{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T13:13:40Z","timestamp":1788786820734,"version":"build-2803163510"},"reference-count":47,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"unspecified","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Yekatit 12 Hospital Medical College, Addis Ababa","award":["No formal grant number assigned; supported by Yeka"],"award-info":[{"award-number":["No formal grant number assigned; supported by Yeka"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,8,20]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to explore healthcare workers\u2019 lived experiences of job satisfaction and examine the multilevel factors perceived to shape these experiences at Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A descriptive phenomenological qualitative study was conducted using in-depth interviews and focus group discussions (FGDs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 24 in-depth interviews and 12 FGDs were conducted with purposively selected hospital staff.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were collected using semistructured interview guides informed by the Social Ecological Model to explore experiences and factors across individual, interpersonal, organisational, community and policy levels. All interviews and discussions were audio-recorded, transcribed verbatim and thematically analysed using ATLAS.ti V.9<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Job satisfaction emerged as a multidimensional experience formed by interconnected factors across individual, interpersonal, organisational, community and policy levels. At the individual level, high workload, burn-out and low salary were key challenges. Interpersonal factors included strained patient\u2013provider relationships and lack of recognition. Organisational barriers such as staff shortages, inadequate infrastructure and limited training opportunities contributed to difficult working conditions and dissatisfaction. At the community level, limited or changing public respect for health workers was reported. At the policy level, delays in procurement systems and inconsistencies in benefit distribution contributed to demotivation. Despite these challenges, many participants expressed a strong sense of professional commitment and purpose.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Hospital staff\u2019s job satisfaction was experienced as a multidimensional phenomenon formed by interconnected conditions across multiple levels of the work and broader health-system environment. The findings suggest that efforts to improve healthcare workers\u2019 experiences should consider these interconnected levels, including fair compensation, supportive leadership, adequate staffing and infrastructure, equitable access to opportunities, and responsive institutional and policy support. Such contextually responsive approaches may contribute to a more supportive working environment and strengthen healthcare workforce well-being and retention in Ethiopia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-108391","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T13:00:25Z","timestamp":1788786025000},"page":"e108391","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Lived experiences of health workers\u2019 job satisfaction at the health facility level in Ethiopia: a phenomenological study"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0517-8476","authenticated-orcid":false,"given":"Trhas Tadesse","family":"Berhe","sequence":"first","affiliation":[{"name":"Department of General Public Health, School of Public Health, Yekatit 12 Hospital Medical College, Addis Ababa, Addis Ababa, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alemu Kibiret","family":"Feleke","sequence":"additional","affiliation":[{"name":"Department of General Public Health, School of Public Health, Yekatit 12 Hospital Medical College, Addis Ababa, Addis Ababa, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2645-8901","authenticated-orcid":false,"given":"Digafe Tsegaye","family":"Nigatu","sequence":"additional","affiliation":[{"name":"Department of General Public Health, School of Public Health, Yekatit 12 Hospital Medical College, Addis Ababa, Addis Ababa, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Getachew","family":"Weldeyohhans","sequence":"additional","affiliation":[{"name":"Department of General Public Health, School of Public Health, Yekatit 12 Hospital Medical College, Addis Ababa, Addis Ababa, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"key":"2026090706001299000_16.9.e108391.1","doi-asserted-by":"crossref","DOI":"10.1002\/puh2.143","article-title":"Healthcare setting staff satisfaction in Ethiopia: Systematic review and meta-analysis","volume":"3","author":"Asres","year":"2024","journal-title":"Public Health Chall"},{"key":"2026090706001299000_16.9.e108391.2","doi-asserted-by":"crossref","DOI":"10.1002\/nop2.70259","article-title":"Healthcare Professionals\u2019 Job Satisfaction and Its Determinants in Ethiopia: A Systematic Review and Meta-Analysis","volume":"12","author":"Teshome","year":"2025","journal-title":"Nurs Open"},{"key":"2026090706001299000_16.9.e108391.3","doi-asserted-by":"publisher","DOI":"10.1037\/amp0000298"},{"key":"2026090706001299000_16.9.e108391.4","unstructured":"Locke EA . The nature and causes of job satisfaction. In: Dunnette MD , ed. Handbook of industrial and organizational psychology. Chicago, IL: Rand McNally, 1976: 1297\u2013343."},{"key":"2026090706001299000_16.9.e108391.5","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.sapharm.2023.10.002","article-title":"Application of the COM-B model to explore barriers and facilitators to participation in research by hospital pharmacists and pharmacy technicians: A cross-sectional mixed-methods survey","volume":"20","author":"Johnson","year":"2024","journal-title":"Res Social Adm Pharm"},{"key":"2026090706001299000_16.9.e108391.6","unstructured":"World Health Organization . Working for health and growth: investing in the health workforce. 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The global nursing shortage and nurse retention. Geneva: International Council of Nurses; 2021. Available: https:\/\/www.icn.ch\/sites\/default\/files\/2023-04\/ICN%20Policy%20Brief_Nurse%20Shortage%20and%20Retention.pdf"},{"key":"2026090706001299000_16.9.e108391.40","unstructured":"World Health Organization . Global strategy on human resources for health: workforce 2030. Geneva: World Health Organization; 2016. Available: https:\/\/www.who.int\/publications\/i\/item\/9789241511131"},{"key":"2026090706001299000_16.9.e108391.41","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2020.36469","article-title":"Prevalence of and Factors Associated With Nurse Burnout in the US","volume":"4","author":"Shah","year":"2021","journal-title":"JAMA Netw Open"},{"key":"2026090706001299000_16.9.e108391.42","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1186\/s12875-024-02336-1","article-title":"Barriers and strategies for primary health care workforce development: synthesis of evidence","volume":"25","author":"Endalamaw","year":"2024","journal-title":"BMC Prim Care"},{"key":"2026090706001299000_16.9.e108391.43","doi-asserted-by":"crossref","DOI":"10.1186\/s12913-024-11441-x","article-title":"Knowledge, attitude, and practice of Iranian health care workers about infodemic management: a cross-sectional descriptive study","volume":"24","author":"Zarei","year":"2024","journal-title":"BMC Health Serv Res"},{"key":"2026090706001299000_16.9.e108391.44","unstructured":"World Health Organization . Attacks on health care in the context of COVID-19. Geneva: WHO; 2020. Available: https:\/\/www.who.int\/news-room\/feature-stories\/detail\/attacks-on-health-care-in-the-context-of-covid-19"},{"key":"2026090706001299000_16.9.e108391.45","doi-asserted-by":"crossref","DOI":"10.1002\/puh2.70181","article-title":"Health Misinformation in Ethiopia: Myths, Media Dynamics, Public Response, and Policy Implications: A Narrative Review","volume":"5","author":"Berhe","year":"2026","journal-title":"Public Health Chall"},{"key":"2026090706001299000_16.9.e108391.46","first-page":"24","article-title":"Factors affecting public procurement contract management: the case of Federal Public Procurement Services, Addis Ababa","volume":"11","author":"Ejigu","year":"2021","journal-title":"Ethiop J Bus Econ"},{"key":"2026090706001299000_16.9.e108391.47","doi-asserted-by":"crossref","unstructured":"Azevedo MJ . The state of health system(s) in Africa: challenges and opportunities. In: Azevedo MJ , ed. Historical perspectives on the state of health and health systems in Africa, Volume II. 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