Health extension workers job satisfaction and associated factors in Ethiopia: a systematic review and meta-analysis

BMC Health Serv Res. 2025 Jan 25;25(1):144. doi: 10.1186/s12913-025-12298-4.

Abstract

Background: Ethiopian healthcare relies heavily on Health Extension Workers (HEWs), who deliver essential services to communities nationwide. By analyzing existing research, the authors explore how prevalent job satisfaction is and what factors affect it. This comprehensive analysis aims to improve HEW satisfaction through targeted interventions, ultimately leading to a more effective healthcare workforce and better health outcomes in Ethiopia. Specifically, this study estimates the pooled level of job satisfaction and associated factors among HEWs in Ethiopia using a systematic review and meta-analysis.

Method: Studies were searched through the search engine of Cochrane Library, PubMed, Web of Science, Google Scholar. Data from included studies was extracted, organized in Excel, and then analyzed using STATA 17. The overall effect across all studies was calculated using a random-effect model. Potential publication bias and heterogeneity in the results between studies were assessed using Egger's test, forest plot, and I2 statistic, respectively.

Results: The pooled level of job satisfaction among health extension workers in Ethiopia was 46% (95%CI: 32%-60%). Supportive supervision (AOR = 4.42; 95% CI: 2.23, 8.23), training opportunities (AOR = 4.69; 95% CI: 2.72, 6.61), and support from management (AOR = 4.90; 95% CI: 3.03, 6.77) were statistically associated with the level of job satisfaction among HEW in Ethiopia.

Conclusion: The pooled level of job satisfaction was low. Getting supportive supervision from higher health experts, having favorable training opportunities, and having managerial support from kebele were found to be the statistically significant variables associated with job satisfaction among health extension workers in Ethiopia.

Keywords: Determinants of Job Satisfaction; Ethiopia; Health Extension Workers; Job Satisfaction; Meta-Analysis; Systematic Review.

Publication types

  • Systematic Review
  • Meta-Analysis

MeSH terms

  • Community Health Workers / psychology
  • Ethiopia
  • Humans
  • Job Satisfaction*