Health Professionals Commitment and its Associated Factors in Public Health Facilities of Addis Ababa, Ethiopia, 2024 Multi Center Mixed Cross-Sectional Study

Health Professionals Commitment and its Associated Factors in Public Health Facilities of Addis Ababa, Ethiopia, 2024 Multi Center Mixed Cross-Sectional Study | 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 Health Professionals Commitment and its Associated Factors in Public Health Facilities of Addis Ababa, Ethiopia, 2024 Multi Center Mixed Cross-Sectional Study Yohannes Godie, Laeke Gebretsadkan, Zewdu Shewangizaw, Teklu Assefa, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4261922/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 3 You are reading this latest preprint version Abstract BACKGROUND : Health professional commitment is an important factor in employee performance. It has a positive impact on an organization’s ability to provide professional services. Health professionals must have a committed health workforce if they are to achieve their goals effectively and efficiently, or even to survive. This study will close a research gap by examining the critical factors influencing the commitment of health professionals as well as the severity of these problems in public health facilities in Addis Ababa, Ethiopia. OBJECTIVE : To assess health professional’s commitment and its associated factors at public health facility in Addis Ababa, Ethiopia, 2024. METHODS : A mixed facility-based, cross-sectional study design was conducted. A total of 535 health professionals were selected by simple random sampling. Data was collected by five data collectors and two supervisors using a pretested questionnaire. Pretests should be done at Nifassilk Woreda 02 HC, Nifas Silk Woreda 12, and Tirunesh Beijing Hospital. Data were collected through an in-depth interview (n = 18). Data was checked for completeness, cleaned, and entered into Epi-Data version 4.2, then exported into SPSS version 26 for analysis. Bivariate and multivariate logistic regression analyses were used, and variables with a P value less than p ≤0.25 were included in multivariable logistic regression. The adjusted odd ratio along with the 95% CI was calculated to see the strength of the association, and P<0.05 was taken as the level of statistical significance. RESULTS : A total of 535 respondents were involved, with a response rate of 530 (99.1%). The magnitude of health professionals’ commitment was 70.8% (95% CI: 66.9, 75.0). Being female (AOR: 4.99, CI: 3.01-8.31, P=0.000), BSc degree holders (AOR: 3.55, CI: 1.47-8.58, P=0.005), health professionals working in health centers (AOR: 2.02, CI: 1.15-3.57, P=0.015), professional training (AOR: 2.84, CI: 1.39-5.79, P=0.004), and good working environments (AOR: 1.72, CI: 1.11-2.66, P=0.016) were factors associated with health professionals’ commitment. CONCLUSION AND RECOMMENDATION : health professional’s commitment is crucial for ensuring quality patient care and maintaining the integrity of the healthcare system. Provide comprehensive training and continuing education opportunities for health professionals to keep them updated with the latest medical knowledge, skills, and best practices. Health professionals Commitment Health facilities Addis Ababa Figures Figure 1 Figure 2 INTRODUCTION Health professional’s commitment refers to the steadfast dedication and responsibility demonstrated by individuals working within the healthcare sector towards providing optimal care and support to patients ( 1 ). These professionals, including doctors, nurses, pharmacists, therapists, and other allied health workers, make a solemn pledge to uphold the highest standards of ethical conduct, compassion, and professionalism in their practice ( 2 ). Health professional commitment is seen in employee behavior, which influences employee performance and boosts output, service quality, and productivity ( 3 , 4 ). It could also take the form of a determination to continue being a member and a promise to go above and beyond the call of duty to further the organization's objectives and beliefs ( 4 ). Health professionals commitment has been defined as the extent to which an individual identifies with and participates in a particular organization ( 5 ). Workers are considered to be making a continuity commitment when they consider the benefits and drawbacks of staying with the company or leaving. Individual employee commitment is defined as people's psychological and emotional links to their workplaces, professions, work teams, and peers ( 6 ). Health professionals commitment is a major issue in research areas, including the study of workers' behavior at work ( 7 ). No business can operate at its peak efficiency in the cutthroat business environment of today unless every employee is dedicated to the organization's objectives and contributes effectively to the team ( 3 , 8 ). Keeping employees motivated in the contemporary workplace is one of the issues that modern health professionals encounter ( 7 ). Health institutions need dedicated health personnel if they are to achieve their objectives successfully and effectively ( 9 ). This idea has drawn a lot of interest in the subject of health professional behavior, which has led to extensive study to learn more about the dedication of health professionals and its correlations ( 3 , 4 ). One of the primary goals of human resources management for many health professionals, especially those in the health industry, is to achieve a high level of commitment from employees. Indeed, there is a pervasive notion that the dedication of healthcare personnel contributes to the financial success of health professionals ( 10 ). To attain an adequate degree of management among health care providers, it is important to take into account the commitment of health professionals and employee job satisfaction. Starting with the hiring of new employees, these two elements need to be monitored and evaluated continuously. In addition to regular measurements and monitoring, other elements that affect the dedication of health professionals and employee job satisfaction must be discovered ( 4 , 11 ). Health professional commitment, has been identified as one of the elements that predated high retention ( 2 ). The goal of healthcare is to provide high-quality treatment at affordable prices, thus keeping nurses on staff may be the best course of action in the long run, even while increasing recruitment of nurses may assist to address the nursing shortage issue in the near term ( 4 ). The majority of healthcare facilities enhance nurse recruitment and retention to maintain enough staffing in order to deal with the turnover of health professionals ( 12 ). Health professionals often face high levels of stress and emotional exhaustion due to the demanding nature of their work, long hours, and exposure to trauma. This can lead to burnout, resulting in decreased commitment to their profession and compromised quality of care ( 13 ). Studies revealed factors that might affect health professional commitment could be personal background, health professional support and commitment, job satisfaction, salary levels, degree of autonomy over work, levels of stress in the work, gender, educational achievement, seniority, diversity of roles occupied, values, and attitudes towards the job ( 14 , 15 ). Health professionals play a vital role in ensuring the well-being and longevity of individuals within society. Their commitment to their profession directly impacts the quality of care provided to patients, overall healthcare outcomes, and the effectiveness of healthcare systems. However, in recent years, there have been concerns regarding the level of commitment among health professionals, with reports of burnout, dissatisfaction, and attrition. Addressing the commitment of health professionals is essential for ensuring the sustainability and effectiveness of healthcare systems. By understanding the underlying factors contributing to commitment issues, stakeholders can implement targeted interventions to support and empower health professionals in their vital roles. This study aims to analyze and evaluate the commitment of health professionals and its implications on healthcare delivery. Therefore, this research will be very helpful to health human resource managers in keeping healthcare professionals committed to the subject topic. This study will close a research gap by examining the critical factors influencing the commitment of health professionals as well as the severity of these problems in public health care facilities in Addis Ababa, Ethiopia. Despite the fact that there are few studies that have looked into the commitment of healthcare workers and the elements that influence it, Ethiopian health professional practitioners remain uninterested. Generally, a limited studies are available in Ethiopia, majority are focusing on a single profession like the nurse profession or only localized to a single sphere, and still, there is a gap in showing health professional commitment and its predicting factors among healthcare professionals that are working in the primary healthcare setting, especially in the current study area. METHODS AND MATERIALS STUDY DESIGN, STUDY AREA AND PERIOD A mixed institution-based cross-sectional study design was used to collect data using both qualitative and quantitative methods. Key informant interviews and in-depth interviews were carried out to collect primary data. The proposed study was conducted to Addis Ababa. Addis Ababa is the capital city of Ethiopia, and it’s situated in the heartland of the country, covering an area of 527 km 2 with a population of more than 7 million and lying at an altitude of 2,300 meters above sea level. This study included professionals working in health facilities were conducted from June 2023 through July 2023. POPULATIONS The source population was all health professionals working at selected public health facilities in Addis Ababa, Ethiopia. The study population consisted of all sampled health professionals in selected public health facilities that fulfilled inclusion criteria. SAMPLING PROCEDURE AND SAMPLE SIZE DETERMINATION A multistage sampling technique was implemented in 11 sub-cities found in Addis Ababa. 30% of the sub cities were selected by a simple random sampling method. Again, from the public health facilities found in each selected sub city, 30% were selected from each sub city randomly. The study participants were allocated proportionally based on the number of health professionals in each health facility using the simple random sampling technique. The sample size (n) required for the objective was calculated using the formula to estimate a single population proportion by considering the following assumptions: n= number of sample required for the study Zα/2 = critical value for normal distribution at 95% confidence level, which equals to 1.96 (Z value at alpha=0.05). P= (32.9%) level and factors associated with the health professional commitment in public health facilities, Southwest Ethiopia. (4) d= Desired degree of accuracy (5%). n=340 and since the sampling method is multistage stratified sampling, by taking 1.5 design effects, 340*1.5 = 510, and by adding 5% non-response rate, 510*0.05 =535. Based on the assumption, the final sample size (n) is 535. DATA COLLECTION INSTRUMENT AND PROCEDURE Five sections make up the questionnaires. Part 1: socio-demographic data; Part 2: commitment questions Part 3: Job Satisfaction; Part 4: Perceptions of Health Professional Support; and Part 5: Working Environment Factors for Health Care Professionals. A five-point Likert scale, with response possibilities ranging from 1 (strongly disagree) to 5 (strongly agree), is used for parts 2, 4, 5, and 6. A five-point Likert scale from 1 (very unsatisfied) to 5 (very satisfied) was used for part 3. In order to gather quantitative data, self-administered questionnaires were used. At the time of data collection, the study population was encouraged to participate willingly by describing the purpose of the study. Three trained data collectors were used to distribute