Does an alignment of employment policies and individual preferences affect intention to stay in the profession? Evidence from Canadian Midwives

HakemZadeh, Farimah; Sayin, Firat K.; Neiterman, Elena; Zeytinoglu, Işık U.; Geraci, Johanna; Plenderleith, Jennifer; Lobb, Derek K.

doi:10.1016/j.healthpol.2021.01.005

Cited by 6 publications

(12 citation statements)

References 48 publications

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“…For hours of work and on-call weeks, midwives’ employment status and compensation are relevant issues. Midwives’ hours of work and on-call weeks are directly affected by their employment status (of an employee or a self-employed midwife), which in turn, affects their entitlement to employment standards legislative coverage (for employees) or exclusion (for self-employed, i.e., independent contractors) [ 15 ]. Hours of work and on-call weeks are directly affected by the compensation model they are working in [ 14 ], and whether they can be paid through a billable-course-of-care, salary/hourly, a combination of these two arrangements, a contract, or through private fees [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

“…Midwives’ hours of work and on-call weeks are directly affected by their employment status (of an employee or a self-employed midwife), which in turn, affects their entitlement to employment standards legislative coverage (for employees) or exclusion (for self-employed, i.e., independent contractors) [ 15 ]. Hours of work and on-call weeks are directly affected by the compensation model they are working in [ 14 ], and whether they can be paid through a billable-course-of-care, salary/hourly, a combination of these two arrangements, a contract, or through private fees [ 15 ]. In the billable-course-of-care [ 16 ] the payment is offered either directly, by health services of the respective provinces, or indirectly, through transfer payment agencies [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

“…When midwives provide occasional care in hospitals or use their midwifery training to improve access to care or other needs of the communities, there can be salary or fee-for-service funding to compensate work that falls outside the definition of a billable-course-of-care [ 19 ]. Midwives paid through private fees receive direct payment for a billable-course-of-care from their clients [ 15 ]. Therefore, depending on the compensation model employed in, midwives across Canada may have different ways in which they are reimbursed (or not reimbursed) for the amount of time they spend caring for their clients.…”

Section: Introductionmentioning

confidence: 99%

“…Empirical research on midwives in Canada presents above discussed various employment models, practice organizations, and compensation [ 14 – 19 ], the need for midwives’ integration into the healthcare system [ 23 ], burnout and occupational stress affecting midwives’ intention to leave the profession [ 2 ], and the alignment of actual and preferred employment policies contributing to Canadian midwives’ job satisfaction and intention to stay in the profession [ 15 ]. In other empirical studies elsewhere, long hours of work and on-call week are found to be significant factors in midwives’ intention to leave the profession [ 9 , 24 , 25 ].…”

Section: Introductionmentioning

confidence: 99%

“…Using the integrative theoretical model of the retention process [ 22 ], and the knowledge gained from the empirical literature on midwives’ work and intention to stay in the profession [ 2 , 9 , 14 , 15 , 24 – 30 ] we develop the conceptual model of this study for Canadian midwives, and test the relationships between ‘met preferences’ for policies and guidelines which limit the hours of work and weeks per year preferred to be on call, and intention to stay in the profession (see Fig. 1 ).…”

Section: Introductionmentioning

confidence: 99%

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Hours of work and on-call weeks preferences of Canadian midwives: relationships with intention to stay in the profession

