaches were as successful as they may have been in producing the anticipated results due to a number of variables. The shortage of human resources in the health system continues Since motivated HPS are more likely to work for profit in the private sector and nongovernmental organizations than they are in the public sector, this appears to be a major issue for the health sectors, especially public health facilities, as many trained HPs are moving abroad or leaving to work in the private sector[ 19 , 20 ]. The study will be utilized to provide details on the HPs motivation and gaps that exist in health system today. The study's findings will be providing input to public hospitals in Hadiya zone and Hadiya health department in which area to intervene and strengthen the system. METHODS Study area and period This study was conducted from October 1, 2023, to November 1, 2023, in public hospitals in Hadiya Zone, which is located in the Central Ethiopia Region at 232 km from Addis Ababa in the south. According to the report of the Hadiya Zone Health Department, the total population is 1,838,043 of whom 900,641 (49%) are male and 937,402 (51%) are female. The zone has 13 woreda and 7 town administrations and there are 5 public hospitals with 1134 health professionals. Study Design An institutional based cross- sectional study was conducted to assess Health Professionals’ motivation and associated factors at public hospitals of Hadiya zone, Central Ethiopia Region. Population Source Population : All health professionals who are working in public hospitals of Hadiya Zone Central Ethiopia Region were the source of population. Study Population All selected Health professionals from the public hospitals of Hadiya Zone who were on the job during the study period. Inclusion Exclusion Criteria Inclusion Criteria All health professionals, who had worked at least for 6 months prior to data collection was included. Exclusion Criteria Health professionals who were not on duty due to sick leave, maternal leave, annual leave, study leave, or long-term and short-term training during data collection time. Sample Size Determination The sample size was determined using Open Epi version 2.3 for a single population proportion while taking into account the following assumptions: Estimated proportion (p) of 50.4% from a similar study conducted at public hospitals in Bahir Dar city[ 44 ]. d = 5% marginal error and at a 95% confidence level. Based on these, the sample size was (n = 384). Considering the non-response rate, it was also considered 10%, and 384*0.1 = 38. Then the final sample size was 384 + 38 = 422. For the inferential objective, a double population proportion formula was used using Epi Info version 7.2 stat calc. Table 1 Shows sample size calculation of motivational status for the second objectives by factors. Factors of Motivational Status P1 = proportion among exposed and P2 = proportion among non-Exposed Power AOR Sample size Total sample( Adding 20% NR) Reference Advancement Advanced P1 = 78.9% 80% 3.47 7 8 [ 43 ] Not advanced P2 = 39.4% Interpersonal r/ship Good P1 = 57.8% 80% 4.62 52 62 [ 44 ] Not Good P2 = 42.2% Not Fair P2 = 50.4% Remuneration Remunerated P1 = 36.1% 80% 4.69 17 20 [ 45 ] Not Remunerated P2 = 63.9% Recognition Recognized P1 = 32.2% 80% 50.44 10 12 [ 45 ] Not Recognized P2 = 67.8% NR= None Response Rate However, compared with the first objective sample size (422), the sample size calculated from factors (62) was very low. Therefore, the final sample size for this was 422 health professionals. Sampling Procedure The five hospitals have different numbers of registered health professionals (NEMMCSH has 619 health professionals, Gimbichu primary hospital has 98 health professionals, Shone primary hospital has 231 health professionals, Homacho primary hospital has 98 health professionals, and Bonsha primary hospital has 88 health professionals). Therefore, the obtained sample size was proportionally allocated for each hospital. Therefore, 231 study participants were allocated to NEMMCSH, 37 to Gimbichu Primary Hospital, 86 to Shone Primary Hospital, 35 to Homacho Primary Hospital, and 33 to Bonsha Hospital. Then the sample was collected from all hospitals by a simple random sampling method from a list of health professionals found in the human resource management department. To collect samples from all categories of health professionals, the source population was stratified according to their professional category. Then, from each stratum, the study participants were collected proportionally from all categories of health professionals by the lottery method (Table 2 ). Table 2 Sample Size Distribution to each public hospital proportional to the number of health professionals R.No Type of profession NEMMCSH Gimbich PH Shone PH Homacho PH Bonsha PH Total Pop S.size Pop S.size Pop S. size Pop S.size Pop S.size Pop S.s 1 Nurses 221 82 37 14 103 38 43 16 38 14 442 113 2 Midwives 73 27 19 7 27 10 12 4 11 4 142 37 3 Specialist/subspecialist 54 20 - 2 1 - 57 14 4 GP 47 18 7 3 15 6 4 1 7 3 79 20 5 Pharmacy 41 15 11 4 18 7 9 3 10 4 89 25 6 PH 20 8 10 3 22 8 12 4 8 3 72 18 7 Laboratory 66 25 12 4 17 6 9 3 6 2 110 27 8 Anesthetist 32 12 4 1 8 3 3 1 2 1 49 18 9 HIT 42 16 3 1 6 2 3 1 3 1 57 21 10 Others 23 8 7 3 12 4 5 2 3 1 50 18 Total 619 231 98 37 231 86 98 35 88 33 1134 422 Study Variables Dependent Variable Health Professionals’ motivation Independent Variable Socio-demographic factors -age, sex, marital statuses, religion, profession, work of experience, educational status, monthly salary, current working positions. Give other name Interpersonal relationships, Resource availability, Working environment, Justice and fairness, Remuneration/Reward/Salary, Achievement, Advancement, Recognition, Responsibility, Job satisfactions, Balanced scorecard. All variables were designed to be categorical, including continuous variables like age, monthly salary, and work of experience [ 53 ]. Data Collection Procedures and Measurement. Data were gathered using a self-administered, well-structured questionnaire. The questionnaire was developed to measure health professionals’ general motivation from a prior study as well as from a document entitled A Guide to Improving Organizational Performance [ 52 ]. The questionnaire has 81 items grouped into 12 dimensions or composites: 'motivation’ (14 items), ‘job satisfaction’ (8 items), ‘work environment’ (6 items), ‘interpersonal relationships’ (5 items), ‘justice and fairness’ (4 items),'resource availability’ (6 items), ‘advancement’ (6 items), ‘remuneration’ (6 items), ‘recognition’ (8 items), ‘achievement’ (5 items), ‘balanced scorecard’ (3 items). The response to each item in the questionnaire was assessed using a 5-point Likert scale of agreement (from 1: “strongly disagree” to 5: “strongly agree”). The tool also includes the demographic characteristics (5 items) of the professionals. The outcome and independent variables were assessed by taking the mean score of these items [ 3 ] [ 53 ]. Before starting the actual data collection, 5% of the questionnaires were pre-tested in out of study area to check the validity and consistency of the questionnaires. In the data collection process, three data collectors, one supervisor, and the principal investigator were involved. Data quality control The data collection instrument was pre-tested to ascertain the contents and clarity of the questionnaires. The principal investigator gave one-day training for three diplomas in HIT and one BSc in Public health supervisor based on the questionnaire and on how to use it appropriately. A supervisor, who checked the completeness and logical consistency at the end of each day and gave feedback on the spot during the data collection process, supervised the data collection procedure. On reliability analysis, Cranach’s alpha was calculated to test the internal consistency (reliability) of all Likert scale questionnaires, and the calculated Cranach’s alpha value was 0.84. Data Processing and Analysis Data was cleaned, stored, and exported to SPSS version 25.0 for analysis after being coded and entered into Epi Info version 4.6. For negatively worded items, they were reverse coded. Descriptive statistics were computed to describe the major findings of the study and presented using tables and figures. Binary logistic regression analyses were used to determine the association between the outcome variable and independent variables. A bivariate analysis was performed to calculate the unadjusted odds ratio and screen out potentially significant independent variables at a p-value 0.25 level of significance to be included in the multivariable binary logistics regression model. The odds ratio, p-value, and 95% CI for the odds ratio were used for testing the significance and interpretation of the results. A variable with a p-value < 0.05 was considered statistically significant. The basic assumptions of the binary logistic regression model, namely multicollinearity and outliers, were checked by using VIF and boxplot, respectively. The adequacy of the final model was assessed using the Hosmer and Lemeshow goodness of fit, and the p-value was 0.66. RESULTS Socio-Demographic Characteristics of the Health Professionals A total of 407 hospital health professionals (HPs) with a response rate of 96.4% participated in the study. The mean age of participants was 27.73 (± 4.18 SD) years, with a range of 20–44 years for overall participants. About 263 (64.6%) of the participants were males. More than half of the participants, 218 (53.5%), were single, and 177 (43.5%) were married. Regarding the religion of the participants, 197 (48.4%) were Protestants. From the total (n = 407) of HPs, nurses were dominant, accounting for 154 (37.8%) of participants, followed by 51 (12.5%) physicians and 51 (12.5%) midwives. More than half of the participants were first-degree holders, 259 (63.5%), and 77 (18.9%) were diploma holders. The mean salary for health professionals working in the public hospital in the Hadiya zone is 7142 (1920 SD) ETB, ranging from 3333 to 15369 per month (Table 3 ). Table 3 Socio-demographic characteristics among health professionals in Public hospitals, hadiya zone, Ethiopia (n = 407) Variables Categories Frequency Percent Age ≤ 29 30–34 ≥ 35 212 147 48 52 36.2 11.8 Sex Male Female 263 144 64.6 35.4 Marital status Single Married Others 218 177 12 53.6 43.5 2.9 Educational status Diploma Bachler’s degree GPs/specialist Master’s degree 77 259 49 22 18.9 63.6 12 5.4 Religion Protestant Orthodox Muslim Catholic Other 209 157 18 9 14 51.4 38.6 4.4 2.2 3.4 Working hospital WUNEMMCSH Primary hospital 221 186 54.3 45.7 Profession Nurses Midwives Physicians Laboratories Public health Pharmacy Anesthetist HIT Others 154 51 51 39 25 31 18 20 18 37.8 12.5 12.5 9.6 6.1 7.6 4.4 4.9 4.4 Work experience ≤ 5 6–10 ≥ 11 235 147 25 57.7 36.2 6.1 Monthly salary 3333–6193 7071–10150 ≥ 11305 141 236 30 ’’Others a’’: divorced & widowed, ’others b’’ Apostolic, Adventist and non-religious. ‘’others c’’: X-ray, environmental, physiotherapy. Abbreviation: GPs, General Practitioners. Facility and personal related factors More than half (54.3%) of the participants were from WUNEMMCSH. About 235 (57.7%) of the participants had 1–5 years of work experience. Nearly half (47.9%) of participants had good interpersonal relationships, and only 41% of participants had recognized More than 53.1% of the participants had advanced. Almost 48.4% of participants had a favorable working environment, and 36.8% of participants were fairly treated in terms of justice and fairness. The mean work experience for health professionals working in a public hospital in Hadiya Zone is 4.2 (SD 2.3) years, ranging from 6 months to 17 years (Table 4 ). Table 4 Facility and personal related factors among health professionals (N = 407) Variables Categories Frequency Percent Working hospital WUNEMMCSH 221 54.3 Primary hospital 186 45.7 Job satisfaction Satisfied 161 39.5 Not satisfied 246 60.5 Interpersonal r/ship Good 195 47.9 Not good 212 52.1 Advancement Advanced 216 53.1 Not advanced 191 46.9 Recognition Recognized 167 41 Not recognized 240 59 Achievement Achieved 196 48.2 Not achieved 211 51.8 Work experience ≤ 5 235 57.7 6–10 147 36.2 ≥ 11 25 6.1 .Work place Favorable 197 48.4 Not favorable 210 51.2 Supply, drug and equipment Available 172 42.3 Not available 235 57.7 Justice and fairness Fair 150 36.8 Unfair 257 63.2 Balanced score card Evaluated good 221 54.3 Not evaluated good 186 45.7 Remuneration Remunerated 169 41.5 Not remunerated 238 58.5 Status of Health Professionals Motivation Bivariate analyses of factors associated with Work Motivation Status among Health Professionals From the bivariate analysis job satisfaction, working environment, advancement, justice and fairness, remuneration, type of working hospitals, educational level, age, sex and monthly salary were candidate variables for multivariable analysis at 25% level of significance (Table 5 ). Table 5 Bivariate analyses of sociodemographic characteristics, facility and personal factors with HPs motivation (N = 407). Variables category HPs motivation COR(95%CI) p-value Motivated Not motivated Age ≤29 134 145 1 30–34 50 50 1.46(.92-2.365) 0.12 ≥ 35 15 13 1.86(0.84–4.12) 0.12 Sex female 76 68 1 male 129 134 1.47(0.94–2.31) 0.09 Marital status Single 120 98 1 Married 78 99 0.87(0.57–1.34) 0.54 Others 7 5 0.5(0.05–4.58) 0.54 Working hospital Primary 60 126 1 CSH 145 76 3.56(2.24–5.64) 0.001 Educational level diploma 