structured and pretested questions to the health professionals. Qualitative data were collected concurrently with the quantitative part. The researcher gathered information from both the in-depth interview and the key informant interview. The investigator gathered information via focus group discussions (FGDs) in support of a qualified facilitator. During data collection, data collectors were closely monitored and guided by two supervisors for their completeness, appropriate collection of the data, and reporting on a daily basis. DATA QUALITY ASSURANCE A pre-test was conducted on 5% of the sample size using validated tools adapted from previously published literature a week before the actual data collection in a similar study population (12,16,17). Any ambiguity, confusion, difficult words, or differences in understanding were revised and corrected based on the pretest experience. The English-adapted tools were translated to the Amharic version using professionals in linguistics and then back to English to check information consistency. The data collectors and supervisors were trained on the objective of the study and the data collection technique using a standardized tool. Supervision was held regularly during the data collection period. The data was cross-checked for consistency and completeness on a daily basis. STUDY VARIABLES: Health professional’s commitment OPERATIONAL DEFINITION Health professional commitment : is the relative strength of an individual’s linkage to the respective profession. It is beyond a commitment for a particular organization and implies the individuals’ perspective towards their profession and the motivation that they have to stay in their job, which refers to one’s loyalty to the profession and the willingness to strive and uphold the value and goals of the profession to maintain membership in the profession, which can be explained by adherence to principles of ethical practice, effective interactions with patients and with other people working in the healthcare system, reliability, commitment to autonomous maintenance and continuous improvement of competence, pride in the profession, and good behavior outside work. This was measured using 10 items on a 5-point Likert scale, with 1 denoting commitment and 0 denoting uncommitted. A professional commitment score was created, and a higher score indicates higher professional commitment. The mean scores for all scales were reported as percentages of the scale mean score (%SM), and after standardization, the mean was calculated (18,19) “Good health professional commitment’’ when the study participant scores above mean value and was coded 1 “Poor health professional commitment’’ when the study participant scores equal to and below the mean value of the sample and was coded 0 DATA ANALYSIS AND PRESENTATION The data was thoroughly cleaned and carefully entered into the computer. During the entry of the data, double-entry verification using Epi-Data version 4.2 is applied and then exported to SPSS version 26 for further analysis. Descriptive statistics were used to summarize the data, and the results were presented using frequency tables and percentages. Bivariate analysis was carried out to identify applicant variables. Those variables in bivariate analysis whose p-value is less than 0.25 were included in multivariate logistic regressions. Then multivariate logistic regression analysis was performed for those factors that showed associations in bivariate analysis to investigate independent predictors by controlling for possible confounders. Finally, variables whose p-value is less than 0.05 were considered statistically significant, and results were presented using text, graphs, and tables. RESULTS Socio demographic characteristics of the study participant From the total 535 respondents, 530 (99.1%) participated in the study. More than half 243 (58.8%) of the respondents were Male, and 315 (59.3%) were not married. Most of the respondents 374 (70.4%) were age group of 20-29.Among the qualification of the study participants 388 (73.1%) are Bachelor degree, 57 (10.7%) are Master of Science (Table 1). From the total respondents, 171 (32.2%) of the health professionals were midwives, and 126 (23.7%) were nurses. (Figure 1) Magnitude of Health professional’s commitment The magnitude of health professionals commitment was 70.8% (95% CI: 66.9, 75.0) of health professionals. Among the respondents, more than half (51.2%) and nearly one-fourth (26.4%) agreed and strongly agreed with the idea that they were extremely glad to choose their profession to work for life in advance, respectively (Figure 2) As for the qualitative data, the service given by the health professionals in the health facility is the primary explanation. Some of the respondents stated that “though there are some problems to make the service as good as possible, it is possible to say that overall the service is good." Similarly, one of the respondents stated that “we are giving the expected services to the public with the challenges of limited resources and poor infrastructure." The respondents also confirmed their professional commitment, saying that it is about personal interest and passion to be a health professional, help people suffering from the disease, and contribute to the overall improvement of the health status of the community. Professional commitment is an important element for health professionals to deliver quality health services to the public. Respondents said, “As health professionals, we are responsible for giving the health service with the expected quality, which demands our professional commitment. We may lose mental and professional satisfaction if we can’t give the expected service to the patient." Another respondent also said that “professional commitment is necessary to give better service." The data confirmed that the loss of health professionals' commitment directly or indirectly affects the people who need to get service in health care organizations. The respondents stated that “commitment is important for professional satisfaction” and “productive work.” Job satisfaction and perceived Health professional related factors about health professional’s commitment Among the total respondents, job satisfaction about professional opportunities was 296 (55.7%). Of these participants, most of them (31.3%) were neutral about the recognition you get for good work. Nearly half of them, 253 (47.6%), received professional training. Most of the 314 (59.1%) had good relationships and interactions with health professionals. About 246 (46.3%) of the health professionals had a good working environment (Table 2) According to the qualitative data, salary may contribute to the low level of job commitment among health professionals. One respondent stated, "We are all not satisfied with the salary we paid, which has shown no considerable improvement as compared to the current inflation. The salary is still the same, but home rent was exponentially inflated from $1,000 to $10,000; in general, the living expense is unaffordable by the current salary." Another respondent said that “the current salary is not satisfactory according to the current living expenses." As teamwork is one component of professional satisfaction that indirectly affects the commitment of health care professionals, the respondents confirmed that they are satisfied. One respondent stated, “Yes, I am satisfied. Health is teamwork; we work in love and peace.” Factors associated with health professional commitment The association between the independent and dependent variables was first tested by using bi-variable analysis, which (P≤0.25) was tested in the final multivariable analysis to see their significant association with their health professional commitment. Accordingly, as shown in Table 4 below, there are bi-variable regressions associated with the crude odds ratios (COR) of health professional commitment, such as sex, age group, educational status, working area, professional training, relationships and interaction, and working environment. In multivariable analysis, results showed that there was a statistically significant association found between health professional commitment parameters, which showed a p-value below 0.05: being female, educational status, working area, professional training, and working environment. As the qualitative data shows measuring the commitment of the health professionals are crucial to improving the healthcare practice through addressing the identified gaps. Some of the indicators repeatedly identified by the respondents were training opportunities, efficiency, salary level, and other benefit packages. One respondent also included “SFPR criteria are important” as an indicator evaluate the health professionals’ commitment. Respondents also identified some ways to measure professional commitment including; supervision, monitoring and valuation, and efficiency. One respondent stated, “The work that we did and the result need to be evaluated as a means of assessing the professional commitment”. The qualitative finding straightens the result of the quantitative survey. They identified factors and components which affect their professional commitment. However, their passion, personal choices and a sense of professionalism to accomplish their job is strong. DISCUSSION This study's findings show that health professional commitment was 70.8% (95% CI: 66.9, 75.0). The finding is lower than other study findings done in Ghana and Jimma, south-eastern Ethiopia, which revealed that levels of professional commitment were 73% ( 20 ) and 72.7% ( 13 ). The possible explanation for the disparity might be due to variations in the working environment and the study setting as well. Another explanation this could be due to organizational factors such as leadership, organizational culture, job satisfaction, workload, work-life balance, professional to patient ratio, organizational stakeholders, and professional development opportunities. Individual factors like personal values, career aspirations, and demographic characteristics might also be considered. This study finding is higher than the study result done in Gurage Zone, Southern Ethiopia, which showed that the proportion of professional commitment to their organization was 69.4% ( 12 ) and 64.81% ( 21 ). The possible explanation might be due to improved promotion opportunities and other incentives like housing loans, medical benefits (risk loans), and ways of paying duty that were provided by the organization to the professionals. In addition, the discrepancy might be attributed to the difference in study setting in that study that was conducted in a referral hospital, which was tied to a high workload, which can greatly affect employees’ commitment to the organization’s interests. According to the findings of this study, being females were five times more likely to have professional commitments compared to males. This is inconsistent with the studies done in Saudi Arabia ( 22 ) and Southwestern Ethiopia ( 23 ). Historically, certain health professions have been dominated by women, such as nursing and midwifery, while others, like surgery or certain specialties, have been dominated by men. This could lead to more females having commitments in health professions compared to males. Another explanation the reason behind this might be due to the difference in the number of participants by gender. This could stem from a combination of societal, cultural, economic, and personal factors. It's crucial to examine the specific context and factors at play in the study to fully understand this disparity. In this study, the qualifications of BSc holders were a significant predictor of health professional commitment. BSc degree holders are four times more likely to have professional commitment compared to diploma holders. This finding was inconsistent with that of a previous study conducted in Tanzania ( 1 ) and Southwest Ethiopia ( 2 ), both stated that the nurses with higher educational levels showed a higher level of health professionals commitment, and education has an important role in professional