Original Research

A comparative analysis of the antecedents and consequences of employee satisfaction for urban and rural healthcare workers in KwaZulu-Natal province, South Africa

Brian Tawana, Nicolene E. Barkhuizen, Yvonne du Plessis
SA Journal of Human Resource Management | Vol 17 | a1080 | DOI: https://doi.org/10.4102/sajhrm.v17i0.1080 | © 2019 Brian Tawana, Nicolene E. Barkhuizen, Yvonne du Plessis | This work is licensed under CC Attribution 4.0
Submitted: 23 May 2018 | Published: 29 November 2019

About the author(s)

Brian Tawana, NWU Business School, North-West University, Mahikeng, South Africa
Nicolene E. Barkhuizen, Global Innovative Forefront Talent Research Niche Area, North-West University, Mahikeng, South Africa
Yvonne du Plessis, NWU Business School, North-West University, Mahikeng, South Africa


Orientation: The South African healthcare industry is facing significant challenges to retain quality healthcare professionals to deliver services in rural areas.

Research purpose: The main purpose of this study was to compare the antecedents and consequences of employee satisfaction for healthcare professionals in urban and rural areas to establish if there are distinguishing factors that can better inform human resource (HR) management to improve job satisfaction and service delivery. KwaZulu-Natal province was chosen because of its number and proximity of rural and urban healthcare facilities.

Motivation for the study: A holistic perspective, focusing on both urban and rural South African settings, on how the healthcare sector can retain healthcare workers through employee satisfaction and service delivery is lacking.

Research approach/design and method: The research design for the study is a mixed-method sequential design. A quantitative survey using a structured questionnaire inclusive of the constructs such as work environment, work satisfaction, job satisfaction, employee retention and service quality was administered to a sample of urban and rural healthcare professionals in KwaZulu-Natal (N = 405). In addition, the researchers conducted three focus group discussions (N = 28).

Main findings: The quantitative results showed that urban and rural sample groups differed significantly in terms of their satisfaction with work duties, compensation, career development, service delivery and turnover intentions. Communalism was found to play a major role in retention and quality of service delivery of healthcare professionals in rural settings.

Practical/managerial implications: The findings of this study require from management to understand the differential factors between urban and rural settings in service quality and staff retention. Human resource practitioners are encouraged to understand the differentiators of job satisfaction and service delivery in an urban and rural context and develop conducive work environments that allow healthcare workers to execute their tasks effectively.

Contribution/value-add: This study provides a unique perspective of the antecedents and outcomes of employee satisfaction for both urban and rural healthcare sector workers and indicates that context is important.


career development; employee satisfaction; healthcare; retention; service delivery


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