24 53 1 degree 143 116 3.24(1.66–6.3) 0.001 Masters 8 14 0.25(0.03–2.1) 0.20 MD/senior 30 19 2.97(1.14–7.77) 0.02 Religion Muslim 13 5 1 Orthodox 88 121 1.08(0.38–3.05 0.84 Protestant 96 61 0.82(0.29–2.28 0.70 Profession Nurses 60 94 1 Midwives 30 18 2.29(1.17–4.48) 0.27 Physicians 29 22 2.29(1.17–4.48) 0.35 Laboratories 18 21 1.45(0.67–3.16) 0.34 Public health 11 14 1.54(0.61–3.86) 0.35 Pharmacy 15 16 1.56(0.67–3.61) 0.29 Anesthetist 12 6 5.15(1.86–14.26 0.002 HIT 8 12 1.09(0.37–3.21) 0.87 others 6 12 1.26(0.42–3.77) 0.67 Work experience ≤ 5 1 6–10 0.89(.47 − 1.7) 0.73 ≥ 11 1.6(0.35–7.30) 0.53 Monthly salary 3333–6193 60 81 1 7071–10150 130 118 1.44(0.91–2.27) 0.119 ≥ 11305 15 3 2.24(0.82–6.12) 0.113 Satisfaction Not satisfied 72 174 1 satisfied 57 104 1.32(0.86–2.02) 0.194 Work environment Not favorable 59 151 1 Favorable 70 127 1.41(0.92–2.14) 0.108 Interpersonal relationship Not good 63 149 1 Good 66 129 1.21(0.79–1.83) 0.371 Justice and fairness Not fair 76 181 1 Fair 53 97 1.42(0.93–2.17) 0.097 Resource availability Not Adequate 85 150 1 Adequate 44 128 1.64(1.06–2.54) 0.02 Advancement Not advanced 54 137 1 Advanced 75 141 1.34(0.88–2.05) 0.163 Remuneration Not remunerated 71 167 1 Remunerated 58 111 1.22(0.80–1.87) 0.213 Recognition Not recognized 73 167 1 Recognized 56 111 1.15(0.75–1.76) 0.507 Achievement Not achieved 63 148 1 Achieved 66 130 1.19(0.78–1.81) 0.409 BSC Not good evaluated 64 122 1 Good evaluated 65 156 1.26(0.82–1.91) 0.281 Multivariable analyses of socio-demographic characteristics, facility and personal related Factors of Motivation Status among Health Professionals Health professionals who were working in WUNEMMCSH were 5.63 times more likely to be motivated as compared to those who were working in primary hospitals (AOR = 5.63, 95% CI (3.06, 10.36). Health professionals who had degrees were 2.41 times more likely to be motivated as compared to those who had a diploma (AOR = 2.41, 95% CI (1.13, 5.13) and those who had masters were 2.3 times more likely to be motivated than those who had a diploma (AOR = 2.3, 95% CI (1.31, 5.21). Similarly, having an MD or specialist is associated with being 2.81 times more likely to be motivated compared with those with a diploma (AOR = 2.81, 95% CI (2.11, 8.12). Satisfied health professionals were 1.29 times more likely to be motivated as compared to those who were not satisfied (AOR = 1.29, 95% CI (1.12, 2.70). Health professionals who were treated fairly were 1.38 times more likely to be motivated as compared to those who were unfairly treated (AOR = 1.38, 95% CI (1.21, 2.21), p-value = 0.021). For health professionals, those who had adequate resources were 2.14 times more likely to be motivated as compared to those who didn’t have adequate resources (AOR = 2.14, 95% CI (1.79, 20.10. Health professionals who had been remunerated were 2.48 times more likely to be motivated as compared to those who hadn't been remunerated (AOR = 2.48, 95% CI (1.14, 5.4). Table 6 Multivariable analysis of socio-demographic characteristics, facility and personal related factors with HPs motivation (N = 407). Variables Category HPs motivation COR(95%CI) AOR(95%CI) p-value Motivated Not motivated Age ≤29 134 145 1 1 30–34 50 50 1.46(.92, 2.36) 2.97(1.54, 5.71 0.041 ≥ 35 15 13 1.86(0.84, 4.12) 3.65(0.89, 14.92) 0.071 Sex female 76 68 1 male 129 134 1.47(0.94, 2.31) 2.58(1.45, 4.59) 0.120 Working hospital Primary 60 126 1 1 CSH 145 76 3.56(2.24, 5.64) 5.63(3.06, 10.36) 0.001* Educational level Diploma 24 53 1 1 Degree 143 116 3.24(1.66, 6.3) 2.41(1.13, 5.13) 0.022* Masters 8 14 2.5(2.31, 5.17) 2.3(1.31, 5.21) 0.03* MD/senior 30 19 2.97(1.14, 7.77) 2.81(2.11, 8.12) 0.04* Monthly salary 3333–6193 60 81 1 1 7071–10150 130 118 1.44(0.91, 2.27) 082(0.09, 6.99 0.86 ≥ 11305 15 3 2.24(0.82, 6.12) 1.80(0.13, 24.74) 0.65 Satisfaction Not satisfied 72 174 1 1 Satisfied 57 104 1.32(0.86, 2.02) 1.29(1.12, 2.70) 0.03* Work environment Not favorable 59 151 1 1 Favorable 70 127 1.41(0.92, 2.14) 1.27(0.68, 2.37) 0.43 Justice and fairness Not fair 76 181 1 1 Fair 53 97 1.42(0.93, 2.17) 1.38(1.21, 2.21) 0.021* Resource availability Not Adequate 85 150 1 1 Adequate 44 128 1.64(1.06, 2.54) 2.14(1.20, 3.81 0.01* Advancement Not advanced 54 137 1 1 Advanced 75 141 1.34(0.88, 2.05) 1.13(0.51, 2.46) 0.75 Remuneration Not remunerated 71 167 1 1 Remunerated 58 111 1.22(0.80, 1.87) 2.48(1.14, 5.4) 0.022* Variables that are *significant at p < 0.05 in multivariate Note; 1 = reference category DISCUSSION Health professionals' motivation has been pointed out as a highly important factor for effective health service delivery. This study showed that the general motivation status of the Hadiya Zone health profession was 31.7% (95% CI of 27.2% to 36.6%). This study's motivation level was lower than that of studies conducted at Bahir Dar City, Northwest Ethiopia (50.4) [ 44 ], at Public Health Institutions in Korahey Zone, Ethiopian Somali Region (70%) [ 20 ] ,at European Gaza hospitals (66.2%) [ 49 ], hospitals in Franko Division, Cameroon (42.7%) [ 47 ], and public hospitals in central Ethiopia's West Shewa Zone (63%) [ 25 ]. The factors affecting the work motivation of healthcare professionals may differ from nation to nation, from area to region, from hospital to hospital, and even from time to time. The time difference between when the research was done and the economic inflation during the period of this study might be mentioned as reasons for the observed discrepancy. The cost of goods is rising for many production and service-giving industries in the country after ethnic-based violence, displacement, and chaos prevailed in the country. Conversely, the status of motivation in this study was higher than in research done at the specialized hospital at Jimma University (25.1%) [ 46 ] and Debre Markos comprehensive specialized hospital(20.4) [ 53 ]. This difference may be due to the difference in the study areas, and the inclusion of only nurse professionals in the study carried out in Jimma. Overall demotivation among health professionals in Hadiya Zone, Central Ethiopia, is a cause for concern, given that motivation has implications for the efficiency, effectiveness, and sustainability of the health system in the Zone. On the multivariable regression job satisfaction, justice and fairness, remuneration, working hospitals, educational level, and resource availability were significantly associated with motivational status among health professionals at public hospitals of Hadiya Zone, central Ethiopia. Health professionals who were working in WUNEMMCSH were 5.63 times more likely to be motivated as compared to those who were working in primary hospitals (AOR = 5.63, 95% CI (3.06, 10.36), p-value = 0.001). The result is similar to a previous study done in Bahir Dar city [ 50 ]. This could be a factor in the orderly and secure work environment, strict oversight, and higher compensation, greater access to resources, positive interpersonal interactions, and superior management system that comprehensive specialized hospitals have over primary hospitals. Health professionals who had degrees were 2.41 times more likely to be motivated as compared to those who had a diploma (AOR = 2.41, 95% CI (1.13, 5.13), p-value = 0.02), and those who had masters were 2.3 times more likely compared to those who had a diploma (AOR = 2.3, 95% CI (1.31, 5.21), p-value = 0.03). Similarly, having an MD or specialist is associated with being 2.81 times more likely to be motivated compared with those with a diploma (AOR = 2.81, 95% CI (2.11, 8.12), p-value = 0.04). The result is similar to the previous study done in Jimma [ 23 ]. This is likely because as HPS' experience and educational attainment grow, so do the expectations of health professionals regarding benefits, competence, and knowledge of management and leadership concerns. Satisfied health professionals were 1.29 times more likely to be motivated as compared to those who were not satisfied health professionals (AOR = 1.29, 95% CI (1.12, 2.70), p-value = 0.03). This finding is further cemented by the prior studies conducted in Jimma University[ 46 ], and Pakistan[58]. Job satisfaction is a complex phenomenon with many different meanings and viewpoints[58]. Despite research showing a connection and dependence between motivation, job happiness, and performance, the relationship is circular: Motivation causes job happiness and performance; happiness and performance cause motivation[59]. Poor salaries would be the flaming barrier to the poor satisfaction of health professionals, which will induce them to migrate to Ethiopia looking for better salaries[60]. This implies that people may not know the true value of their health until it is impaired, upon which the government of Ethiopia should work. Health professionals who were treated fairly were 1.38 times more likely to be motivated as compared to those who were unfairly treated (AOR = 1.38, 95% CI (1.21, 2.21), p-value = 0.021). The result is similar to a previous study done in Tanzania [ 51 ]. Similarities may perceive fairness in areas such as promotions, salary levels, and access to training and upgrading as having a positive impact on their motivation to work. health professionals, those who had adequate resources were 2.14 times more likely to be motivated as compared to those who didn’t have adequate resources (AOR = 2.14, 95% CI (1.79, 20.10), p-value = 0.01). This finding was consistent with the study done at Jimma Medical Center [ 45 ]. This in turn implies that the availability of Medical supplies needs to be ensured to satisfy their clients' requirements so that appropriate prescriptions and diagnostics, as well as other promotion interventions can be offered for a better outcome. Health professionals who had been remunerated were 2.48 times more likely to be motivated as compared to those who hadn't been remunerated (AOR = 2.48, 95% CI (1.14, 5.4), p-value = 0.022). The result is similar to the previous study done in Jimma [ 25 ]. The similarities might be related to health professional characteristics, allowance, and income. Strength of the Study A key strength of this study is its comparative design, which examined motivation levels between a Comprehensive Specialized Hospital and several Primary Hospitals. This approach provides unique insights into how different tiers of the healthcare system influence staff morale. Furthermore, unlike many studies that focus solely on a single professional group, this research encompassed a diverse range of healthcare providers, including physicians, midwives, laboratory technicians, and pharmacists. The study also achieved an exceptionally high response rate of 96.4% (407 out of 422 sampled professionals), significantly enhancing the reliability and representativeness of the findings. Limitation of the Study The reliance on self-reported data may introduce social desirability bias. Furthermore, the study was restricted to public hospitals in the Hadiya Zone, which may limit the generalizability of the findings to the private sector of Ethiopia. And while quantitative predictors were identified, the absence of a qualitative component means the deeper subjective experiences of the participants were not captured. CONCLUSION The findings of this study indicate that the overall motivation status among healthcare professionals in public hospitals within the Hadiya Zone is low, with only 31.7% (95% CI: 27.2%–36.6%) of participants categorized as motivated. This deficiency suggests that a substantial majority of the healthcare workforce lacks the necessary drive to perform at their full potential, which can negatively impact the performance of individual institutions and the broader health system. Significant predictors of motivation status identified in this study included job satisfaction, organizational justice and fairness, recognition, remuneration, the specific hospital of employment, educational attainment, and the availability of resources. Consequently, we recommend that future researchers utilize mixed-methods approaches to more comprehensively elaborate on the motivational status of healthcare professionals. Abbreviations AOR: Adjusted Odds Ratio, CI: Confidence Interval, COR: Crude Odds Ratio EM:Extrinsic motivation, ETB: Ethiopian Birr, HPs: Health Professionals,IM:Intrinsic Motivation, PI:Principal Investigator ,SD: Standard Deviation SPSS:Statistical Package for Social Science,VIF:Variance Inflation Factors,WHO:World Health Organization,WUNEMMCSH:Wachemo University Nigist Elin Mohammed Memorial Comprehensive Specialized Hospital Declarations Ethics approval and consent to participate This study was approved by the Institutional Review Committee of Wachemo University College of Medicine and Health Sciences reference no./Wcu/SGS/609/16 .Written informed consent was obtained from each study participant and informed consent was obtained from their parents. Permission was obtained from head of health facilities before the data collection process. The purpose of the study was explained to the participants. The data collection procedure was anonymous to keep the confidentiality of any information provided by the study participants. The study was followed the principles of declaration of Helsinki. Consent for publication Not applicable Data availability The datasets used and/or analysed during the current study are available from the corresponding author based on reasonable request. Competing interests We have no competing of interest to declare. Funding The author(s) received no financial support for the research, authorship, and/or publication of this article. Acknowledgements The authors would like to acknowledge Wachemo University College of Medicine and Health Science for their contribution. The authors are also grateful to the study participants for their dedicated time and volunteer participation. References Mbindyo, P., et al., Contextual influences on health worker motivation in district hospitals in Kenya. Implementation Science, 2009. 