commitment. Previous studies have shown that as the education level increases, belief in the aim and values of the profession and professional commitment are positively affected ( 24 ). The discrepancy might be due to no role difference between the two categories (the same job description). Another explanation for this finding might be due to the fact that individual motivations and circumstances can vary, and further research may be needed to fully understand the relationship between educational qualifications and professional commitment. And also it may be due to degree holders are encouraged more by their salary, position, and training than diploma holders. The other finding from this study was that health professionals working in health centers were twice as committed compared to hospital workers. This finding is consistent with study findings done by Havid Norway ( 25 ) and Southern Ethiopia ( 12 ). The reason for the difference in professional commitment between health professionals working in hospitals and health centers might be due to decreased work overload in health centers compared to hospitals. Another explanation health centers often serve smaller population, and not received critical ill patient compared to hospitals The presence of professional training made them three times more likely to have professional commitment compared to their counterparts. The same result was reported by research from South Ethiopia ( 2 ) and Nigeria on health care workers ( 26 ). This can be explained as training can help health professionals to cope better with the requirements of their job. It can also enable them to take on more demanding duties and positions and to achieve personal goals of professional advancement. Another explanation this may be through professional training, individuals gain confidence in their abilities and competencies. This confidence translates into a stronger dedication to their profession as they feel more capable of fulfilling their roles and responsibilities. Overall, the combination of enhanced skills, confidence, career opportunities, knowledge, recognition, and personal fulfillment derived from professional training contributes to significantly higher levels of health professional commitment compared to individuals who lack such training. This study also showed a significant association between health professional commitment and working environments. The odds of health professional commitment were two times higher among those who were committed to their good working environments than among those who were less committed. This was congruent with previous studies Saudi Arabia ( 27 ), Nigeria ( 1 ),Jimma zone ( 2 ), and ( 17 )) Addis Ababa, Ethiopia ( 4 ) when good working environment of health care providers increases, their health professional commitment level also increases. Work environment can have a positive or negative effect on your daily life. “Positive” work environments can be defined as those workplaces where there is trust, cooperation, safety, risk-taking support, accountability, and equity. There are some abstract concepts when thinking about a positive work environment ( 28 ). The WHO defines workplace violence as any situation related to job or professional activities where a person is subjected to harassment, threats or assaults or where their safety and health are endangered. Exposure to violence negatively affects the job satisfaction of employees, increases their intentions to leave the job and decreases their professional commitment ( 24 ). This is due to justify for the statement lies in the understanding that a positive working environment fosters job satisfaction, which in turn enhances commitment among healthcare professionals. This correlation is supported by empirical evidence and is a well-established principle in organizational behavior and management theory. ACRONYMS AND ABBREVIATIONS FGD: Focus Group Discussion, FMOH: Federal Minister of Health, HC: Health Center, HPC: Health Professional’s Commitment, IRB: Institutional Review Board, KMU: Kotebe Metropolitan University, PHC: Primary Health Care, SDG: Sustainable Development Goal, SNNP: South Nation Nationality People, SPSS: Statistical Package for Social Sciences, WHO: World Health Organization Declarations Ethical approval The research was submitted to the KMU and Minilik II Health Science College research offices for approval. Ethical clearance was obtained from the Addis Ababa Public Health Research and Emergency Management Directorate and then granted to the sub-city and selected health facilities. The data was collected after the purpose or objective of the study was presented to each participant and written informed consent was obtained. Any personal identifying variables for each participant were kept confidential. Availability of Data and materials The data and other documents used in this study are available from the corresponding author. Conflict of interest All authors confirmed that they have no conflict of interest. However, some parts of the paper Funding This research did not receive any specific grant from fund agencies Author’s contribution YG, LG, and ZS were equally involved in the conception, study design, execution, acquisition of data analysis, and interpretation. YG , DB and EA were involved in data analysis, drafting of the manuscript and advising the entire research paper. As well as FK and TA took part in drafting, and critically reviewing the article; wrote the manuscript paper, and prepared all the components of the manuscript and process for publication. All authors reviewed the final draft of the manuscript. 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Variable Category Health professional commitment No Yes Sex Female Male 30(19.4%) 125(80.6%) 189(50.3%) 187(49.7%) Age (years) 20-29 30-39 40-49 133(35.6%) 13(8.4%) 3 (1.9%) 239(63.6%) 125 (33.2%) 12(3.2%) Marital status Not Married Divorced Married Widowed 94(20.6%) 12(7.7%) 47(30.3%) 2(1.3%) 221(58.8%) 2(0.5%) 149(39.6%) 4(1.1%) Educational status MD MSc Degree Bachelor degree Diploma 12(7.7%) 18(11.6%) 111(71.6%) 14(9.0%) 38(10.1%) 39(10.4%) 277(73.7%) 22(5.9%) Working area Health center Hospital 23(21.9%) 132(31.0%) 82(78.1%) 294(69.0%) Work experience <2 Years 2-5 Years ≥5 Years 46(29.7%) 85(54.8%) 24(15.5%) 132(35.1%) 80(21.3%) 164(43.6%) Income/salary in Eth birr ≤6193 6194-9056 ≥9057 38(24.5%) 100(64.5%) 17(11.0%) 118(31.4%) 203(54.0%) 55(14.6%) Table 2: Job satisfaction and perceived Health professional related factors of health professionals' among public health facilities in Addis Ababa, Ethiopia, from June, 2023 to July 2023 (n=531). Variable Category Health professional commitment No Yes Professional opportunities Yes No 72(46.5%) 83(53.5%) 224(59.6%) 152(40.4%) Professional Training Yes No 63(40.6%) 92(59.4%) 190(50.5%) 186(49.5%) Pay and benefits Yes No 83(53.5%) 72(46.5%) 178(47.3%) 198(52.7%) Perceived Health professional Yes No 84(54.2%) 71(45.8%) 189(50.3%) 187(49.7%) Relationships and interaction Yes No 99(63.9%) 56(36.1%) 215(57.2%) 161(42.8%) Working environment Yes No 61(39.4%) 94(60.6%) 185(49.2%) 191(50.8%) Table 3: Factors associated with health professionals' commitment among public health facilities in Addis Ababa, Ethiopia, from June, 2023 to July 2023 (n=531). Variable Health professionals' commitment COR [95%CI] AOR [95%CI] p-value Not committed Committed Sex Female Male 30(19.4%) 125(80.6%) 189(50.3%) 187(49.7%) 4.21(2.69-6.58) 1 4.99(3.01-8.31) 1 0.000 Age group 20-29 30-39 ≥40 133(35.6%) 13(8.4%) 3(1.9%) 239(63.6%) 125 (33.2%) 12(3.2%) 0.76(0.26-2.19) 3.02(0.95-9.62) 1 0.47(0.13-1.68) 2.14(0.56-8.19) 1 0.246 0.266 Educational status MD Master’s degree Bachelor degree Diploma 12(7.7%) 18(11.6%) 111(71.6%) 14(9.0%) 38(10.1%) 39(10.4%) 277(73.7%) 22(5.9%) 2.02 (0.79-5.12) 1.38 (0.58-3.29) 1.59 (0.78-3.22) 1 2.49(0.85-7.23) 1.41(0.51-3.89) 3.55(1.47-8.58 ) 1 0.095 0.511 0.005 Working area Health center Hospital 23(21.9%) 132(31.0%) 82(78.1%) 294(69.0%) 1.60(0.97-2.66) 1 2.02(1.15-3.57) 1 0.015 Professional opportunities Yes No 72(46.5%) 83(53.5%) 224(59.6%) 152(40.4%) 1.69(1.17-2.48) 1 1.32(0.71-2.47) 1 0.383 Professional Training Yes No 63(40.6%) 92(59.4%) 190(50.5%) 186(49.5%) 1.49(1.02-2.18) 1 2.84(1.39-5.79) 1 0.004 Pay and benefits Yes No 83(53.5%) 72(46.5%) 178(47.3%) 198(52.7%) 0.78(0.54-1.14) 1 0.63(0.37-1.06) 1 . 0.080 Good relationships and interaction Yes No 99(63.9%) 56(36.1%) 215(57.2%) 161(42.8%) 0.76(0.51-1.11) 1 0.72(0.42-1.25) 1 0.241 Stable working environment Yes No 61(39.4%) 94(60.6%) 185(49.2%) 191(50.8%) 1.49(1.02-2.18) 1 1.72(1.11-2.66) 1 0.016 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editor assigned by journal 15 Apr, 2024 Submission checks completed at journal 14 Apr, 2024 First submitted to journal 13 Apr, 2024 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-4261922","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":291162970,"identity":"7044f0ed-e7f2-4073-9bda-1e996ccce208","order_by":0,"name":"Yohannes Godie","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA8klEQVRIiWNgGAWjYFACHjjL4ABDBZBiZm4gRcsZkBZGErQwMLaBaAJaDI73HntcUFFnt+H44Y0HPs6rjeZvB2r5UbENt5Yz59KNZ5w5nLzhTFrBwZnbjufOOMzYwNhz5jZuLTdyzKR52w4kGxzIMTjMu+1YbgNQCzNjGyEt/+qSDc6/MTj8d86x3PnEaWlgtgMyDICKa3I3ENIieeaMmTTPscMJkjeeFRzsOXYgdyNQy0F8fuE73gPUUlNnz3c+efOHHzV1ufPOHz744EcFbi0KByB0YgOEPgwmD+BUDwTyUKX2UH4dPsWjYBSMglEwQgEAKtxk5NCxoDQAAAAASUVORK5CYII=","orcid":"","institution":"Menelik II Medical and Health science college","correspondingAuthor":true,"prefix":"","firstName":"Yohannes","middleName":"","lastName":"Godie","suffix":""},{"id":291162971,"identity":"00159451-590b-45a6-9cc6-53289e197b9a","order_by":1,"name":"Laeke Gebretsadkan","email":"","orcid":"","institution":"Alert comprehensive specialized 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13:29:21","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4261922/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4261922/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":55010030,"identity":"4fc36f31-cc97-4bc3-bca6-e8f9ac3487b5","added_by":"auto","created_at":"2024-04-19 19:16:50","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":26582,"visible":true,"origin":"","legend":"\u003cp\u003eProfessions of health care providers among public health facilities in Addis Ababa, Ethiopia, from June, 2023 to July 2023 (n=531).\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-4261922/v1/c73406543f3e3f0a2ad49bda.png"},{"id":55010491,"identity":"ad7cb0ad-b141-453d-b391-2b4f586596ba","added_by":"auto","created_at":"2024-04-19 19:24:50","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":16778,"visible":true,"origin":"","legend":"\u003cp\u003eMagnitude of health professional commitment among public health facilities in Addis Ababa, Ethiopia, from June, 2023 to July 2023 (n=531)\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-4261922/v1/93a4cac8abdf67971ff3a8e8.png"},{"id":55010797,"identity":"1f089d77-8321-4cb8-9a76-24ebb33b1914","added_by":"auto","created_at":"2024-04-19 19:32:51","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":562177,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4261922/v1/f8630542-e2ab-4ce0-bcc8-7a6d62ca2c95.