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Vallieres, Frederique, Mubiri, Paul, Agyei Agyemang, Samuel, Amon, Samuel, Gerold, Jana, Martineau, Tim 
ORCID: https://orcid.org/0000-0003-4833-3149, Nolan, Ann, O'Byrne, Thomasena, Sanudi, Lifah, Sengooba, Freddie and Prytherch, Helen
(2021)
'Determinants of safety climate at primary care level in Ghana, Malawi and Uganda: a cross-sectional study across 138 selected primary healthcare facilities'. Human Resources for Health, Vol 19, Issue 73.
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Vallières et al. Hum Resour Health21.pdf - Published Version Available under License Creative Commons Attribution. Download (1MB) | Preview |
Abstract
Background
Safety climate is an essential component of achieving Universal Health Coverage, with several organisational, unit or team-level, and individual health worker factors identified as influencing safety climate. Few studies however, have investigated how these factors contribute to safety climate within health care settings in low- and middle-income countries (LMICs). The current study examines the relationship between key organisational, unit and individual-level factors and safety climate across primary health care centres in Ghana, Malawi and Uganda.
Methods
A cross-sectional, self-administered survey was conducted across 138 primary health care facilities in nine districts across Uganda, Ghana and Malawi. In total, 760 primary health workers completed the questionnaire. The relationships between individual (sex, job satisfaction), unit (teamwork climate, supportive supervision), organisational-level (district managerial support) and safety climate were tested using structural equation modelling (SEM) procedures. Post hoc analyses were also carried out to explore these relationships within each country.
Results
Our model including all countries explained 55% of the variance in safety climate. In this model, safety climate was most strongly associated with teamwork (β = 0.56, p < 0.001), supportive supervision (β = 0.34, p < 0.001), and district managerial support (β = 0.29, p < 0.001). In Ghana, safety climate was positively associated with job satisfaction (β = 0.30, p < 0.05), teamwork (β = 0.46, p < 0.001), and supportive supervision (β = 0.21, p < 0.05), whereby the model explained 43% of the variance in safety climate. In Uganda, the total variance explained by the model was 64%, with teamwork (β = 0.56, p < 0.001), supportive supervision (β = 0.43, p < 0.001), and perceived district managerial support (β = 0.35, p < 0.001) all found to be positively associated with climate. In Malawi, the total variance explained by the model was 63%, with teamwork (β = 0.39, p = 0.005) and supportive supervision (β = 0.27, p = 0.023) significantly and positively associated with safety climate.
Discussion/conclusions
Our findings highlight the importance of unit-level factors—and in specific, teamwork and supportive supervision—as particularly important contributors to perceptions of safety climate among primary health workers in LMICs. Implications for practice are discussed.
| Item Type: | Article |
|---|---|
| Subjects: | W General Medicine. Health Professions > Health Services. Patients and Patient Advocacy > W 84 Health services. Delivery of health care WA Public Health > WA 20.5 Research (General) WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries |
| Faculty: Department: | Biological Sciences > Vector Biology Department |
| Digital Object Identifer (DOI): | https://doi.org/10.1186/s12960-021-00617-9 |
| Depositing User: | Jan Randles |
| Date Deposited: | 11 Aug 2021 12:27 |
| Last Modified: | 11 Aug 2021 12:27 |
| URI: | https://archive.lstmed.ac.uk/id/eprint/18634 |
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