{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:51:28Z","timestamp":1790808688723,"version":"4.1.0"},"reference-count":89,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T00:00:00Z","timestamp":1752537600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Job satisfaction in sub-Saharan Africa is crucial as it directly impacts employee productivity, retention, and overall economic growth, fostering a motivated workforce that drives regional development. In sub\u2013Saharan Africa, poor remuneration, limited professional development opportunities, and inadequate working conditions impact satisfaction. This study examined job-satisfaction predictors among health workers in primary healthcare settings across eight countries: Ethiopia, Kenya, Malawi, Senegal, South Sudan, Tanzania, Uganda, and Zambia. A cross-sectional study surveyed 1711 health workers, assessing five dimensions: employer\u20132employee relationships, remuneration and recognition, professional development, physical work environment, and supportive supervision. The study was conducted from October 2023 to March 2024. The job-satisfaction assessment tool was adopted from a validated tool originally developed for use in low-income healthcare settings. The tool was reviewed by staff from all the country offices to ensure contextual relevance and organization alignment. The responses were measured on a five-point Likert scale: 0: Not applicable, 1: Very dissatisfied, 2: Dissatisfied, 3: Neutral, 4: Satisfied, and 5: Very satisfied. The analysis employed descriptive and multivariable regression methods. Job satisfaction varied significantly by country. Satisfaction with the employer\u2013employee relationship was highest in Zambia (80%) and lowest in Tanzania (16%). Remuneration satisfaction was highest in Senegal (63%) and Zambia (49%), while it was very low in Malawi (9.8%) and Ethiopia (2.3%). Overall, 44% of respondents were satisfied with their professional development, with Uganda leading (62%) and Ethiopia having the lowest satisfaction level (29%). Satisfaction with the physical environment was at 27%, with Uganda at 40% and Kenya at 12%. Satisfaction with supervisory support stood at 62%, with Zambia at 73% and Ethiopia at 30%. Key predictors of job satisfaction included a strong employer\u2013employee relationships (OR = 2.20, p &lt; 0.001), fair remuneration (OR = 1.59, p = 0.002), conducive work environments (OR = 1.71, p &lt; 0.001), and supervisory support (OR = 3.58, p &lt; 0.001. Improving the job satisfaction, retention, and performance of health workers in sub-Saharan Africa requires targeted interventions in employer\u2013employee relationships, fair compensation, supportive supervision, and working conditions. Strategies must be tailored to each country\u2019s unique challenges, as one-size-fits-all solutions may not be effective. Policymakers should prioritize these factors to build a motivated, resilient workforce, with ongoing research and monitoring essential to ensure sustained progress and improved healthcare delivery.<\/jats:p>","DOI":"10.3390\/ijerph22071108","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T08:04:41Z","timestamp":1752566681000},"page":"1108","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Predictors of Health-Workforce Job Satisfaction in Primary Care Settings: Insights from a Cross-Sectional Multi-Country Study in Eight African Countries"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7992-6532","authenticated-orcid":false,"given":"Samuel","family":"Muhula","sequence":"first","affiliation":[{"name":"Amref Health Africa, Headquarters, Nairobi P.O. Box 27691-00506, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3163-0633","authenticated-orcid":false,"given":"Yvonne","family":"Opanga","sequence":"additional","affiliation":[{"name":"Amref Health Africa, Kenya Country Office, Nairobi P.O. Box 30125-00100, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6104-6158","authenticated-orcid":false,"given":"Saida","family":"Kassim","sequence":"additional","affiliation":[{"name":"Amref Health Africa, Headquarters, Nairobi P.O. Box 27691-00506, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lazarus","family":"Odeny","sequence":"additional","affiliation":[{"name":"Amref Health Africa, Headquarters, Nairobi P.O. Box 27691-00506, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9799-9396","authenticated-orcid":false,"given":"Richard Zule","family":"Mbewe","sequence":"additional","affiliation":[{"name":"Amref Health Africa, Headquarters, Nairobi P.O. Box 27691-00506, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beverlyne","family":"Akoth","sequence":"additional","affiliation":[{"name":"Amref Health Africa, Headquarters, Nairobi P.O. Box 27691-00506, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mable","family":"Jerop","sequence":"additional","affiliation":[{"name":"Amref Health Africa, Headquarters, Nairobi P.O. Box 27691-00506, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lizah","family":"Nyawira","sequence":"additional","affiliation":[{"name":"Amref Health Africa, Headquarters, Nairobi P.O. Box 27691-00506, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahima","family":"Gueye","sequence":"additional","affiliation":[{"name":"Amref Health Africa, Headquarters, Nairobi P.O. Box 27691-00506, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Kiplimo","sequence":"additional","affiliation":[{"name":"Amref Health Africa, Headquarters, Nairobi P.O. Box 27691-00506, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0573-5860","authenticated-orcid":false,"given":"Thom","family":"Salamba","sequence":"additional","affiliation":[{"name":"Amref Health Africa, Malawi Country Office, Lilongwe P.O. Box 30768, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jackline","family":"Kiarie","sequence":"additional","affiliation":[{"name":"Amref Health Africa, Headquarters, Nairobi P.O. Box 27691-00506, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Kimathi","sequence":"additional","affiliation":[{"name":"Amref Health Africa, Headquarters, Nairobi P.O. Box 27691-00506, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,15]]},"reference":[{"key":"ref_1","unstructured":"Ivancevich, J.M., Konopaske, R., and Matteson, M.T. (2014). Organizational, Behavior & Management, McGraw Hill Higher Education. [10th ed.]."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"100427","DOI":"10.1016\/j.joitmc.2024.100427","article-title":"Analyzing the impact of employee job satisfaction on their job behavior in the industrial setting: An analysis from the perspective of job performance","volume":"10","author":"Gazi","year":"2024","journal-title":"J. Open Innov. Technol. Mark. 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