Zeytinoglu

Sayin

Neiterman

et al. 2022

BMC Health Serv Res

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Background Midwives have long workdays and work many weeks on call. There is a concern that these extended work schedules can negatively affect their intention to stay in the profession. Purpose This study provides evidence on Canadian midwives’ preferences for and experiences with policies and guidelines which limit the hours of work and weeks per year preferred to be on call, and examines the relationship between preferences and midwives’ intention to stay in the profession. Methods Data come from our 2018 pan-Canadian survey of midwives. Descriptive statistics of 720 midwives’ preferences and experiences are provided. In the correlations followed by the OLS regressions, 596 midwives’ data are used to test the associations between preferences and intention to stay in the profession. STATA (version 15) is used. A thematic analysis of 274 midwives’ responses to the open-ended survey question is conducted to give voice to midwives on what can be done for retention. Results Three quarters of the 720 respondents prefer policies and guidelines to limit hours of work in a 24-hour period, though less than half have policies and guidelines on hours of work. More than half prefer to have fewer on-call weeks or never to be on call, less than a third prefer same number of on-call weeks, and only 2% prefer more weeks to be on call. Midwives are currently working on average 33 weeks per year on call. OLS regression analysis shows that ‘met preference’ for hours of work and on-call weeks are positively associated with intention to stay. In responding to the open-ended survey question, midwives recommend limiting the consecutive hours of work and on-call weeks to manageable hours and weeks to retain them in the profession. Conclusion Midwives whose preferences are met are the ones intending to stay in the profession. There is, however, a large number of midwives with ‘unmet needs’ preferring to have policies and guidelines to limit the hours but do not have that currently, and would like to work fewer weeks on call than currently. These are the midwives who are not intending to stay in the profession.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Hours of work and on-call weeks preferences of Canadian midwives: relationships with intention to stay in the profession

Zeytinoglu

Sayin

Neiterman

et al. 2022

BMC Health Serv Res

Self Cite

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Differential Relationships Between Work-Life Interface Constructs and Intention to Stay in or Leave the Profession: Evidence From Midwives in Canada

et al. 2022

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This paper investigates how positive and negative work-personal life interface constructs are differentially associated with intentions to stay in or leave the profession. The findings help map work-personal life interface constructs on the typology of determinants of intention to stay and intention to leave (disengagers, retainers, criticals, and neutrals). The ordered logistic regression (ologit) modelling of cross-sectional data from a representative sample ( n = 601) of midwives in Canada shows that work interference with personal life is a disengager, which has a stronger association with intention to leave than with intention to stay in the profession. Among the work-personal life interface constructs, work enhancement of personal life seems to be the most critical determinant, showing the most substantive association with both intention to stay and intention to leave. This finding suggests that interventions to increase midwives’ intention to stay and decrease their intention to leave should focus on amplifying the enhancing effects of working on midwives’ personal lives. Interventions that aim to reduce work interference with personal life might be more effective in decreasing intention to leave the profession than increasing intention to stay.

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Individual, Work, and Financial Factors on Job Satisfaction and Remaining as a Midwife

Widyayu,

Amarta,

Wulandari

et al. 2023

IJOSH

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Introduction: The delivery of health services at mother and child hospitals involves the midwife’s role. Midwives are more responsible for providing patient care when faced with high Bed Occupation Rate (BOR) situations and emergency cases. However, several factors can affect midwives’ turnover rates in hospitals. Purpose: This study aimed to analyze the relationship between individual factors (age, marital status, education level, years of service, and employment status), work factors (workload, work environment, and work stress), and financial compensation on job satisfaction and intention to leave midwives as well as recommendations for reducing turnover rates. Methods: This study was conducted at the Trisna Medika Women and Children Hospital, Tulungagung, Indonesia, in April 2022. The questionnaires were distributed to 65 respondents. The research results were analyzed using the partial least squares (PLS)Structural Equation Model (SEM) method. Results: Individual factors had no significant effect on job satisfaction or intention to leave. The variables that directly affect the intention to leave (medium) are workload, financial compensation (strong), and job satisfaction (medium). Job satisfaction is directly affected (moderately) by financial compensation and work stress. The indirect effect shows a significant relationship between job stress and job satisfaction in the work environment. Conclusion: The direct effect of financial compensation on intention to leave was stronger than the effect of financial compensation on job satisfaction.

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Does an alignment of employment policies and individual preferences affect intention to stay in the profession? Evidence from Canadian Midwives

Cited by 6 publications

References 48 publications

Hours of work and on-call weeks preferences of Canadian midwives: relationships with intention to stay in the profession

Hours of work and on-call weeks preferences of Canadian midwives: relationships with intention to stay in the profession

Differential Relationships Between Work-Life Interface Constructs and Intention to Stay in or Leave the Profession: Evidence From Midwives in Canada

Individual, Work, and Financial Factors on Job Satisfaction and Remaining as a Midwife

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