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Health Professionals Commitment and its Associated Factors in Public Health Facilities of Addis Ababa, Ethiopia, 2024 Multi Center Mixed Cross-Sectional Study","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eHealth professional\u0026rsquo;s commitment refers to the steadfast dedication and responsibility demonstrated by individuals working within the healthcare sector towards providing optimal care and support to patients (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). These professionals, including doctors, nurses, pharmacists, therapists, and other allied health workers, make a solemn pledge to uphold the highest standards of ethical conduct, compassion, and professionalism in their practice (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eHealth professional commitment is seen in employee behavior, which influences employee performance and boosts output, service quality, and productivity (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). It could also take the form of a determination to continue being a member and a promise to go above and beyond the call of duty to further the organization's objectives and beliefs (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Health professionals commitment has been defined as the extent to which an individual identifies with and participates in a particular organization (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Workers are considered to be making a continuity commitment when they consider the benefits and drawbacks of staying with the company or leaving. Individual employee commitment is defined as people's psychological and emotional links to their workplaces, professions, work teams, and peers (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eHealth professionals commitment is a major issue in research areas, including the study of workers' behavior at work (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). No business can operate at its peak efficiency in the cutthroat business environment of today unless every employee is dedicated to the organization's objectives and contributes effectively to the team (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Keeping employees motivated in the contemporary workplace is one of the issues that modern health professionals encounter (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Health institutions need dedicated health personnel if they are to achieve their objectives successfully and effectively (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). This idea has drawn a lot of interest in the subject of health professional behavior, which has led to extensive study to learn more about the dedication of health professionals and its correlations (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). One of the primary goals of human resources management for many health professionals, especially those in the health industry, is to achieve a high level of commitment from employees. Indeed, there is a pervasive notion that the dedication of healthcare personnel contributes to the financial success of health professionals (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eTo attain an adequate degree of management among health care providers, it is important to take into account the commitment of health professionals and employee job satisfaction. Starting with the hiring of new employees, these two elements need to be monitored and evaluated continuously. In addition to regular measurements and monitoring, other elements that affect the dedication of health professionals and employee job satisfaction must be discovered (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eHealth professional commitment, has been identified as one of the elements that predated high retention (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). The goal of healthcare is to provide high-quality treatment at affordable prices, thus keeping nurses on staff may be the best course of action in the long run, even while increasing recruitment of nurses may assist to address the nursing shortage issue in the near term (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). The majority of healthcare facilities enhance nurse recruitment and retention to maintain enough staffing in order to deal with the turnover of health professionals (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Health professionals often face high levels of stress and emotional exhaustion due to the demanding nature of their work, long hours, and exposure to trauma. This can lead to burnout, resulting in decreased commitment to their profession and compromised quality of care (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eStudies revealed factors that might affect health professional commitment could be personal background, health professional support and commitment, job satisfaction, salary levels, degree of autonomy over work, levels of stress in the work, gender, educational achievement, seniority, diversity of roles occupied, values, and attitudes towards the job (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eHealth professionals play a vital role in ensuring the well-being and longevity of individuals within society. Their commitment to their profession directly impacts the quality of care provided to patients, overall healthcare outcomes, and the effectiveness of healthcare systems. However, in recent years, there have been concerns regarding the level of commitment among health professionals, with reports of burnout, dissatisfaction, and attrition. Addressing the commitment of health professionals is essential for ensuring the sustainability and effectiveness of healthcare systems. By understanding the underlying factors contributing to commitment issues, stakeholders can implement targeted interventions to support and empower health professionals in their vital roles. This study aims to analyze and evaluate the commitment of health professionals and its implications on healthcare delivery. Therefore, this research will be very helpful to health human resource managers in keeping healthcare professionals committed to the subject topic. This study will close a research gap by examining the critical factors influencing the commitment of health professionals as well as the severity of these problems in public health care facilities in Addis Ababa, Ethiopia. Despite the fact that there are few studies that have looked into the commitment of healthcare workers and the elements that influence it, Ethiopian health professional practitioners remain uninterested. Generally, a limited studies are available in Ethiopia, majority are focusing on a single profession like the nurse profession or only localized to a single sphere, and still, there is a gap in showing health professional commitment and its predicting factors among healthcare professionals that are working in the primary healthcare setting, especially in the current study area.\u003c/p\u003e"},{"header":"METHODS AND MATERIALS","content":"\u003ch2\u003eSTUDY DESIGN,\u0026nbsp;STUDY AREA AND PERIOD\u003c/h2\u003e\n\u003cp\u003eA mixed institution-based cross-sectional study design was used to collect data using both qualitative and quantitative methods. Key informant interviews and in-depth interviews were carried out to collect primary data.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eThe proposed study was conducted to Addis Ababa. Addis Ababa is the capital city of Ethiopia, and it\u0026rsquo;s situated in the heartland of the country, covering an area of 527 km\u003csup\u003e2\u003c/sup\u003e with a population of more than 7 million and lying at an altitude of 2,300 meters above sea level.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eThis study included professionals working in health facilities were conducted from June 2023 through July 2023.\u003c/p\u003e\n\u003ch2\u003ePOPULATIONS\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/h2\u003e\n\u003cp\u003eThe source population was all health professionals working at selected public health facilities in Addis Ababa, Ethiopia. The study population consisted of all sampled health professionals in selected public health facilities that fulfilled inclusion criteria.\u003c/p\u003e\n\u003ch2\u003eSAMPLING PROCEDURE AND SAMPLE SIZE DETERMINATION\u0026nbsp;\u003c/h2\u003e\n\u003cp\u003eA multistage sampling technique was implemented in 11 sub-cities found in Addis Ababa. 30% of the sub cities were selected by a simple random sampling method. Again, from the public health facilities found in each selected sub city, 30%\u0026nbsp;were selected from each sub city randomly. The study participants were allocated proportionally based on the number of health professionals in each health facility using the simple random sampling technique.\u003c/p\u003e\n\u003cp\u003eThe sample size (n) required for the objective was calculated using the formula to estimate a single population proportion by considering the following assumptions:\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;n= number of sample required for the study\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Z\u0026alpha;/2 = critical value for normal distribution at 95% confidence level, which equals to 1.96 (Z value at alpha=0.05).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;P= (32.9%) level and factors associated with the health professional commitment in public health facilities, Southwest Ethiopia.\u0026nbsp;(4)\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;d= Desired degree of accuracy (5%).\u003c/p\u003e\n\u003cp\u003e\u003cimg 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3S0XP/5DAOYy1ioY9PNeHTnpJ17m6Dn7hy/4vnbDBwqlasSDT7JLPPFZc8gR/qnYNA+9woA+Ys4LHp87oBOSgQsNPcjqWXZ0VfFmXRrXtVqMNBav2f84tnTPZyvELl9Ut3rW/GzjEoxUK9IJLuREeZGNeNWihZ1r24cJrkQBkF44ppVXfVzXarKpwst6BUy0nQmg5AC8mnymLxarxvOVJCnp2OK+RW4tKC2fs+5LnhVvaw62FRuLgUgc5fXhoD5IZCzGBoF5rvxnDnqF9wh++IDO1gIg3xjX4qG+eFUtyLauUWbkPsaA/1WcH8GIHBGH/CMfInvLP/DOdduSbfWvx7qWhRv1E3xv9buR2avVUhz4fIsGCSDYUsHcwva1OiFRtdBU+pAjvn+pkVMWg9aGMYrFYQkOABTJRwEYBeojcjra4vOtGjiAxy1trOU7u+Wlix2L+eiCsJaf99TDhrBGvIcjuI44vr6/JTIW/wYW1yw4hyN4DpIdi5XuIx9EZJ1rPeMTvm25q2KT93t7bJwyPror8Taken+8x3iv8YnTDa+12uEJvhYQ1mMEZkTABJ8xq47JCPwfARPcpWAEJkbABJ84uQ7NCJjgrgEjMDECJvjEyXVoRsAEdw0YgYkRMMEnTq5DMwImuGvACEyMgAk+cXIdmhEwwV0DRmBiBEzwiZPr0IyACe4aMAITI2CCT5xch2YETHDXgBGYGAETfOLkbhla/G20j/6O2JZ+z27LBL9Thvnxg73+MANkvfSHGSKp+YWZI/1e3p1KYBOzJvgmMJ8b4VdJ+M2t3Pg1Fn6rDIL0fkk0z9MzpNSvm0K43u/VQcD8U0/xRxuZO0rS/Asr6PnXfiRROdjb1QTfOCMQhx9HzA1yQ2pIxU88IafnLFs9s2AgL7Khh+eK5NiCgCwCelU/gsiCMUry6BM+mOARkfvdm+AbYg9xKfy4U8o8RIOQ8ffbkGOXFWklm6+MI5eP/CJxlkdu9He/0HHpcR2/sy/ZBz9vg4AJvg3Ob1YoekicGzsqBM27JWSnv9pdow7mIYee2NjV6Y+7ODqrE0ScF+/lc1x44nh17927QuU+fSb4hrhDbnbq3NghIWK160EWxnoNvZWMTgBRL/fIopeFIS8K2Y5OB9WpI8vyjP4lndU8990GgX7l3MbmP6lVRIlkExDagatjMwsChIy7sOZx1e5f7cqyGU8A2NKigV5e1Qd+sjF6ikDeR3Ohtp+rCb5RLrRzVgQXiSFkbr0xZEXi6mTQG4O4+KLdv0dyLQTZt/iMLRYPNRae0V1fc3xdHwETfH1MS40ieG+X3pLgclKf1kPi1tFaO77m5Kti00Kga5bz8/YImOAbYd7bifXdd4/grSM6/RCqt4PHI3oVrt6rV4sP8vK9muu+fSNggm+UH+1y1bFVY9XXUSO7ITLVp/PSy3WpoaPyjXkm+BJ6+x03wTfKTY9s2oXje1jc0gdoSzuwTgD5iK0P71q7fwwdguf5Gh9ZZCTr674QMME3yoc+8GrtpuySeRfW0Tkf3XmO30tLdz4B8N65OrrnkLGz9CHbiJ6s18/3R8AE3zAHPcKxe0Jw7eKQNj7LTX1nnnd1CIo8uzXkR4+e81wWGS0QkBtdepasrlo8Wsd3yfm6TwRM8A3zomN6yyTk1PtdFoO8IzOPD8I4Mlc7LvohNeOQNh+50c/35TpyY2uJuPiAztYC0IrF/ftAwATfMA+QBOIukWpDlxZNsSBUC83iRAvsAgETfOM0aBc9wo7IaSG/FdgYLpv7IAIm+AcBvGY6JK+O2NfoutUcfOR9/BEWolthMINeE/xOWeT9cesT9Tu59Mcs5Pax/A8ch74xwQ+dPjtvBPoImOB9fDxqBA6NgAl+6PTZeSPQR8AE7+PjUSNwaARM8EOnz84bgT4CJngfH48agUMjYIIfOn123gj0ETDB+/h41AgcGgET/NDps/NGoI+ACd7Hx6NG4NAImOCHTp+dNwJ9BEzwPj4eNQKHRsAEP3T67LwR6CNggvfx8agRODQCJvih02fnjUAfARO8j49HjcChETDBD50+O28E+giY4H18PGoEDo2ACX7o9Nl5I9BHwATv4+NRI3BoBEzwQ6fPzhuBPgImeB8fjxqBQyNggh86fXbeCPQRMMH7+HjUCBwaARP80Omz80agj4AJ3sfHo0bg0AiY4IdOn503An0ETPA+Ph41AodGwAQ/dPrsvBHoI2CC9/HxqBE4NAIm+KHTZ+eNQB8BE7yPj0eNwKERMMEPnT47bwT6CJjgfXw8agQOjcCUBH9+fj59+vTp9PDwcPr8+fPpx48fQ0l6enp6m1MJ//z58/Tly5eLdVa63GcEtkJgOoJD0sfHxxMk//bt2xshIToE7TXGkeOVGwsE/d+/f38benl5eXvm6mYE9ozA39W8Z28XfPv9+/cfEkoUUkJOCN9qr6+vb7uzdugoxxinARaN2Fg86GfczQjsFYGpCF6RTTuzdt8qEV+/fn3b4SFx3sFbu3Xe1Su97jMC90ZgNYJDLkjELshu+evXr7ddD8JAHHbXezT51LLNOMd6WkVwyE8M+YhPPIqtpdv9RuDeCKxGcAggMnDlCEsfBIII9LWadlnkRl4tPbEfAi4do5GJR++K4HxIh0/V6YB+juluRmCvCKxGcAIUUbUjKujqva3GbnGVH1ossM+JIjcIHfsrgktHnstzb6ySd58R2BqBmxA8f6BVEWeLQHmfrMWFa2z4yOkitsrPHol7Y1Gv743AvRDYBcHzjivitK6XgqVjtnZr7FVvGSqC6/v0yib++YheIeO+vSCwC4LfGgx9Eg6xaSJyawGhH5koq8XhrTO8HZGc+n01AntC4J8guE4I+iQfwnNEzy/t9PTrj1j0IaGelTwtGvmYr3FfjcAeEPgnCA5hqyN5ToB29tjPp+ccw/P8pU/oow7fG4F7IbAqwSESx1uKXw2CaGfMx1zJrHXl03vIiB/6Wosdlg/Y9NyzVREcef1Ri3bx1q7e0+0xI3APBFYjuMgR39fqaBz7IN+tGkTUYoJNiB3JvmRXMVRyUTd69X6+knWfEdgLAqsRfC8B2Q8jYATeETDB37HwnRGYDoFpCB7fBtzjfrrKcEBTIDANwafIhoMwAisjYIKvDKjVGYE9IWCC7ykb9sUIrIyACb4yoFZnBPaEgAm+p2zYFyOwMgIm+MqAWp0R2BMCJviesmFfjMDKCJjgKwNqdUZgTwiY4HvKhn0xAisjYIKvDKjVGYE9IWCC7ykb9sUIrIyACb4yoFZnBPaEgAm+p2zYFyOwMgL/Aw3rjGMGeTj+AAAAAElFTkSuQmCC\" width=\"248\" height=\"214\"\u003e\u003c/p\u003e\n\u003cp\u003en=340 and since the sampling method is multistage stratified sampling, by taking 1.5 design effects, 340*1.5 = 510, and by adding 5% non-response rate, 510*0.05 =535. Based on the assumption, the final sample size (n) is 535.