4 (1): p. 1-10. Franco, L.M., S. 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BMC health services research, 2016. 16 (1): p. 1-10. Baljoon, R.A., H.E. Banjar, and M.A. Banakhar, Nurses’ work motivation and the factors affecting It: A scoping review. International Journal of Nursing & Clinical Practices, 2018. 5 (1): p. 277. Bakhtiyari, M., Work environment and employee performance: a brief literature review. Authorea Preprints, 2019. Kok, M.C., et al., Does supportive supervision enhance community health worker motivation? A mixed-methods study in four African countries. Health policy and planning, 2018. 33 (9): p. 988-998. Stilwell, B., Health worker motivation in Zimbabwe—international report. Geneva: WHO, 2001. Ojakaa, D., S. Olango, and J. Jarvis, Factors affecting motivation and retention of primary health care workers in three disparate regions in Kenya. Human resources for health, 2014. 12 : p. 1-13. Aduo-Adjei, K., O. Emmanuel, and O.M. Forster, The impact of motivation on the work performance of health workers (Korle Bu Teaching Hospital): Evidence from Ghana. Hospital Practices and Research, 2016. 1 (2): p. 47-52. Leshabari, M.T., et al., Motivation of health care workers in Tanzania: a case study of Muhimbili National Hospital. East Afr J Public Health, 2008. 5 (1): p. 32-37. Mengistu, M.M. and A.G. Bali, Factors associated to job satisfaction among healthcare workers at public hospitals of west Shoa zone, Oromia regional state, Ethiopia: a cross sectional study. Science Journal of Public Health, 2015. 3 (2): p. 161-167. Ahmed, S.M., M. Tolera, and M.T. Angamo, Assessment of job satisfaction among pharmacy professionals in south-west Ethiopia. International Journal of Pharmaceutical Sciences and Research, 2013. 4 (6): p. 2351. Yami, A., et al., Job satisfaction and its determinants among health workers in jimma university specialized hospital, southwest ethiopia. Ethiopian journal of health sciences, 2011. . Negussie, B.B. and G.B. Oliksa, Factors influence nurses’ job motivation at governmental health institutions of Jimma Town, South-west Ethiopia. International Journal of Africa Nursing Sciences, 2020. 13 : p. 100253. Legesse, S., et al., Motivational Status and Associated Factors among Jimma University Specialized Hospital Health Professional, South West Ethiopia. Quality in Primary Care, 2018. 26 (2): p. 53-63. Elive, S.M., S.N. Cumber, and F.C. Landis, Assessing the motivational level and implication of lack of motivation of nurses in hospital in Fako division Cameroon. World Journal of Public Health, 2016. 1 (1): p. 10. Negussie, N., Relationship between rewards and nurses’ work motivation in Addis Ababa hospitals. Ethiopian journal of health sciences, 2012. 22 (2). Ayyash, H. and Y. Aljeesh, Nurses’ motivation and their performance at European Gaza Hospital in Gaza Strip. Journal of Al Azhar University-Gaza (Natural Sciences), 2011. 13 (1): p. 55-68. Eleni, T.T., K.M. Tessema, and T.T. Kaleab, Inpatient Care Satisfaction among public and private health sectors in Bahir Dar town, Amhara regional state, North West Ethiopia. International Journal of Caring Sciences, 2018. 11 (3): p. 1609-1622. Songstad NG, Rekdal OB, Massay DA, Blystad A. Perceived unfairness in working conditions: the case of public health services in Tanzania. BMC health services research. 2011;11(1):1-15. Herzberg, F., Motivation to work. 2017: Routledge. Tegegne, E., et al., Work motivation and factors associated with it among health professionals in Debre Markos Comprehensive Specialized Hospital. Scientific Reports, 2024. 14 (1): p. 2381. Prytherch, H., et al., Motivation and incentives of rural maternal and neonatal health care providers: a comparison of qualitative findings from Burkina Faso, Ghana and Tanzania. BMC health services research, 2013. 13 (1): p. 1-15. Lai ER. Motivation: A literature review. Person Research’s Report. 2011;6:40-1. Mathauer I, Imhoff I. Health worker motivation in Africa: the role of non-financial incentives and human resource management tools. Human resources for health. 2006;4(1):1-17. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9073720","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":603165600,"identity":"492fdbb0-41ca-46d2-a84b-1062de17ae10","order_by":0,"name":"Adane Etore","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABAklEQVRIiWNgGAWjYFCCBDDJw8DA2PjgQwWQyczcQEgLYwNEC3Oz4YwzIC2MxGkBAvY2ac42EIOAFv725ONA99yTkW9vbJBmnFcbzd8O1PKjYhtOLRJnniU2zjhTzGNw5mCDceG247kzDjM2MPacuY3bmhs5hs28bQk8BhKJDckztx3LbQBqYWZsw61F/kb+x2befwk88jMSGw7zzjmWO5+QFoMbOYzNvA0JPAw3EhuBjJrcDYS0GJ55ZjhzxrEEkF+aGWccO5C7EajlID6/yB1PfvDhQ02CvXx7+/MfH2rqcuedP3zwwY8KPN5HA4fB5AGi1QNBHSmKR8EoGAWjYIQAADcvY47rKCvlAAAAAElFTkSuQmCC","orcid":"","institution":"Wachemo University","correspondingAuthor":true,"prefix":"","firstName":"Adane","middleName":"","lastName":"Etore","suffix":""},{"id":603165601,"identity":"48e58616-d64c-4366-b6f3-9a4e244510a3","order_by":1,"name":"Tekle Ejajo","email":"","orcid":"","institution":"Wachemo University","correspondingAuthor":false,"prefix":"","firstName":"Tekle","middleName":"","lastName":"Ejajo","suffix":""},{"id":603165602,"identity":"debced8a-50c5-4077-a167-08bdd3074f94","order_by":2,"name":"Dawit Sullamo","email":"","orcid":"","institution":"Wachemo University","correspondingAuthor":false,"prefix":"","firstName":"Dawit","middleName":"","lastName":"Sullamo","suffix":""},{"id":603165603,"identity":"a68f65fd-8d9a-4803-8d69-67474c12b94f","order_by":3,"name":"Demeke Daselegn Lendebo","email":"","orcid":"","institution":"Wachemo University","correspondingAuthor":false,"prefix":"","firstName":"Demeke","middleName":"Daselegn","lastName":"Lendebo","suffix":""},{"id":603165604,"identity":"887804dd-23f8-461f-a7ea-2758cd532011","order_by":4,"name":"Abera lire kibemo","email":"","orcid":"","institution":"Wachemo University","correspondingAuthor":false,"prefix":"","firstName":"Abera","middleName":"lire","lastName":"kibemo","suffix":""},{"id":603165605,"identity":"8a26865d-63ea-4624-be4a-93bd667d6fbc","order_by":5,"name":"Lire Lemma Tirore","email":"","orcid":"","institution":"Wachemo University","correspondingAuthor":false,"prefix":"","firstName":"Lire","middleName":"Lemma","lastName":"Tirore","suffix":""},{"id":603165606,"identity":"720760d2-7edb-4350-99b0-28d9237fa4ab","order_by":6,"name":"Deginet Tesfaye Lonsako","email":"","orcid":"","institution":"Wachemo University","correspondingAuthor":false,"prefix":"","firstName":"Deginet","middleName":"Tesfaye","lastName":"Lonsako","suffix":""},{"id":603165607,"identity":"0981d375-3a45-4eff-bc39-aea1ee516bb4","order_by":7,"name":"Melaku Eriso Tilore","email":"","orcid":"","institution":"Hossana College of Health Sciences","correspondingAuthor":false,"prefix":"","firstName":"Melaku","middleName":"Eriso","lastName":"Tilore","suffix":""}],"badges":[],"createdAt":"2026-03-09 13:40:14","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9073720/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9073720/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":104342210,"identity":"68de31c7-1a6e-4e73-a0a7-3ba18a0e2d6d","added_by":"auto","created_at":"2026-03-10 17:00:07","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":24218,"visible":true,"origin":"","legend":"\u003cp\u003eOverall health professionals motivational status was 129 (31.7%), 95% CI (27.2%, 36.6%)\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-9073720/v1/2ae0b9384496067250b50492.png"},{"id":104405543,"identity":"87ab3e78-f144-4d09-9890-e12c58b2ad98","added_by":"auto","created_at":"2026-03-11 12:23:14","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1794580,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9073720/v1/ab23f806-3c3e-43a5-9b52-305b4b4c8edd.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Motivation and Associated Factors among health Professionals at Public Hospitals of Ethiopia","fulltext":[{"header":"Background","content":"\u003cp\u003eAn individual's willingness to work effectively and efficiently to accomplish personal and organizational goals is referred to as motivation. It is the individual emotion and process by which an individual responds to determine stimulus that the environment challenges the worker to boost performance and energized to establish positively( [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e], [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]).\u003c/p\u003e \u003cp\u003eAdditionally, both internal and external pressures act as a catalyst for work behavior and as the force that shapes the direction, intensity, and length of work behavior ([\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]).Without enough desire to achieve their work objectives, workers would not complete tasks, even if they have clear work objectives, and the appropriate abilities, in a supportive work environment[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Given that providing healthcare requires a lot of labor, the motivational concern is especially powerful in the health sector [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eExtrinsic motivation (EM) refers to external factors that can be assessed through rewards, benefits, the workplace, working circumstances, and management[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. The work itself cannot fully satisfy extrinsic motivations. According to Jung, the fulfillment of needs is also influenced by the impacts of employment and its contributing variables [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. The impact of intrinsic incentives, which are motivated by the quality of one's working life, is likely to be more profound and long lasting. It is impossible to separate these two distinct motivational facets from one another due to their interconnectedness [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe interactions between employees and their workplace are reflected in the motivation of healthcare practitioners. Policies at the local, organizational, and overall sector levels can positively or negatively affect health workers, and as a result, influence the functioning of the health system. This is due to the interactive nature of motivation. Yet little is understood about the essential components and outcomes of motivation in emerging and transitional countries like Ethiopia[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe act of being motivated by one's job insofar as it meets their individual needs is known as intrinsic motivation. Self-generated intrinsic motivation is theorized to lead people to search for employment in the field they believe will best meet their needs. Responsibility, autonomy, the courage to use and develop one's own skills, engaging tasks, and opportunities for advancement are some of the factors affecting intrinsic motivation[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eExtrinsic and intrinsic motivation (IM) is two categories under Herzberg's two-factor theory of motivation. The urge for someone to do their job successfully to satisfy their intrinsic needs is known as intrinsic motivation [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. A task's completion or other psychological benefits are examples of intrinsic motivation [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. It includes components that are related to internal considerations, such as job satisfaction, accomplishment, acknowledgment, and possibilities for growth (advancement) [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe importance of health professionals' motivation for the efficiency of the healthcare system is being recognized by policymakers. The quality, efficiency, and equity of the healthcare system's service delivery depend on how motivated healthcare employees are to put effort into their work. Although resources and the skills of health workers are important, managers and decision-makers in the field should be aware that these factors alone will not cause health workers to perform to the standards expected of them. Instead, health workers are willing to show up for work regularly, work hard, be adaptable, and be willing to perform the necessary tasks [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, and \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn the workplace, motivational processes take place at the individual level and consist of two parallel elements: the degree to which employees adopt organizational goals (their \"will do\") and the degree to which they successfully use their resources to accomplish shared objectives (their \"can do\") [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eInadequate health systems with insufficient tools, supplies, and management structures result in low output, a narrow range of competencies, and inadequate reactivity. The linked complexity of these aspects is the core reason for unsatisfactory performance in various domains. These difficulties can lead to work discontent and low motivation among healthcare personnel, as can the complexity and difficulties involved in providing and juggling competing needs for patient care [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe motivation of healthcare workers may have an impact on how well services are delivered. It has repeatedly been mentioned as a significant hindrance to the delivery of efficient health services [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. It is generally known that there is a shortage of healthcare workers in the majority of the world. As a result, certain medical facilities are enticing potential employees with bonuses. The healthcare system depends on each healthcare professional, and any shortage affects other occupational groups. There is a chance that patients could receive subpar care or possibly be put in danger due to industry-wide shortages. Additionally, these shortages produce a setting that is unfriendly to employee retention[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAccording to a study done in Africa, a lot of Human Resources are demotivated and frustrated because they are unable to satisfy their professional consciences and are hindered from pursuing their vocations due to a lack of resources and supplies, as well as insufficient or improperly applied Human Resource Management techniques. Health workers' motivation may suffer as a result.