Ethiopian healthcare workers describe what drives and blocks their productivity

Healthcare professionals in Ethiopia say their productivity depends less on counting outputs than on training, fair incentives, teamwork and adequate resources, according to a qualitative study published in BMC Health Services Research. Using a phenomenological design, researchers interviewed 30 healthcare providers and managers working in ten hospitals across eight regions and city administrations between July 1 and July 23, 2023, aiming to capture how frontline staff themselves experience and interpret the factors that shape their day-to-day work efficiency.

The study, led by Jemal Mohammed Ali and colleagues, used purposive sampling to recruit participants, with each contributing hospital providing one manager and two clinical staff members. Data were collected through in-depth and key informant interviews and analyzed thematically. The phenomenological approach was chosen specifically to move beyond numerical performance measures and understand the lived experiences of health workers in a system where, despite ongoing efforts to improve workforce performance, detailed qualitative insights have been lacking.

Five key themes emerged from the interviews: capacity building, motivation and satisfaction, performance management, work climate, and absenteeism. Within these themes, participants identified continuous professional development opportunities, access to mentoring and coaching support, non-financial incentives, efforts to enhance work environments, and communication as the main facilitators of productivity.

Set against these facilitators were persistent barriers. Respondents pointed to resource constraints, inadequate infrastructure, a lack of transparent decision-making around promotion and recognition, shortages of health professionals, and the absence of a standardized performance appraisal system. Shortages of supplies and equipment, weak performance management systems, poor working conditions, absenteeism and staff turnover were also reported to negatively affect productivity.

A notable finding concerns how the participants defined productivity itself. Rather than equating it with quantitative measures alone, healthcare professionals in the study perceived productivity as closely linked to quality of care, patient outcomes and efficient service delivery. This broader conception suggests that policies judging workforce performance purely on output volumes may miss what frontline workers consider the essential dimensions of their work.

The authors conclude that addressing organizational and system-level challenges through improved workforce support, motivation, infrastructure and professional development may strengthen both productivity and retention of the health workforce in Ethiopia. The findings arrive at a time when countries across sub-Saharan Africa, including Ethiopia, are working to improve the performance of their health workers amid persistent staffing and resource pressures.

Methodologically, the study offers depth rather than breadth. As a phenomenological investigation drawing on 30 interviews in ten hospitals, it reflects the perceptions and lived experiences of the participants interviewed and does not measure productivity outcomes directly. The authors note that the qualitative design allowed a deeper understanding of how professionals experience and interpret workplace factors, but the findings represent reported experiences rather than quantified effects.

For policymakers, the study highlights a practical agenda: expanding training and mentorship, introducing fair and transparent incentive and promotion systems, standardizing performance appraisal, and tackling supply shortages and infrastructure gaps. According to the researchers, such measures could support both the efficiency of service delivery and the ability of Ethiopia’s health system to retain its workforce.

Subject of Research: Qualitative research on facilitators and barriers to healthcare professionals' productivity in Ethiopian hospitals

Article Title: Facilitators and barriers influencing healthcare professionals’ productivity in Ethiopia: a phenomenological study

Article References: Ali, J. M., Abosse, Z., Ayalew, F., Sendekie, T. Y., Shawula, S., Tadesse, T., Asrat, F., Yitayal, M., & Stekelenburg, J. (2026). Facilitators and barriers influencing healthcare professionals’ productivity in Ethiopia: a phenomenological study. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15525-8

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15525-8

Keywords: Ethiopia, health workforce, productivity, qualitative research, phenomenology, hospitals, health services research, motivation, performance management, absenteeism, workforce retention, sub-Saharan Africa