\u003c/p\u003e\n\u003ch2\u003eDATA COLLECTION INSTRUMENT AND PROCEDURE\u003c/h2\u003e\n\u003cp\u003eFive sections make up the questionnaires. Part 1: socio-demographic data; Part 2: commitment questions Part 3: Job Satisfaction; Part 4: Perceptions of Health Professional Support; and Part 5: Working Environment Factors for Health Care Professionals. A five-point Likert scale, with response possibilities ranging from 1 (strongly disagree) to 5 (strongly agree), is used for parts 2, 4, 5, and 6. A five-point Likert scale from 1 (very unsatisfied) to 5 (very satisfied) was used for part 3.\u0026nbsp;In order to gather quantitative data, self-administered questionnaires were used. At the time of data collection, the study population was encouraged to participate willingly by describing the purpose of the study. Three trained data collectors were used to distribute structured and pretested questions to the health professionals. Qualitative data were collected concurrently with the quantitative part. The researcher gathered information from both the in-depth interview and the key informant interview. The investigator gathered information via focus group discussions (FGDs) in support of a qualified facilitator. During data collection, data collectors were closely monitored and guided by two supervisors for their completeness, appropriate collection of the data, and reporting on a daily basis.\u003c/p\u003e\n\u003ch2\u003eDATA QUALITY ASSURANCE\u003c/h2\u003e\n\u003cp\u003eA pre-test was conducted on 5% of the sample size using validated tools adapted from previously published literature a week before the actual data collection in a similar study population\u0026nbsp;(12,16,17).\u0026nbsp;Any ambiguity, confusion, difficult words, or differences in understanding were revised and corrected based on the pretest experience. The English-adapted tools were translated to the Amharic version using professionals in linguistics and then back to English to check information consistency. The data collectors and supervisors were trained on the objective of the study and the data collection technique using a standardized tool. Supervision was held regularly during the data collection period. The data was cross-checked for consistency and completeness on a daily basis.\u003c/p\u003e\n\u003ch2\u003eSTUDY VARIABLES:\u0026nbsp;Health professional\u0026rsquo;s commitment\u003c/h2\u003e\n\u003ch2\u003eOPERATIONAL DEFINITION\u003c/h2\u003e\n\u003cp\u003e\u003cstrong\u003eHealth professional commitment\u003c/strong\u003e: is the relative strength of an individual\u0026rsquo;s linkage to the respective profession. It is beyond a commitment for a particular organization and implies the individuals\u0026rsquo; perspective towards their profession and the motivation that they have to stay in their job, which refers to one\u0026rsquo;s loyalty to the profession and the willingness to strive and uphold the value and goals of the profession to maintain membership in the profession, which can be explained by adherence to principles of ethical practice, effective interactions with patients and with other people working in the healthcare system, reliability, commitment to autonomous maintenance and continuous improvement of competence, pride in the profession, and good behavior outside work. This was measured using 10 items on a 5-point Likert scale, with 1 denoting commitment and 0 denoting uncommitted. A professional commitment score was created, and a higher score indicates higher professional commitment. The mean scores for all scales were reported as percentages of the scale mean score (%SM), and after standardization, the mean was calculated\u0026nbsp;(18,19)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026ldquo;Good health professional commitment\u0026rsquo;\u0026rsquo;\u0026nbsp;\u003c/strong\u003ewhen the study participant scores above mean value and was coded 1\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026ldquo;Poor health professional commitment\u0026rsquo;\u0026rsquo;\u0026nbsp;\u003c/strong\u003ewhen the study participant scores equal to and below the mean value of the sample and was coded 0\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDATA ANALYSIS AND PRESENTATION\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data was thoroughly cleaned and carefully entered into the computer. During the entry of the data, double-entry verification using Epi-Data version 4.2 is applied and then exported to SPSS version 26 for further analysis. Descriptive statistics were used to summarize the data, and the results were presented using frequency tables and percentages. Bivariate analysis was carried out to identify applicant variables. Those variables in bivariate analysis whose p-value is less than 0.25 were included in multivariate logistic regressions. Then multivariate logistic regression analysis was performed for those factors that showed associations in bivariate analysis to investigate independent predictors by controlling for possible confounders. Finally, variables whose p-value is less than 0.05 were considered statistically significant, and results were presented using text, graphs, and tables.\u003c/p\u003e"},{"header":"RESULTS","content":"\u003ch2\u003eSocio demographic characteristics of the study participant\u003c/h2\u003e\n\u003cp\u003eFrom the total 535 respondents, 530 (99.1%) participated in the study. More than half 243 (58.8%) of the respondents were Male, and 315 (59.3%) were not married. Most of the respondents 374 (70.4%) were age group of 20-29.Among the qualification of the study participants 388 (73.1%) are Bachelor degree,\u0026nbsp;57 (10.7%) are Master of Science \u003cstrong\u003e(Table 1).\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFrom the total respondents, 171 (32.2%) of the health professionals were midwives, and 126 (23.7%) were nurses. \u003cstrong\u003e(Figure 1)\u003c/strong\u003e\u003c/p\u003e\n\u003ch2\u003eMagnitude of Health professional\u0026rsquo;s commitment\u003c/h2\u003e\n\u003cp\u003eThe magnitude of health professionals commitment was 70.8% (95% CI: 66.9, 75.0) of health professionals. Among the respondents, more than half (51.2%) and nearly one-fourth (26.4%) agreed and strongly agreed with the idea that they were extremely glad to choose their profession to work for life in advance, respectively \u003cstrong\u003e(Figure 2)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAs for the qualitative data, the service given by the health professionals in the health facility is the primary explanation. Some of the respondents stated that \u0026ldquo;though there are some problems to make the service as good as possible, it is possible to say that overall the service is good.\u0026quot; Similarly, one of the respondents stated that \u0026ldquo;we are giving the expected services to the public with the challenges of limited resources and poor infrastructure.\u0026quot; The respondents also confirmed their professional commitment, saying that it is about personal interest and passion to be a health professional, help people suffering from the disease, and contribute to the overall improvement of the health status of the community. Professional commitment is an important element for health professionals to deliver quality health services to the public. Respondents said, \u0026ldquo;As health professionals, we are responsible for giving the health service with the expected quality, which demands our professional commitment. We may lose mental and professional satisfaction if we can\u0026rsquo;t give the expected service to the patient.\u0026quot; \u0026nbsp;Another respondent also said that \u0026ldquo;professional commitment is necessary to give better service.\u0026quot; \u0026nbsp;The data confirmed that the loss of health professionals\u0026apos; commitment directly or indirectly affects the people who need to get service in health care organizations. \u0026nbsp;The respondents stated that \u0026ldquo;commitment is important for professional satisfaction\u0026rdquo; and \u0026ldquo;productive work.\u0026rdquo;\u003c/p\u003e\n\u003ch2\u003eJob satisfaction and perceived Health professional related factors about health\u0026nbsp;professional\u0026rsquo;s commitment\u003c/h2\u003e\n\u003cp\u003eAmong the total respondents, job satisfaction about professional opportunities was 296 (55.7%). Of these participants, most of them (31.3%) were neutral about the recognition you get for good work. Nearly half of them, 253 (47.6%), received professional training. Most of the 314 (59.1%) had good relationships and interactions with health professionals. About 246 (46.3%) of the health professionals had a good working environment (Table 2)\u003c/p\u003e\n\u003cp\u003eAccording to the qualitative data, salary may contribute to the low level of job commitment among health professionals. One respondent stated, \u0026quot;We are all not satisfied with the salary we paid, which has shown no considerable improvement as compared to the current inflation. The salary is still the same, but home rent was exponentially inflated from $1,000 to $10,000; in general, the living expense is unaffordable by the current salary.\u0026quot; \u0026nbsp;Another respondent said that \u0026ldquo;the current salary is not satisfactory according to the current living expenses.\u0026quot; \u0026nbsp;As teamwork is one component of professional satisfaction that indirectly affects the commitment of health care professionals, the respondents confirmed that they are satisfied. One respondent stated, \u0026ldquo;Yes, I am satisfied. Health is teamwork; we work in love and peace.\u0026rdquo;\u003c/p\u003e\n\u003ch2\u003eFactors associated with health professional commitment\u003c/h2\u003e\n\u003cp\u003eThe association between the independent and dependent variables was first tested by using bi-variable analysis, which (P\u0026le;0.25) was tested in the final multivariable analysis to see their significant association with their health professional commitment. Accordingly, as shown in Table 4 below, there are bi-variable regressions associated with the crude odds ratios (COR) of health professional commitment, such as sex, age group, educational status, working area, professional training, relationships and interaction, and working environment.\u0026nbsp;In multivariable analysis, results showed that there was a statistically significant association found between health professional commitment parameters, which showed a p-value below 0.05: being female, educational status, working area, professional training, and working environment.\u003c/p\u003e\n\u003cp\u003eAs the qualitative data shows measuring the commitment of the health professionals are crucial to improving the healthcare practice through addressing the identified gaps. Some of the indicators repeatedly identified by the respondents were training opportunities, efficiency, salary level, and other benefit packages. \u0026nbsp;One respondent also included \u0026ldquo;SFPR criteria are important\u0026rdquo; as an indicator evaluate the health professionals\u0026rsquo; commitment. Respondents also identified some ways to measure professional commitment including; supervision, monitoring and valuation, and efficiency. \u0026nbsp; One respondent stated, \u0026ldquo;The work that we did and the result need to be evaluated as a means of assessing the professional commitment\u0026rdquo;. The qualitative finding straightens the result of the quantitative survey. They identified factors and components which affect their professional commitment. However, their passion, personal choices and a sense of professionalism to accomplish their job is strong.