[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eIn Ethiopia, the government included the creation of a CRC (compassionate, respectful, and caring health workforce) in its GTP2 strategy. To do this, the government undertook training of health professionals based on research to significantly increase their number. A clear promotion ladder was developed for healthcare workers at the entry level and mid-level. In the health industry, human resources serve as a strategic asset and are a crucial resource for maintaining employee motivation. As a result, the provision of healthcare services depends heavily on qualified employees[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAccording to research from Ethiopia, the health system has been making efforts to raise the quality of healthcare services by implementing significant healthcare reforms, such as business processing and re-engineering, healthcare funding, and health information systems. The Ethiopian FMOH acknowledged the issue as a component of a sector-wide reform program intended to improve the quality and accessibility of healthcare through a decentralized system and put importance on developing hospitals' management capabilities through trailblazing blueprint standards[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. However, none of these approaches were as successful as they may have been in producing the anticipated results due to a number of variables. The shortage of human resources in the health system continues Since motivated HPS are more likely to work for profit in the private sector and nongovernmental organizations than they are in the public sector, this appears to be a major issue for the health sectors, especially public health facilities, as many trained HPs are moving abroad or leaving to work in the private sector[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe study will be utilized to provide details on the HPs motivation and gaps that exist in health system today. The study's findings will be providing input to public hospitals in Hadiya zone and Hadiya health department in which area to intervene and strengthen the system.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy area and period\u003c/h2\u003e \u003cp\u003eThis study was conducted from October 1, 2023, to November 1, 2023, in public hospitals in Hadiya Zone, which is located in the Central Ethiopia Region at 232 km from Addis Ababa in the south. According to the report of the Hadiya Zone Health Department, the total population is 1,838,043 of whom 900,641 (49%) are male and 937,402 (51%) are female. The zone has 13 woreda and 7 town administrations and there are 5 public hospitals with 1134 health professionals.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStudy Design\u003c/h3\u003e\n\u003cp\u003eAn institutional based cross- sectional study was conducted to assess Health Professionals\u0026rsquo; motivation and associated factors at public hospitals of Hadiya zone, Central Ethiopia Region.\u003c/p\u003e\n\u003ch3\u003ePopulation\u003c/h3\u003e\n\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e\u003cb\u003eSource Population\u003c/b\u003e:\u003c/h2\u003e \u003cp\u003eAll health professionals who are working in public hospitals of Hadiya Zone Central Ethiopia Region were the source of population.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStudy Population\u003c/h3\u003e\n\u003cp\u003eAll selected Health professionals from the public hospitals of Hadiya Zone who were on the job during the study period.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eInclusion Exclusion Criteria\u003c/h2\u003e \u003cdiv id=\"Sec9\" class=\"Section3\"\u003e \u003ch2\u003eInclusion Criteria\u003c/h2\u003e \u003cp\u003eAll health professionals, who had worked at least for 6 months prior to data collection was included.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e\n\u003ch3\u003eExclusion Criteria\u003c/h3\u003e\n\u003cp\u003eHealth professionals who were not on duty due to sick leave, maternal leave, annual leave, study leave, or long-term and short-term training during data collection time.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eSample Size Determination\u003c/h2\u003e \u003cp\u003eThe sample size was determined using Open Epi version 2.3 for a single population proportion while taking into account the following assumptions: Estimated proportion (p) of 50.4% from a similar study conducted at public hospitals in Bahir Dar city[\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e]. d\u0026thinsp;=\u0026thinsp;5% marginal error and at a 95% confidence level. Based on these, the sample size was (n\u0026thinsp;=\u0026thinsp;384).\u003c/p\u003e \u003cp\u003eConsidering the non-response rate, it was also considered 10%, and 384*0.1\u0026thinsp;=\u0026thinsp;38. Then the final sample size was 384\u0026thinsp;+\u0026thinsp;38\u0026thinsp;=\u0026thinsp;422.\u003c/p\u003e \u003cp\u003eFor the inferential objective, a double population proportion formula was used using Epi Info version 7.2 stat calc.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eShows sample size calculation of motivational status for the second objectives by factors.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eFactors of Motivational Status\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eP1\u0026thinsp;=\u0026thinsp;proportion among exposed and P2\u0026thinsp;=\u0026thinsp;proportion among non-Exposed\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePower\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAOR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eSample size\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eTotal sample( Adding 20% NR)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eReference\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAdvancement\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAdvanced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eP1\u0026thinsp;=\u0026thinsp;78.9%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e80%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e3.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot advanced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eP2\u0026thinsp;=\u0026thinsp;39.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eInterpersonal r/ship\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eP1\u0026thinsp;=\u0026thinsp;57.8%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e80%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e4.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot Good\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eP2\u0026thinsp;=\u0026thinsp;42.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot Fair\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eP2\u0026thinsp;=\u0026thinsp;50.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eRemuneration\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRemunerated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eP1\u0026thinsp;=\u0026thinsp;36.1%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e80%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e4.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot Remunerated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eP2\u0026thinsp;=\u0026thinsp;63.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eRecognition\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRecognized\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eP1\u0026thinsp;=\u0026thinsp;32.2%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e80%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e50.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot Recognized\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eP2\u0026thinsp;=\u0026thinsp;67.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"8\"\u003eNR= None Response Rate\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eHowever, compared with the first objective sample size (422), the sample size calculated from factors (62) was very low. Therefore, the final sample size for this was 422 health professionals.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eSampling Procedure\u003c/h2\u003e \u003cp\u003eThe five hospitals have different numbers of registered health professionals (NEMMCSH has 619 health professionals, Gimbichu primary hospital has 98 health professionals, Shone primary hospital has 231 health professionals, Homacho primary hospital has 98 health professionals, and Bonsha primary hospital has 88 health professionals). Therefore, the obtained sample size was proportionally allocated for each hospital. Therefore, 231 study participants were allocated to NEMMCSH, 37 to Gimbichu Primary Hospital, 86 to Shone Primary Hospital, 35 to Homacho Primary Hospital, and 33 to Bonsha Hospital. Then the sample was collected from all hospitals by a simple random sampling method from a list of health professionals found in the human resource management department. To collect samples from all categories of health professionals, the source population was stratified according to their professional category. Then, from each stratum, the study participants were collected proportionally from all categories of health professionals by the lottery method (Table \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSample Size Distribution to each public hospital proportional to the number of health professionals\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"14\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c14\" colnum=\"14\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eR.No\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eType of\u003c/p\u003e \u003cp\u003eprofession\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eNEMMCSH\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003eGimbich PH\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003eShone PH\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e \u003cp\u003eHomacho PH\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c12\" namest=\"c11\"\u003e \u003cp\u003eBonsha PH\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c14\" namest=\"c13\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePop\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eS.size\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePop\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eS.size\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003ePop\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eS. size\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003ePop\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eS.size\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003ePop\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c12\"\u003e \u003cp\u003eS.size\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c13\"\u003e \u003cp\u003ePop\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c14\"\u003e \u003cp\u003eS.s\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNurses\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e221\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e103\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e442\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e113\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMidwives\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e142\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSpecialist/subspecialist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePharmacy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLaboratory\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e110\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAnesthetist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHIT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e619\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e231\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e231\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e1134\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e422\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eStudy Variables\u003c/h2\u003e \u003cdiv id=\"Sec14\" class=\"Section3\"\u003e \u003ch2\u003eDependent Variable\u003c/h2\u003e \u003cp\u003eHealth Professionals\u0026rsquo; motivation\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eIndependent Variable\u003c/h2\u003e \u003cp\u003e \u003cstrong\u003eSocio-demographic factors\u003c/strong\u003e \u003cp\u003e-age, sex, marital statuses, religion, profession, work of experience, educational status, monthly salary, current working positions. \u003cb\u003eGive other name Interpersonal\u003c/b\u003e relationships, Resource availability, Working environment, Justice and fairness, Remuneration/Reward/Salary, Achievement, Advancement, Recognition, Responsibility, Job satisfactions, Balanced scorecard. All variables were designed to be categorical, including continuous variables like age, monthly salary, and work of experience [\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e].