HEALTHCARE WORKFORCE RETENTION IN ETHIOPIAN PUBLIC HOSPITALS: AN INTEGRATED ANALYSIS OF LEADERSHIP, ORGANIZATIONAL JUSTICE AND EMPLOYEE RETENTION

Abstract

Retaining healthcare workers is critical challenge for Ethiopia public health institutions it  significantly impacts service quality and population health outcomes. This study looks at connections between transformational leadership, organizational justice dimensions and intentions of healthcare workers to stay or leave their jobs in Ethiopia organizations. we used structural equation modeling with robust maximum likelihood estimation to analyze survey data from 487 healthcare workers across 12 selected public hospitals. results from this data show that good leadership has a strong direct effect on whether employees want to stay (β=0.34, p<0.001). it influences retention indirectly through fairness of procedures (β=0.21, p<0.001) and fairness of interactions in the organizations (β=0.17, p<0.001). Interestingly, unlike studies conducted in Western countries our research found that retention  mostly unaffected by fairness in resource distribution and compensation this suggests that different factors may matter in different contexts in retention of employees in these organizations. The integrated model explained 62.3% of  variance in retention intentions which is significantly higher than single predictor frameworks found in previous studies. Significant variations between hospital sizes, professional categories and geographical areas revealed by multi-group invariance testing. These results improve our knowledge of the factors that keep healthcare workers in developing nations healthcare systems and prevent them from quitting. It offers legislators useful suggestions that highlight  significance of leadership development and general equity in healthcare institutions.