\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThis study's findings show that health professional commitment was 70.8% (95% CI: 66.9, 75.0). The finding is lower than other study findings done in Ghana and Jimma, south-eastern Ethiopia, which revealed that levels of professional commitment were 73% (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e) and 72.7% (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). The possible explanation for the disparity might be due to variations in the working environment and the study setting as well. Another explanation this could be due to organizational factors such as leadership, organizational culture, job satisfaction, workload, work-life balance, professional to patient ratio, organizational stakeholders, and professional development opportunities. Individual factors like personal values, career aspirations, and demographic characteristics might also be considered.\u003c/p\u003e \u003cp\u003eThis study finding is higher than the study result done in Gurage Zone, Southern Ethiopia, which showed that the proportion of professional commitment to their organization was 69.4% (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e) and 64.81% (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). The possible explanation might be due to improved promotion opportunities and other incentives like housing loans, medical benefits (risk loans), and ways of paying duty that were provided by the organization to the professionals. In addition, the discrepancy might be attributed to the difference in study setting in that study that was conducted in a referral hospital, which was tied to a high workload, which can greatly affect employees’ commitment to the organization’s interests.\u003c/p\u003e \u003cp\u003eAccording to the findings of this study, being females were five times more likely to have professional commitments compared to males. This is inconsistent with the studies done in Saudi Arabia (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e) and Southwestern Ethiopia (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). Historically, certain health professions have been dominated by women, such as nursing and midwifery, while others, like surgery or certain specialties, have been dominated by men. This could lead to more females having commitments in health professions compared to males. Another explanation the reason behind this might be due to the difference in the number of participants by gender. This could stem from a combination of societal, cultural, economic, and personal factors. It's crucial to examine the specific context and factors at play in the study to fully understand this disparity.\u003c/p\u003e \u003cp\u003eIn this study, the qualifications of BSc holders were a significant predictor of health professional commitment. BSc degree holders are four times more likely to have professional commitment compared to diploma holders. This finding was inconsistent with that of a previous study conducted in Tanzania (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e) and Southwest Ethiopia (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e), both stated that the nurses with higher educational levels showed a higher level of health professionals commitment, and education has an important role in professional commitment. Previous studies have shown that as the education level increases, belief in the aim and values of the profession and professional commitment are positively affected (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). The discrepancy might be due to no role difference between the two categories (the same job description). Another explanation for this finding might be due to the fact that individual motivations and circumstances can vary, and further research may be needed to fully understand the relationship between educational qualifications and professional commitment. And also it may be due to degree holders are encouraged more by their salary, position, and training than diploma holders.\u003c/p\u003e \u003cp\u003eThe other finding from this study was that health professionals working in health centers were twice as committed compared to hospital workers. This finding is consistent with study findings done by Havid Norway (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e) and Southern Ethiopia (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). The reason for the difference in professional commitment between health professionals working in hospitals and health centers might be due to decreased work overload in health centers compared to hospitals. Another explanation health centers often serve smaller population, and not received critical ill patient compared to hospitals\u003c/p\u003e \u003cp\u003eThe presence of professional training made them three times more likely to have professional commitment compared to their counterparts. The same result was reported by research from South Ethiopia (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) and Nigeria on health care workers (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). This can be explained as training can help health professionals to cope better with the requirements of their job. It can also enable them to take on more demanding duties and positions and to achieve personal goals of professional advancement. Another explanation this may be through professional training, individuals gain confidence in their abilities and competencies. This confidence translates into a stronger dedication to their profession as they feel more capable of fulfilling their roles and responsibilities. Overall, the combination of enhanced skills, confidence, career opportunities, knowledge, recognition, and personal fulfillment derived from professional training contributes to significantly higher levels of health professional commitment compared to individuals who lack such training.\u003c/p\u003e \u003cp\u003eThis study also showed a significant association between health professional commitment and working environments. The odds of health professional commitment were two times higher among those who were committed to their good working environments than among those who were less committed. This was congruent with previous studies Saudi Arabia (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e), Nigeria (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e),Jimma zone (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e), and (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e)) Addis Ababa, Ethiopia (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e) when good working environment of health care providers increases, their health professional commitment level also increases. Work environment can have a positive or negative effect on your daily life. “Positive” work environments can be defined as those workplaces where there is trust, cooperation, safety, risk-taking support, accountability, and equity. There are some abstract concepts when thinking about a positive work environment (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). The WHO defines workplace violence as any situation related to job or professional activities where a person is subjected to harassment, threats or assaults or where their safety and health are endangered. Exposure to violence negatively affects the job satisfaction of employees, increases their intentions to leave the job and decreases their professional commitment (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). This is due to justify for the statement lies in the understanding that a positive working environment fosters job satisfaction, which in turn enhances commitment among healthcare professionals. This correlation is supported by empirical evidence and is a well-established principle in organizational behavior and management theory.\u003c/p\u003e "},{"header":"ACRONYMS AND ABBREVIATIONS","content":"\u003cp\u003e FGD: Focus Group Discussion, FMOH: Federal Minister of Health, HC: Health Center, HPC: Health Professional’s Commitment, IRB: Institutional Review Board, KMU: Kotebe Metropolitan University, PHC: Primary Health Care, SDG: Sustainable Development Goal, SNNP: South Nation Nationality People, SPSS: Statistical Package for Social Sciences, WHO: World Health Organization\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eEthical\u0026nbsp;approval\u003c/h2\u003e\n\u003cp\u003eThe research was submitted to the KMU and Minilik II Health Science College research offices for approval. Ethical clearance was obtained from the Addis Ababa Public Health Research and Emergency Management Directorate and then granted to the sub-city and selected health facilities. The data was collected after the purpose or objective of the study was presented to each participant and written informed consent was obtained. Any personal identifying variables for each participant were kept confidential.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of Data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data and other documents used in this study are available from the corresponding author.\u003c/p\u003e\n\u003ch2\u003eConflict of interest\u003c/h2\u003e\n\u003cp\u003eAll authors confirmed that they have no conflict of interest. However, some parts of the paper\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003eFunding\u0026nbsp;\u003c/h2\u003e\n\u003cp\u003eThis research did not receive any specific grant from fund agencies\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor\u0026rsquo;s contribution\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eYG, LG,\u0026nbsp;\u003c/strong\u003eand\u003cstrong\u003e\u0026nbsp;ZS\u0026nbsp;\u003c/strong\u003ewere equally involved in the conception, study design, execution, acquisition of data analysis, and interpretation.\u0026nbsp;\u003cstrong\u003eYG\u003c/strong\u003e,\u0026nbsp;\u003cstrong\u003eDB\u003c/strong\u003e and\u0026nbsp;\u003cstrong\u003eEA\u0026nbsp;\u003c/strong\u003ewere involved\u0026nbsp;in data analysis, drafting of the manuscript and advising the entire research\u0026nbsp;paper.\u0026nbsp;As well as \u003cstrong\u003eFK\u0026nbsp;\u003c/strong\u003eand\u003cstrong\u003e\u0026nbsp;TA\u003c/strong\u003e took part in drafting, and critically reviewing the article; wrote the manuscript paper, and prepared all the components of the manuscript and process for publication. All authors reviewed the final draft of the manuscript.\u003c/p\u003e\n\u003ch2\u003eAcknowledgement\u003c/h2\u003e\n\u003cp\u003eWe would like to express our appreciation to the study participants, data collectors, supervisors for their contribution and commitment throughout the study period.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eKhan AS, Jan F. The Study of Organization Commitment and Job Satisfactionamong Hospital Nurses. A Survey of District Hospitals of DeraIsmail. Khan. 2015;15(1).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eISrael B, W K, Fantahun DT. W. Organizational Commitment and its Predictors among Nurses Working in Jimma University Specialized Teaching Hospital, Southwest Ethiopia. Prim Heal Care Open Access. 2017;07(01).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOuyang Y, Zhou W, Qu H. The impact of psychological empowerment and organisational commitment on Chinese nurses \u0026rsquo; job satisfaction. 2015;(June):37\u0026ndash;41.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eArage SM, Daba DB. Organizational commitment of health professionals and associated factors in primary healthcare facilities of Addis Ababa, Ethiopia : A multi-center cross-sectional study. Front Public Heal. 2022.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePendidikan U, Idris S. A three-Component Conceptualization of Organizational Commitment. 2016;6(12):16\u0026ndash;23.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSolinger ON, Amsterdam VU, Van Olffen W. On Becoming (Un) Committed: A Taxonomy and Test of Newcomer Onboarding Scenarios. 2013;(December).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLeigh Branham. 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Professional Commitment and Its Associated Factors Among Institutional Delivery Services Providers In Public Health Facilities, In Shone District, Southern. 2021.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMaheshwari S, Bhat R, Saha S. Commitment among state health officials \u0026amp; its implications for health sector reform: Lessons from Gujarat. 