\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eData Collection Procedures and Measurement.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eData were gathered using a self-administered, well-structured questionnaire. The questionnaire was developed to measure health professionals\u0026rsquo; general motivation from a prior study as well as from a document entitled A Guide to Improving Organizational Performance [\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe questionnaire has 81 items grouped into 12 dimensions or composites: 'motivation\u0026rsquo; (14 items), \u0026lsquo;job satisfaction\u0026rsquo; (8 items), \u0026lsquo;work environment\u0026rsquo; (6 items), \u0026lsquo;interpersonal relationships\u0026rsquo; (5 items), \u0026lsquo;justice and fairness\u0026rsquo; (4 items),'resource availability\u0026rsquo; (6 items), \u0026lsquo;advancement\u0026rsquo; (6 items), \u0026lsquo;remuneration\u0026rsquo; (6 items), \u0026lsquo;recognition\u0026rsquo; (8 items), \u0026lsquo;achievement\u0026rsquo; (5 items), \u0026lsquo;balanced scorecard\u0026rsquo; (3 items). The response to each item in the questionnaire was assessed using a 5-point Likert scale of agreement (from 1: \u0026ldquo;strongly disagree\u0026rdquo; to 5: \u0026ldquo;strongly agree\u0026rdquo;). The tool also includes the demographic characteristics (5 items) of the professionals. The outcome and independent variables were assessed by taking the mean score of these items [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e] [\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eBefore starting the actual data collection, 5% of the questionnaires were pre-tested in out of study area to check the validity and consistency of the questionnaires.\u003c/p\u003e \u003cp\u003eIn the data collection process, three data collectors, one supervisor, and the principal investigator were involved.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eData quality control\u003c/h2\u003e \u003cp\u003eThe data collection instrument was pre-tested to ascertain the contents and clarity of the questionnaires. The principal investigator gave one-day training for three diplomas in HIT and one BSc in Public health supervisor based on the questionnaire and on how to use it appropriately. A supervisor, who checked the completeness and logical consistency at the end of each day and gave feedback on the spot during the data collection process, supervised the data collection procedure. On reliability analysis, Cranach\u0026rsquo;s alpha was calculated to test the internal consistency (reliability) of all Likert scale questionnaires, and the calculated Cranach\u0026rsquo;s alpha value was 0.84.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eData Processing and Analysis\u003c/h2\u003e \u003cp\u003eData was cleaned, stored, and exported to SPSS version 25.0 for analysis after being coded and entered into Epi Info version 4.6. For negatively worded items, they were reverse coded. Descriptive statistics were computed to describe the major findings of the study and presented using tables and figures.\u003c/p\u003e \u003cp\u003eBinary logistic regression analyses were used to determine the association between the outcome variable and independent variables. A bivariate analysis was performed to calculate the unadjusted odds ratio and screen out potentially significant independent variables at a p-value 0.25 level of significance to be included in the multivariable binary logistics regression model. The odds ratio, p-value, and 95% CI for the odds ratio were used for testing the significance and interpretation of the results. A variable with a p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant.\u003c/p\u003e \u003cp\u003eThe basic assumptions of the binary logistic regression model, namely multicollinearity and outliers, were checked by using VIF and boxplot, respectively. The adequacy of the final model was assessed using the Hosmer and Lemeshow goodness of fit, and the p-value was 0.66.\u003c/p\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003eSocio-Demographic Characteristics of the Health Professionals\u003c/h2\u003e \u003cp\u003eA total of 407 hospital health professionals (HPs) with a response rate of 96.4% participated in the study. The mean age of participants was 27.73 (± 4.18 SD) years, with a range of 20–44 years for overall participants. About 263 (64.6%) of the participants were males.\u003c/p\u003e \u003cp\u003eMore than half of the participants, 218 (53.5%), were single, and 177 (43.5%) were married. Regarding the religion of the participants, 197 (48.4%) were Protestants.\u003c/p\u003e \u003cp\u003e From the total (n = 407) of HPs, nurses were dominant, accounting for 154 (37.8%) of participants, followed by 51 (12.5%) physicians and 51 (12.5%) midwives. More than half of the participants were first-degree holders, 259 (63.5%), and 77 (18.9%) were diploma holders. The mean salary for health professionals working in the public hospital in the Hadiya zone is 7142 (1920 SD) ETB, ranging from 3333 to 15369 per month (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" class=\"colspec\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\"\u003e\u003c/div\u003e\u003ctable id=\"Tab3\" border=\"1\"\u003e \u003ccaption\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSocio-demographic characteristics among health professionals in Public hospitals, hadiya zone, Ethiopia (n = 407)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003c/colgroup\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e≤ 29\u003c/p\u003e \u003cp\u003e30–34\u003c/p\u003e \u003cp\u003e≥ 35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e212\u003c/p\u003e \u003cp\u003e147\u003c/p\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e52\u003c/p\u003e \u003cp\u003e36.2\u003c/p\u003e \u003cp\u003e11.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e263\u003c/p\u003e \u003cp\u003e144\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e64.6\u003c/p\u003e \u003cp\u003e35.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003cp\u003eMarried\u003c/p\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e218\u003c/p\u003e \u003cp\u003e177\u003c/p\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e53.6\u003c/p\u003e \u003cp\u003e43.5\u003c/p\u003e \u003cp\u003e2.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eEducational status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eDiploma\u003c/p\u003e \u003cp\u003eBachler’s degree\u003c/p\u003e \u003cp\u003eGPs/specialist\u003c/p\u003e \u003cp\u003eMaster’s degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e77\u003c/p\u003e \u003cp\u003e259\u003c/p\u003e \u003cp\u003e49\u003c/p\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e18.9\u003c/p\u003e \u003cp\u003e63.6\u003c/p\u003e \u003cp\u003e12\u003c/p\u003e \u003cp\u003e5.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eReligion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eProtestant\u003c/p\u003e \u003cp\u003eOrthodox\u003c/p\u003e \u003cp\u003eMuslim\u003c/p\u003e \u003cp\u003eCatholic\u003c/p\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e209\u003c/p\u003e \u003cp\u003e157\u003c/p\u003e \u003cp\u003e18\u003c/p\u003e \u003cp\u003e9\u003c/p\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e51.4\u003c/p\u003e \u003cp\u003e38.6\u003c/p\u003e \u003cp\u003e4.4\u003c/p\u003e \u003cp\u003e2.2\u003c/p\u003e \u003cp\u003e3.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eWorking hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eWUNEMMCSH\u003c/p\u003e \u003cp\u003ePrimary hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e221\u003c/p\u003e \u003cp\u003e186\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e54.3\u003c/p\u003e \u003cp\u003e45.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eProfession\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eNurses\u003c/p\u003e \u003cp\u003eMidwives\u003c/p\u003e \u003cp\u003ePhysicians\u003c/p\u003e \u003cp\u003eLaboratories\u003c/p\u003e \u003cp\u003ePublic health\u003c/p\u003e \u003cp\u003ePharmacy\u003c/p\u003e \u003cp\u003eAnesthetist\u003c/p\u003e \u003cp\u003eHIT\u003c/p\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e154\u003c/p\u003e \u003cp\u003e51\u003c/p\u003e \u003cp\u003e51\u003c/p\u003e \u003cp\u003e39\u003c/p\u003e \u003cp\u003e25\u003c/p\u003e \u003cp\u003e31\u003c/p\u003e \u003cp\u003e18\u003c/p\u003e \u003cp\u003e20\u003c/p\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e37.8\u003c/p\u003e \u003cp\u003e12.5\u003c/p\u003e \u003cp\u003e12.5\u003c/p\u003e \u003cp\u003e9.6\u003c/p\u003e \u003cp\u003e6.1\u003c/p\u003e \u003cp\u003e7.6\u003c/p\u003e \u003cp\u003e4.4\u003c/p\u003e \u003cp\u003e4.9\u003c/p\u003e \u003cp\u003e4.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eWork experience\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e≤ 5\u003c/p\u003e \u003cp\u003e6–10\u003c/p\u003e \u003cp\u003e≥ 11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e235\u003c/p\u003e \u003cp\u003e147\u003c/p\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e57.7\u003c/p\u003e \u003cp\u003e36.2\u003c/p\u003e \u003cp\u003e6.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eMonthly salary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e3333–6193\u003c/p\u003e \u003cp\u003e7071–10150\u003c/p\u003e \u003cp\u003e≥ 11305\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e141\u003c/p\u003e \u003cp\u003e236\u003c/p\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/table\u003e\u003c/div\u003e \u003cp\u003e\u003c/p\u003e \u003cp\u003e’’Others a’’: divorced \u0026amp; widowed, ’others b’’ Apostolic, Adventist and non-religious. ‘’others c’’: X-ray, environmental, physiotherapy. Abbreviation: GPs, General Practitioners.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003eFacility and personal related factors\u003c/h2\u003e \u003cp\u003eMore than half (54.3%) of the participants were from WUNEMMCSH. About 235 (57.7%) of the participants had 1–5 years of work experience. Nearly half (47.9%) of participants had good interpersonal relationships, and only 41% of participants had recognized More than 53.1% of the participants had advanced. Almost 48.4% of participants had a favorable working environment, and 36.8% of participants were fairly treated in terms of justice and fairness. The mean work experience for health professionals working in a public hospital in Hadiya Zone is 4.2 (SD 2.3) years, ranging from 6 months to 17 years (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" class=\"colspec\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\"\u003e\u003c/div\u003e\u003ctable id=\"Tab4\" border=\"1\"\u003e \u003ccaption\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFacility and personal related factors among health professionals (N = 407)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003c/colgroup\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eWorking hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eWUNEMMCSH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e221\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e54.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003ePrimary hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e186\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e45.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eJob satisfaction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eSatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e161\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e39.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eNot satisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e246\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e60.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eInterpersonal r/ship\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e195\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e47.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eNot good\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e212\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e52.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eAdvancement\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eAdvanced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e216\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e53.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eNot advanced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e191\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e46.