Improving Job Satisfaction and Motivation Among Health Professionals in the Public Health Sectors in Ethiopia: Evidence from a Repeated Cross-Sectional Study

Background : Healthcare professional satisfaction is a critical component of effective health service delivery. However, many low-income countries face persistent challenges in maintaining high levels of job satisfaction among their health workforces. This study aims to assess changes in job satisfaction and motivational factors among health professionals in Ethiopia by comparing data collected in 2022 with baseline data from 2014. Methods : A repeated cross-sectional study design was employed to compare job satisfaction and motivational factors among health professionals in 2014 (n = 1,356) and 2022 (n = 1,655). Data was collected using a validated 35-item job satisfaction tool and key informant interviews. Quantitative data were analyzed using descriptive statistics, t-tests, and point-biserial correlation coefficients. Qualitative data were analyzed using thematic approaches. Results : Overall job satisfaction increased significantly by 16 percentage points (50.8% in 2014, 66.8% in 2022, p<0.001). Significant improvements were observed in salary and benefits (mean score 0.5, 95% CI [0.44, 0.56], p < 0.001), professional and career development (mean score 0.4, 95% CI [0.03, 0.33], p < 0.001), workload (mean score 0.2, 95% CI [0.14, 0.26], p < 0.001), Human Resources for health management (mean score=0.1, 95% CI [0.04, 0.16], p = 0.009), and working conditions (mean score 0.1, 95% CI [0.06, 0.14], p < 0.001). Qualitative findings also revealed perceived improvements in salary, financial incentives, and performance evaluations but highlighted persistent dissatisfaction with salary levels and inconsistencies in the performance evaluation process. Conclusion : Ethiopia has made notable progress in enhancing job satisfaction among health professionals by strengthening human resources for health (HRH) management, increasing financial incentives, and expanding opportunities for career development. Despite this progress, challenges remain, including gender, age, and regional disparities, low salary levels, and inadequate education opportunities. Addressing these issues with targeted interventions and integrating comprehensive incentive schemes into the broader developmental agenda will be crucial for fostering a resilient and motivated health workforce, ultimately enhancing health service delivery and contributing to the country's health sector transformation.