2008;(February):148\u0026ndash;53.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYibeltal S, Adamu A, Erchafo B, Hailu M. Level and Factors Associated with Professional Commitment of Health Professionals Providing Institutional Delivery Services in Public Health Facilities, Southwest Ethiopia.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZelellw D, Tegegne T. The Use and Perceived Barriers of the Partograph at Public Health Institutions in East Gojjam Zone, Northwest Ethiopia. Annu Glob. 2018;84(1):198\u0026ndash;203.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eIsrael* K, Tigist W. and F. Organizational Commitment and its Predictors among Nurses Working in Primary Health Care: Open Access Organizational Commitment and its Predictors among Nurses Working in Jimma University Specialized Teaching Hospital, Southwest Ethiopia. Prim Heal Care; 2017. (March 2019).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlemayehu D. Organizational Commitment and Associated Factors Among Health Professionals Working in Public Health Facilities of Benchsheko Zone Southwest Ethiopia. 2020;1\u0026ndash;23.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMasud H. Human Resource Management Practices and Organizational Commitment: Research Methods, Issues, and Future Directions. 2019;8(1):217\u0026ndash;26.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNatalie J, Allen*. The measurement and antecedents of affective, continuance and normative commitment to the organization. J Occup Psychol. 2015;63:1\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZelellw DA, Tegegne TK. Level of partograph utilization and its associated factors among obstetric caregivers at public health facilities in East Gojam Zone, Northwest Ethiopia. PLOS/ONE. 2018;07:1\u0026ndash;13.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZone G, Nima GH, Kerie MW, Nebeb GT. Organizational Commitment of Health Professionals and Associated Factors. Government Health Facilities of. 2016;5(5):82\u0026ndash;90.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlvarez-uria G, Midde M, Pakam R, Bachu L, Naik PK. Effect of Formula Feeding and Breastfeeding on Child Growth, Infant Mortality, and HIV Transmission in Children Born to HIV-Infected Pregnant Women Who Received Triple Antiretroviral Therapy in a Resource-Limited Setting : Data from an HIV Cohort Study. 2015;2012.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMekonnen T, Abera T, Tilahun A, Tadese A, Yadesa T. Self-reported turnover intention and associated factors among health professionals in Kafa Zone, Southwest Ethiopia. SAGE Open Med. 2022;10.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDuran S, Celik I, Ertugrul B, Ok S, Albayrak S. Factors affecting nurses\u0026rsquo; professional commitment during the COVID-19 pandemic: A cross-sectional study. J Nurs Manag. 2021;29(7):1906\u0026ndash;15.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHavig AK, Skogstad A, Veenstra M, Rom\u0026oslash;ren TI. The effects of leadership and ward factors on job satisfaction in nursing homes: a multilevel approach. 2021;(3532):3532\u0026ndash;42.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMowday RT, Steers RM, Porter LW. Meas Organizational Commit. 1979;247:224\u0026ndash;47.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAl- HI, Al-qahtani MF. Assessment of Organizational Commitment Among Nurses in a Major Public Hospital in Saudi Arabia. 2020;519\u0026ndash;26.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMariya Aleksynska (ILO). Janine Berg (ILO), David Foden (Eurofound) HJ (ILO), Agn\u0026egrave;s Parent-Thirion (Eurofound) JV (Eurofound). Working conditions in a global perspective. 2020.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTable 1: Socio demographic characteristics of health professionals\u0026apos; among public health facilities in Addis Ababa, Ethiopia, from June, 2023 to July 2023 (n=531).\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"95%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"47.474747474747474%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eHealth professional commitment\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.680851063829785%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"55.319148936170215%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003eSex\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\" valign=\"top\"\u003e\n \u003cp\u003eFemale\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.21212121212121%\" valign=\"top\"\u003e\n \u003cp\u003e30(19.4%)\u003c/p\u003e\n \u003cp\u003e125(80.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.262626262626263%\" valign=\"top\"\u003e\n \u003cp\u003e189(50.3%)\u003c/p\u003e\n \u003cp\u003e187(49.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\" valign=\"top\"\u003e\n \u003cp\u003e20-29\u003c/p\u003e\n \u003cp\u003e30-39\u003c/p\u003e\n \u003cp\u003e40-49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.21212121212121%\" valign=\"top\"\u003e\n \u003cp\u003e133(35.6%)\u003c/p\u003e\n \u003cp\u003e13(8.4%)\u003c/p\u003e\n \u003cp\u003e3 (1.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.262626262626263%\" valign=\"top\"\u003e\n \u003cp\u003e239(63.6%)\u003c/p\u003e\n \u003cp\u003e125 (33.2%)\u003c/p\u003e\n \u003cp\u003e12(3.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003eMarital status\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\" valign=\"top\"\u003e\n \u003cp\u003eNot Married\u003c/p\u003e\n \u003cp\u003eDivorced\u003c/p\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003cp\u003eWidowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.21212121212121%\" valign=\"top\"\u003e\n \u003cp\u003e94(20.6%)\u003c/p\u003e\n \u003cp\u003e12(7.7%)\u003c/p\u003e\n \u003cp\u003e47(30.3%)\u003c/p\u003e\n \u003cp\u003e2(1.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.262626262626263%\" valign=\"top\"\u003e\n \u003cp\u003e221(58.8%)\u003c/p\u003e\n \u003cp\u003e2(0.5%)\u003c/p\u003e\n \u003cp\u003e149(39.6%)\u003c/p\u003e\n \u003cp\u003e4(1.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003eEducational status\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\" valign=\"top\"\u003e\n \u003cp\u003eMD\u003c/p\u003e\n \u003cp\u003eMSc Degree\u003c/p\u003e\n \u003cp\u003eBachelor degree\u003c/p\u003e\n \u003cp\u003eDiploma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.21212121212121%\" valign=\"top\"\u003e\n \u003cp\u003e12(7.7%)\u003c/p\u003e\n \u003cp\u003e18(11.6%)\u003c/p\u003e\n \u003cp\u003e111(71.6%)\u003c/p\u003e\n \u003cp\u003e14(9.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.262626262626263%\" valign=\"top\"\u003e\n \u003cp\u003e38(10.1%)\u003c/p\u003e\n \u003cp\u003e39(10.4%)\u003c/p\u003e\n \u003cp\u003e277(73.7%)\u003c/p\u003e\n \u003cp\u003e22(5.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003eWorking area\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\" valign=\"top\"\u003e\n \u003cp\u003eHealth center\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;Hospital\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.21212121212121%\" valign=\"top\"\u003e\n \u003cp\u003e23(21.9%)\u003c/p\u003e\n \u003cp\u003e132(31.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.262626262626263%\" valign=\"top\"\u003e\n \u003cp\u003e82(78.1%)\u003c/p\u003e\n \u003cp\u003e294(69.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003eWork experience\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;2 Years\u003c/p\u003e\n \u003cp\u003e2-5 Years\u003c/p\u003e\n \u003cp\u003e\u0026ge;5 Years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.21212121212121%\" valign=\"top\"\u003e\n \u003cp\u003e46(29.7%)\u003c/p\u003e\n \u003cp\u003e85(54.8%)\u003c/p\u003e\n \u003cp\u003e24(15.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.262626262626263%\" valign=\"top\"\u003e\n \u003cp\u003e132(35.1%)\u003c/p\u003e\n \u003cp\u003e80(21.3%)\u003c/p\u003e\n \u003cp\u003e164(43.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003eIncome/salary in Eth birr\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.19191919191919%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026le;6193\u003c/p\u003e\n \u003cp\u003e6194-9056\u003c/p\u003e\n \u003cp\u003e\u0026ge;9057\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.21212121212121%\" valign=\"top\"\u003e\n \u003cp\u003e38(24.5%)\u003c/p\u003e\n \u003cp\u003e100(64.5%)\u003c/p\u003e\n \u003cp\u003e17(11.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.262626262626263%\" valign=\"top\"\u003e\n \u003cp\u003e118(31.4%)\u003c/p\u003e\n \u003cp\u003e203(54.0%)\u003c/p\u003e\n \u003cp\u003e55(14.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003eTable 2: Job satisfaction and perceived Health professional \u0026nbsp;related factors of health professionals\u0026apos; among public health facilities in Addis Ababa, Ethiopia, from June, 2023 to July 2023 (n=531).\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"94%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.408163265306122%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"45.91836734693877%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;Health professional commitment\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.666666666666664%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"53.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003eProfessional opportunities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.408163265306122%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.428571428571427%\" valign=\"top\"\u003e\n \u003cp\u003e72(46.5%)\u003c/p\u003e\n \u003cp\u003e83(53.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.489795918367346%\" valign=\"top\"\u003e\n \u003cp\u003e224(59.6%)\u003c/p\u003e\n \u003cp\u003e152(40.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003eProfessional Training\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.408163265306122%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.428571428571427%\" valign=\"top\"\u003e\n \u003cp\u003e63(40.6%)\u003c/p\u003e\n \u003cp\u003e92(59.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.489795918367346%\" valign=\"top\"\u003e\n \u003cp\u003e190(50.5%)\u003c/p\u003e\n \u003cp\u003e186(49.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003ePay and benefits\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.408163265306122%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.428571428571427%\" valign=\"top\"\u003e\n \u003cp\u003e83(53.5%)\u003c/p\u003e\n \u003cp\u003e72(46.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.489795918367346%\" valign=\"top\"\u003e\n \u003cp\u003e178(47.3%)\u003c/p\u003e\n \u003cp\u003e198(52.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003ePerceived Health professional\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.408163265306122%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.428571428571427%\" valign=\"top\"\u003e\n \u003cp\u003e84(54.2%)\u003c/p\u003e\n \u003cp\u003e71(45.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.489795918367346%\" valign=\"top\"\u003e\n \u003cp\u003e189(50.3%)\u003c/p\u003e\n \u003cp\u003e187(49.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003eRelationships and interaction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.408163265306122%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.428571428571427%\" valign=\"top\"\u003e\n \u003cp\u003e99(63.9%)\u003c/p\u003e\n \u003cp\u003e56(36.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.489795918367346%\" valign=\"top\"\u003e\n \u003cp\u003e215(57.2%)\u003c/p\u003e\n \u003cp\u003e161(42.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003eWorking environment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.408163265306122%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.428571428571427%\" valign=\"top\"\u003e\n \u003cp\u003e61(39.4%)\u003c/p\u003e\n \u003cp\u003e94(60.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.489795918367346%\" valign=\"top\"\u003e\n \u003cp\u003e185(49.2%)\u003c/p\u003e\n \u003cp\u003e191(50.