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eRecognition\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eRecognized\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e167\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e41\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eNot recognized\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e240\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eAchievement\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eAchieved\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e196\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e48.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eNot achieved\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e211\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e51.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"3\"\u003e \u003cp\u003eWork experience\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e≤ 5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e235\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e57.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e6–10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e147\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e36.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e≥ 11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e6.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"2\"\u003e \u003cp\u003e .Work place\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eFavorable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e197\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e48.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eNot favorable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e210\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e51.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eSupply, drug and equipment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eAvailable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e172\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e42.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eNot available\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e235\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e57.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eJustice and fairness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eFair\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e150\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e36.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eUnfair\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e257\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e63.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eBalanced score card\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eEvaluated good\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e221\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e54.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eNot evaluated good\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e186\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e45.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eRemuneration\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eRemunerated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e169\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e41.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eNot remunerated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e238\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e58.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/table\u003e\u003c/div\u003e \u003cp\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003ch2\u003eStatus of Health Professionals Motivation\u003c/h2\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003eBivariate analyses of factors associated with Work Motivation Status among Health Professionals\u003c/h2\u003e \u003cp\u003eFrom the bivariate analysis job satisfaction, working environment, advancement, justice and fairness, remuneration, type of working hospitals, educational level, age, sex and monthly salary were candidate variables for multivariable analysis at 25% level of significance (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" class=\"colspec\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" class=\"colspec\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" class=\"colspec\"\u003e\u003c/div\u003e\u003ctable id=\"Tab5\" border=\"1\"\u003e \u003ccaption\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBivariate analyses of sociodemographic characteristics, facility and personal factors with HPs motivation (N = 407).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003c/colgroup\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" rowspan=\"2\"\u003e \u003cp\u003ecategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\"\u003e \u003cp\u003eHPs motivation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eCOR(95%CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" rowspan=\"2\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\"\u003e \u003cp\u003eMotivated\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\"\u003e \u003cp\u003eNot motivated\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"3\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e≤29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e134\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e145\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e30–34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1.46(.92-2.365)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e\u003cb\u003e0.12\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e≥ 35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1.86(0.84–4.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e\u003cb\u003e0.12\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003efemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003emale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e129\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e134\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1.47(0.94–2.31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e\u003cb\u003e0.09\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"3\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e0.87(0.57–1.34)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e0.54\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e0.5(0.05–4.58)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e0.54\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eWorking hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e126\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eCSH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e145\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e3.56(2.24–5.64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eEducational level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003ediploma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003edegree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e143\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e116\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e3.24(1.66–6.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eMasters\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e0.25(0.03–2.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e\u003cb\u003e0.20\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eMD/senior\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e2.97(1.14–7.77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e\u003cb\u003e0.02\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"3\"\u003e \u003cp\u003eReligion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eMuslim\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eOrthodox\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e121\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1.08(0.38–3.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e0.84\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eProtestant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e0.82(0.29–2.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e0.70\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"9\"\u003e \u003cp\u003eProfession\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eNurses\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eMidwives\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e2.29(1.17–4.48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e0.27\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003ePhysicians\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e2.29(1.17–4.48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e0.35\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eLaboratories\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1.45(0.67–3.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e0.34\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003ePublic health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1.54(0.61–3.86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e0.35\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003ePharmacy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1.56(0.67–3.61)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e0.29\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eAnesthetist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e5.15(1.86–14.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eHIT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1.09(0.37–3.21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e0.87\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eothers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1.26(0.42–3.77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e0.67\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"3\"\u003e \u003cp\u003eWork experience\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e≤ 5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e6–10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e0.89(.47 − 1.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e0.73\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e≥ 11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1.6(0.35–7.30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e0.53\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"3\"\u003e \u003cp\u003eMonthly salary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e3333–6193\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e7071–10150\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e118\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1.44(0.91–2.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e\u003cb\u003e0.119\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e≥ 11305\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e2.24(0.82–6.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e\u003cb\u003e0.113\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eSatisfaction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eNot satisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e174\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003esatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e104\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1.32(0.86–2.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e\u003cb\u003e0.194\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eWork environment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eNot favorable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e151\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eFavorable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e127\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1.41(0.92–2.14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e\u003cb\u003e0.108\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eInterpersonal relationship\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eNot good\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e149\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e129\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1.21(0.79–1.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e0.371\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eJustice and fairness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eNot fair\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e181\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eFair\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1.42(0.93–2.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e\u003cb\u003e0.097\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eResource availability\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eNot Adequate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e150\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eAdequate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e128\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1.64(1.06–2.54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e\u003cb\u003e0.02\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eAdvancement\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eNot advanced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e137\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eAdvanced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e141\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1.34(0.88–2.05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e\u003cb\u003e0.163\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eRemuneration\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eNot remunerated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e167\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eRemunerated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e111\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1.22(0.80–1.87)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e\u003cb\u003e0.213\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eRecognition\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eNot recognized\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e167\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eRecognized\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e111\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1.15(0.75–1.76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e0.507\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eAchievement\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eNot achieved\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e148\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eAchieved\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1.19(0.78–1.81)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e0.409\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eBSC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eNot good evaluated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e122\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eGood evaluated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e156\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1.26(0.82–1.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\"\u003e \u003cp\u003e0.281\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/table\u003e\u003c/div\u003e \u003cp\u003e\u003c/p\u003e \u003cp\u003e \u003cb\u003eMultivariable analyses of socio-demographic characteristics, facility and personal related Factors of Motivation Status among Health Professionals\u003c/b\u003e \u003c/p\u003e \u003cp\u003eHealth professionals who were working in WUNEMMCSH were 5.63 times more likely to be motivated as compared to those who were working in primary hospitals (AOR = 5.63, 95% CI (3.06, 10.36).\u003c/p\u003e \u003cp\u003eHealth professionals who had degrees were 2.41 times more likely to be motivated as compared to those who had a diploma (AOR = 2.41, 95% CI (1.13, 5.13) and those who had masters were 2.3 times more likely to be motivated than those who had a diploma (AOR = 2.3, 95% CI (1.31, 5.21). Similarly, having an MD or specialist is associated with being 2.81 times more likely to be motivated compared with those with a diploma (AOR = 2.81, 95% CI (2.11, 8.12).\u003c/p\u003e \u003cp\u003eSatisfied health professionals were 1.29 times more likely to be motivated as compared to those who were not satisfied (AOR = 1.29, 95% CI (1.12, 2.70).\u003c/p\u003e \u003cp\u003eHealth professionals who were treated fairly were 1.38 times more likely to be motivated as compared to those who were unfairly treated (AOR = 1.38, 95% CI (1.21, 2.21), p-value = 0.021).\u003c/p\u003e \u003cp\u003eFor health professionals, those who had adequate resources were 2.14 times more likely to be motivated as compared to those who didn’t have adequate resources (AOR = 2.14, 95% CI (1.79, 20.10.\u003c/p\u003e \u003cp\u003eHealth professionals who had been remunerated were 2.48 times more likely to be motivated as compared to those who hadn't been remunerated (AOR = 2.48, 95% CI (1.14, 5.4).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\"\u003e\u003c/div\u003e\u003ctable id=\"Tab6\" border=\"1\"\u003e \u003ccaption\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cb\u003eMultivariable analysis of socio-demographic characteristics, facility and personal related factors with HPs motivation (N = 407).\u003c/b\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003c/colgroup\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\"\u003e \u003cp\u003eHPs motivation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" rowspan=\"2\"\u003e \u003cp\u003eCOR(95%CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eAOR(95%CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" rowspan=\"2\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\"\u003e \u003cp\u003eMotivated\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\"\u003e \u003cp\u003eNot motivated\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"3\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e≤29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e134\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e145\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e30–34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\"\u003e \u003cp\u003e1.46(.92, 2.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e2.97(1.54, 5.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e0.041\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e≥ 35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\"\u003e \u003cp\u003e1.86(0.84, 4.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e3.65(0.89, 14.92)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e0.071\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003efemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003emale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e129\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e134\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\"\u003e \u003cp\u003e1.47(0.94, 2.31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e2.58(1.45, 4.59)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e0.120\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eWorking hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e126\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eCSH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e145\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\"\u003e \u003cp\u003e3.56(2.24, 5.64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e5.63(3.06, 10.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e\u003cb\u003e0.001*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eEducational level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eDiploma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eDegree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e143\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e116\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\"\u003e \u003cp\u003e3.24(1.66, 6.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e2.41(1.13, 5.13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e\u003cb\u003e0.022*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eMasters\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\"\u003e \u003cp\u003e2.5(2.31, 5.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e2.3(1.31, 5.21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e\u003cb\u003e0.03*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eMD/senior\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\"\u003e \u003cp\u003e2.97(1.14, 7.77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e2.81(2.11, 8.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e\u003cb\u003e0.04*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"3\"\u003e \u003cp\u003eMonthly salary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e3333–6193\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e7071–10150\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e118\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1.44(0.91, 2.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\"\u003e \u003cp\u003e082(0.09, 6.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e0.86\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e≥ 11305\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e2.24(0.82, 6.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\"\u003e \u003cp\u003e1.80(0.13, 24.74)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e0.65\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eSatisfaction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eNot satisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e174\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eSatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e104\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1.32(0.86, 2.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\"\u003e \u003cp\u003e1.29(1.12, 2.70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e\u003cb\u003e0.03*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eWork environment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eNot favorable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e151\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eFavorable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e127\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1.41(0.92, 2.14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\"\u003e \u003cp\u003e1.27(0.68, 2.37)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e0.43\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eJustice and fairness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eNot fair\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e181\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eFair\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1.42(0.93, 2.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\"\u003e \u003cp\u003e1.38(1.21, 2.21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e\u003cb\u003e0.021*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eResource availability\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eNot Adequate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e150\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eAdequate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e128\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1.64(1.06, 2.54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\"\u003e \u003cp\u003e2.14(1.20, 3.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e\u003cb\u003e0.01*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eAdvancement\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eNot advanced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e137\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eAdvanced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e141\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1.34(0.88, 2.05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\"\u003e \u003cp\u003e1.13(0.51, 2.46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e0.75\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" rowspan=\"2\"\u003e \u003cp\u003eRemuneration\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eNot remunerated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e167\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\"\u003e \u003cp\u003eRemunerated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e111\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e1.22(0.80, 1.87)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\"\u003e \u003cp\u003e2.48(1.14, 5.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\"\u003e \u003cp\u003e\u003cb\u003e0.022*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/table\u003e\u003c/div\u003e \u003cp\u003e\u003c/p\u003e \u003cp\u003eVariables that are *significant at p \u0026lt; 0.05 in multivariate Note; 1 = reference category\u003c/p\u003e \u003cdiv id=\"Sec23\" class=\"Section3\"\u003e \u003c/div\u003e \u003c/div\u003e "},{"header":"DISCUSSION","content":"\u003cp\u003eHealth professionals' motivation has been pointed out as a highly important factor for effective health service delivery. This study showed that the general motivation status of the Hadiya Zone health profession was 31.7% (95% CI of 27.2% to 36.6%). This study's motivation level was lower than that of studies conducted at Bahir Dar City, Northwest Ethiopia (50.4) [\u003cspan class=\"CitationRef\"\u003e44\u003c/span\u003e], at Public Health Institutions in Korahey Zone, Ethiopian Somali Region (70%) [\u003cspan class=\"CitationRef\"\u003e20\u003c/span\u003e] ,at European Gaza hospitals (66.2%) [\u003cspan class=\"CitationRef\"\u003e49\u003c/span\u003e], hospitals in Franko Division, Cameroon (42.7%) [\u003cspan class=\"CitationRef\"\u003e47\u003c/span\u003e], and public hospitals in central Ethiopia's West Shewa Zone (63%) [\u003cspan class=\"CitationRef\"\u003e25\u003c/span\u003e]. The factors affecting the work motivation of healthcare professionals may differ from nation to nation, from area to region, from hospital to hospital, and even from time to time. The time difference between when the research was done and the economic inflation during the period of this study might be mentioned as reasons for the observed discrepancy. The cost of goods is rising for many production and service-giving industries in the country after ethnic-based violence, displacement, and chaos prevailed in the country.\u003c/p\u003e\u003cp\u003eConversely, the status of motivation in this study was higher than in research done at the specialized hospital at Jimma University (25.1%) [\u003cspan class=\"CitationRef\"\u003e46\u003c/span\u003e] and Debre Markos comprehensive specialized hospital(20.4) [\u003cspan class=\"CitationRef\"\u003e53\u003c/span\u003e]. This difference may be due to the difference in the study areas, and the inclusion of only nurse professionals in the study carried out in Jimma.\u003c/p\u003e\u003cp\u003eOverall demotivation among health professionals in Hadiya Zone, Central Ethiopia, is a cause for concern, given that motivation has implications for the efficiency, effectiveness, and sustainability of the health system in the Zone.