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003eTable 3: Factors associated with health professionals\u0026apos; commitment among public health facilities in Addis Ababa, Ethiopia, from June, 2023 to July 2023 (n=531).\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"98%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.649484536082475%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Variable\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.02061855670103%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eHealth professionals\u0026apos; commitment\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.556701030927837%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCOR [95%CI]\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAOR [95%CI]\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"53.125%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNot committed\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"46.875%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCommitted\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.875%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eFemale\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;Male\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e30(19.4%)\u003c/p\u003e\n \u003cp\u003e125(80.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e189(50.3%)\u003c/p\u003e\n \u003cp\u003e187(49.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.75%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e4.21(2.69-6.58)\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e4.99(3.01-8.31)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.875%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge group\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 20-29\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; 30-39\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026ge;40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e133(35.6%)\u003c/p\u003e\n \u003cp\u003e13(8.4%)\u003c/p\u003e\n \u003cp\u003e3(1.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e239(63.6%)\u003c/p\u003e\n \u003cp\u003e125 (33.2%)\u003c/p\u003e\n \u003cp\u003e12(3.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.75%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.76(0.26-2.19)\u003c/p\u003e\n \u003cp\u003e3.02(0.95-9.62)\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.47(0.13-1.68)\u003c/p\u003e\n \u003cp\u003e2.14(0.56-8.19)\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.246\u003c/p\u003e\n \u003cp\u003e0.266\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.875%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducational status\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;MD\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Master\u0026rsquo;s degree\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Bachelor degree\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Diploma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e12(7.7%)\u003c/p\u003e\n \u003cp\u003e18(11.6%)\u003c/p\u003e\n \u003cp\u003e111(71.6%)\u003c/p\u003e\n \u003cp\u003e14(9.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e38(10.1%)\u003c/p\u003e\n \u003cp\u003e39(10.4%)\u003c/p\u003e\n \u003cp\u003e277(73.7%)\u003c/p\u003e\n \u003cp\u003e22(5.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.75%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2.02 (0.79-5.12)\u003c/p\u003e\n \u003cp\u003e1.38 (0.58-3.29)\u003c/p\u003e\n \u003cp\u003e1.59 (0.78-3.22)\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2.49(0.85-7.23)\u003c/p\u003e\n \u003cp\u003e1.41(0.51-3.89)\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e3.55(1.47-8.58\u003c/strong\u003e)\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.095\u003c/p\u003e\n \u003cp\u003e0.511\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.005\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.875%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eWorking area\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Health center\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Hospital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e23(21.9%)\u003c/p\u003e\n \u003cp\u003e132(31.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e82(78.1%)\u003c/p\u003e\n \u003cp\u003e294(69.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.75%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1.60(0.97-2.66)\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e2.02(1.15-3.57)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.015\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.875%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eProfessional opportunities\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Yes\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; No\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e72(46.5%)\u003c/p\u003e\n \u003cp\u003e83(53.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e224(59.6%)\u003c/p\u003e\n \u003cp\u003e152(40.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.75%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1.69(1.17-2.48)\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1.32(0.71-2.47)\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.383\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.875%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eProfessional Training\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Yes\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; No\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e63(40.6%)\u003c/p\u003e\n \u003cp\u003e92(59.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e190(50.5%)\u003c/p\u003e\n \u003cp\u003e186(49.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.75%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1.49(1.02-2.18)\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e2.84(1.39-5.79)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.004\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.875%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePay and benefits\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Yes\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; No\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e83(53.5%)\u003c/p\u003e\n \u003cp\u003e72(46.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e178(47.3%)\u003c/p\u003e\n \u003cp\u003e198(52.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.75%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.78(0.54-1.14)\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.63(0.37-1.06)\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e.\u003c/p\u003e\n \u003cp\u003e0.080\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.875%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eGood relationships and interaction\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;Yes\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; No\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e99(63.9%)\u003c/p\u003e\n \u003cp\u003e56(36.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e215(57.2%)\u003c/p\u003e\n \u003cp\u003e161(42.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.75%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.76(0.51-1.11)\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.72(0.42-1.25)\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.241\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.875%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eStable working environment\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e61(39.4%)\u003c/p\u003e\n \u003cp\u003e94(60.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e185(49.2%)\u003c/p\u003e\n \u003cp\u003e191(50.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.75%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1.49(1.02-2.18)\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e1.72(1.11-2.66)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.016\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"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":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Health professionals, Commitment, Health facilities, Addis Ababa","lastPublishedDoi":"10.21203/rs.3.rs-4261922/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4261922/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBACKGROUND\u003c/strong\u003e: Health professional commitment is an important factor in employee performance. It has a positive impact on an organization’s ability to provide professional services. Health professionals must have a committed health workforce if they are to achieve their goals effectively and efficiently, or even to survive. This study will close a research gap by examining the critical factors influencing the commitment of health professionals as well as the severity of these problems in public health facilities in Addis Ababa, Ethiopia.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eOBJECTIVE\u003c/strong\u003e: To assess health professional’s commitment and its associated factors at public health facility in Addis Ababa, Ethiopia, 2024.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMETHODS\u003c/strong\u003e: A mixed facility-based, cross-sectional study design was conducted. A total of 535 health professionals were selected by simple random sampling. Data was collected by five data collectors and two supervisors using a pretested questionnaire. Pretests should be done at Nifassilk Woreda 02 HC, Nifas Silk Woreda 12, and Tirunesh Beijing Hospital. Data were collected through an in-depth interview (n = 18). Data was checked for completeness, cleaned, and entered into Epi-Data version 4.2, then exported into SPSS version 26 for analysis. Bivariate and multivariate logistic regression analyses were used, and variables with a P value less than p ≤0.25 were included in multivariable logistic regression. The adjusted odd ratio along with the 95% CI was calculated to see the strength of the association, and P\u0026lt;0.05 was taken as the level of statistical significance.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRESULTS\u003c/strong\u003e: A total of 535 respondents were involved, with a response rate of 530 (99.1%). The magnitude of health professionals’ commitment was 70.8% (95% CI: 66.9, 75.0). Being female (AOR: 4.99, CI: 3.01-8.31, P=0.000), BSc degree holders (AOR: 3.55, CI: 1.47-8.58, P=0.005), health professionals working in health centers (AOR: 2.02, CI: 1.15-3.57, P=0.015), professional training (AOR: 2.84, CI: 1.39-5.79, P=0.004), and good working environments (AOR: 1.72, CI: 1.11-2.66, P=0.016) were factors associated with health professionals’ commitment.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCONCLUSION AND RECOMMENDATION\u003c/strong\u003e: health professional’s commitment is crucial for ensuring quality patient care and maintaining the integrity of the healthcare system. Provide comprehensive training and continuing education opportunities for health professionals to keep them updated with the latest medical knowledge, skills, and best practices.\u003c/p\u003e","manuscriptTitle":"Health Professionals Commitment and its Associated Factors in Public Health Facilities of Addis Ababa, Ethiopia, 2024 Multi Center Mixed Cross-Sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-04-19 19:16:45","doi":"10.21203/rs.3.rs-4261922/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorAssigned","content":"","date":"2024-04-15T04:46:37+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-04-15T02:12:28+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2024-04-13T13:18:48+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"5437ac0f-e057-4a57-9e74-91ec265e6219","owner":[],"postedDate":"April 19th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-04-25T12:53:10+00:00","versionOfRecord":[],"versionCreatedAt":"2024-04-19 19:16:45","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4261922","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4261922","identity":"rs-4261922","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}