\u003c/p\u003e\u003cp\u003eOn the multivariable regression job satisfaction, justice and fairness, remuneration, working hospitals, educational level, and resource availability were significantly associated with motivational status among health professionals at public hospitals of Hadiya Zone, central Ethiopia.\u003c/p\u003e\u003cp\u003eHealth professionals who were working in WUNEMMCSH were 5.63 times more likely to be motivated as compared to those who were working in primary hospitals (AOR = 5.63, 95% CI (3.06, 10.36), p-value = 0.001).\u003c/p\u003e\u003cp\u003eThe result is similar to a previous study done in Bahir Dar city [\u003cspan class=\"CitationRef\"\u003e50\u003c/span\u003e]. This could be a factor in the orderly and secure work environment, strict oversight, and higher compensation, greater access to resources, positive interpersonal interactions, and superior management system that comprehensive specialized hospitals have over primary hospitals.\u003c/p\u003e\u003cp\u003eHealth professionals who had degrees were 2.41 times more likely to be motivated as compared to those who had a diploma (AOR = 2.41, 95% CI (1.13, 5.13), p-value = 0.02), and those who had masters were 2.3 times more likely compared to those who had a diploma (AOR = 2.3, 95% CI (1.31, 5.21), p-value = 0.03). Similarly, having an MD or specialist is associated with being 2.81 times more likely to be motivated compared with those with a diploma (AOR = 2.81, 95% CI (2.11, 8.12), p-value = 0.04).\u003c/p\u003e\u003cp\u003eThe result is similar to the previous study done in Jimma [\u003cspan class=\"CitationRef\"\u003e23\u003c/span\u003e]. This is likely because as HPS' experience and educational attainment grow, so do the expectations of health professionals regarding benefits, competence, and knowledge of management and leadership concerns.\u003c/p\u003e\u003cp\u003eSatisfied health professionals were 1.29 times more likely to be motivated as compared to those who were not satisfied health professionals (AOR = 1.29, 95% CI (1.12, 2.70), p-value = 0.03).\u003c/p\u003e\u003cp\u003eThis finding is further cemented by the prior studies conducted in Jimma University[\u003cspan class=\"CitationRef\"\u003e46\u003c/span\u003e], and Pakistan[58]. Job satisfaction is a complex phenomenon with many different meanings and viewpoints[58]. Despite research showing a connection and dependence between motivation, job happiness, and performance, the relationship is circular: Motivation causes job happiness and performance; happiness and performance cause motivation[59]. Poor salaries would be the flaming barrier to the poor satisfaction of health professionals, which will induce them to migrate to Ethiopia looking for better salaries[60]. This implies that people may not know the true value of their health until it is impaired, upon which the government of Ethiopia should work.\u003c/p\u003e\u003cp\u003eHealth professionals who were treated fairly were 1.38 times more likely to be motivated as compared to those who were unfairly treated (AOR = 1.38, 95% CI (1.21, 2.21), p-value = 0.021). The result is similar to a previous study done in Tanzania [\u003cspan class=\"CitationRef\"\u003e51\u003c/span\u003e]. Similarities may perceive fairness in areas such as promotions, salary levels, and access to training and upgrading as having a positive impact on their motivation to work.\u003c/p\u003e\u003cp\u003ehealth professionals, those who had adequate resources were 2.14 times more likely to be motivated as compared to those who didn’t have adequate resources (AOR = 2.14, 95% CI (1.79, 20.10), p-value = 0.01). This finding was consistent with the study done at Jimma Medical Center [\u003cspan class=\"CitationRef\"\u003e45\u003c/span\u003e]. This in turn implies that the availability of Medical supplies needs to be ensured to satisfy their clients' requirements so that appropriate prescriptions and diagnostics, as well as other promotion interventions can be offered for a better outcome.\u003c/p\u003e\u003cp\u003eHealth professionals who had been remunerated were 2.48 times more likely to be motivated as compared to those who hadn't been remunerated (AOR = 2.48, 95% CI (1.14, 5.4), p-value = 0.022). The result is similar to the previous study done in Jimma [\u003cspan class=\"CitationRef\"\u003e25\u003c/span\u003e]. The similarities might be related to health professional characteristics, allowance, and income.\u003c/p\u003e\u003ch2\u003eStrength of the Study\u003c/h2\u003e\u003cp\u003eA key strength of this study is its comparative design, which examined motivation levels between a Comprehensive Specialized Hospital and several Primary Hospitals. This approach provides unique insights into how different tiers of the healthcare system influence staff morale. Furthermore, unlike many studies that focus solely on a single professional group, this research encompassed a diverse range of healthcare providers, including physicians, midwives, laboratory technicians, and pharmacists. The study also achieved an exceptionally high response rate of 96.4% (407 out of 422 sampled professionals), significantly enhancing the reliability and representativeness of the findings.\u003c/p\u003e\u003ch2\u003eLimitation of the Study\u003c/h2\u003e\u003cp\u003eThe reliance on self-reported data may introduce social desirability bias. Furthermore, the study was restricted to public hospitals in the Hadiya Zone, which may limit the generalizability of the findings to the private sector of Ethiopia. And while quantitative predictors were identified, the absence of a qualitative component means the deeper subjective experiences of the participants were not captured.\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eThe findings of this study indicate that the overall motivation status among healthcare professionals in public hospitals within the Hadiya Zone is low, with only 31.7% (95% CI: 27.2%\u0026ndash;36.6%) of participants categorized as motivated. This deficiency suggests that a substantial majority of the healthcare workforce lacks the necessary drive to perform at their full potential, which can negatively impact the performance of individual institutions and the broader health system. Significant predictors of motivation status identified in this study included job satisfaction, organizational justice and fairness, recognition, remuneration, the specific hospital of employment, educational attainment, and the availability of resources. Consequently, we recommend that future researchers utilize mixed-methods approaches to more comprehensively elaborate on the motivational status of healthcare professionals.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eAOR: Adjusted Odds Ratio, CI: Confidence Interval, COR: Crude Odds Ratio EM:Extrinsic motivation, ETB: Ethiopian Birr, HPs: Health Professionals,IM:Intrinsic Motivation, PI:Principal Investigator ,SD: Standard Deviation SPSS:Statistical Package for Social Science,VIF:Variance Inflation Factors,WHO:World Health Organization,WUNEMMCSH:Wachemo University Nigist Elin Mohammed Memorial Comprehensive Specialized Hospital\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the Institutional Review Committee of Wachemo University College of Medicine and Health Sciences \u003cstrong\u003ereference no./Wcu/SGS/609/16\u003c/strong\u003e .Written informed consent was obtained from each study participant and informed consent was obtained from their parents. Permission was obtained from head of health facilities before the data collection process. The purpose of the study was explained to the participants. The data collection procedure was anonymous to keep the confidentiality of any information provided by the study participants. The study was followed the principles of declaration of Helsinki.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author based on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe have no competing of interest to declare.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe author(s) received no financial support for the research, authorship, and/or publication of this article.\u003c/p\u003e\n\u003cp\u003eAcknowledgements\u003c/p\u003e\n\u003cp\u003eThe authors would like to acknowledge Wachemo University College of Medicine and Health Science for their contribution. The authors are also grateful to the study participants for their dedicated time and volunteer participation.\u003c/p\u003e\n"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eMbindyo, P., et al., Contextual influences on health worker motivation in district hospitals in Kenya. Implementation Science, 2009. \u003cstrong\u003e4\u003c/strong\u003e(1): p. 1-10.\u003c/li\u003e\n\u003cli\u003eFranco, L.M., S. Bennett, and R. Kanfer, Health sector reform and public sector health worker motivation: a conceptual framework. Social science \u0026amp; medicine, 2002. \u003cstrong\u003e54\u003c/strong\u003e(8): p. 1255-1266.\u003c/li\u003e\n\u003cli\u003ePinder, C.C., Work motivation in organizational behavior. 2014: psychology press.\u003c/li\u003e\n\u003cli\u003eImam, T., I. Tyasari, and M.H. Pahi, Re-evaluating multifactor leadership questionnaire construct: a validation study in the pharmaceutical sector of Punjab, Pakistan context. 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BMC health services research. 2011;11(1):1-15.\u003c/li\u003e\n\u003cli\u003eHerzberg, F., Motivation to work. 2017: Routledge.\u003c/li\u003e\n\u003cli\u003eTegegne, E., et al., Work motivation and factors associated with it among health professionals in Debre Markos Comprehensive Specialized Hospital. Scientific Reports, 2024. \u003cstrong\u003e14\u003c/strong\u003e(1): p. 2381.\u003c/li\u003e\n\u003cli\u003ePrytherch, H., et al., Motivation and incentives of rural maternal and neonatal health care providers: a comparison of qualitative findings from Burkina Faso, Ghana and Tanzania. BMC health services research, 2013. \u003cstrong\u003e13\u003c/strong\u003e(1): p. 1-15.\u003c/li\u003e\n\u003cli\u003eLai ER. Motivation: A literature review. Person Research\u0026rsquo;s Report. 2011;6:40-1.\u003c/li\u003e\n\u003cli\u003eMathauer I, Imhoff I. Health worker motivation in Africa: the role of non-financial incentives and human resource management tools. Human resources for health. 2006;4(1):1-17.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Motivation, Associated Factors, Health Professionals, Public Hospitals","lastPublishedDoi":"10.21203/rs.3.rs-9073720/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9073720/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eHealthcare professional motivation is basically related to job satisfaction, remuneration, hospital work environments, educational attainment, and resource availability. Conversely, low motivation adversely affects the performance of individual healthcare institutions, health workers, and the health system as a whole. This study aims to assess the motivation levels and associated factors among healthcare professionals in public hospitals of Ethiopia.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eAn institution based cross- sectional study was conducted from October 1, to November 1, 2023. A total of 407 healthcare professionals were included in the study by using simple random sampling. Data was collected by using a pretested structured self-administered questionnaire. Binary logistic regression analyses were used to determine the association between the dependent variable and independent variable. Variable with p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was declared as statistically significant.\u003c/p\u003e\u003ch2\u003eResult\u003c/h2\u003e \u003cp\u003eA total of 407 health professionals participated in this study, yielding a 96.4% response rate. Of these, 31.7% (95% CI: 27.0%\u0026ndash;36.6%) were motivated. Multivariable analysis revealed that job satisfaction (AOR\u0026thinsp;=\u0026thinsp;1.29 (95% CI: 1.12\u0026ndash;2.70), justice and fairness (AOR\u0026thinsp;=\u0026thinsp;1.38 ( 95% CI: 1.21\u0026ndash;2.21), remuneration (AOR\u0026thinsp;=\u0026thinsp;2.48 (95% CI: 1.14\u0026ndash;5.4), educational level (AOR\u0026thinsp;=\u0026thinsp;2.41(95% CI: 1.13\u0026ndash;5.13), and resource availability (AOR\u0026thinsp;=\u0026thinsp;2.14 (95% CI: 1.20\u0026ndash;3.81) were significantly associated with the participants' motivational status. Additionally, the specific hospital where they worked (AOR\u0026thinsp;=\u0026thinsp;5.6) was also a significant factor\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003efinding of this study showed that most of the health professionals were not motivated. The presence of job satisfaction, justice and fairness, remuneration, working hospitals, educational level, and resource availability were significantly associated with motivational status.\u003c/p\u003e","manuscriptTitle":"Motivation and Associated Factors among health Professionals at Public Hospitals of Ethiopia","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-10 16:59:57","doi":"10.21203/rs.3.rs-9073720/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e58c4387-b444-48d2-8139-6e34ea753299","owner":[],"postedDate":"March 10th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-03-10T16:59:58+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-10 16:59:57","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9073720","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9073720","identity":"rs-9073720","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}