Abstract Background: Job satisfaction among health workers is critical for improving healthcare delivery and staff retention. This study investigated employment-related determinants of job satisfaction among health workers in three deprived districts of Ghana. Methods: We conducted a cross-sectional survey of 200 public-sector health workers in Kwahu Afram Plains North, Kwahu Afram Plains South, and Kwahu East. A structured questionnaire captured socio-demographic characteristics, employment variables, and satisfaction across domains including teamwork, rewards, communication, and working conditions. Descriptive statistics and non-parametric tests assessed group differences. Ordered logistic regression identified predictors of two outcomes: willingness to recommend the facility as a workplace and overall career satisfaction at the facility. Results: Participants were predominantly female (67.5%) and on permanent contracts (98.7%); median age was 32 years. District, age group, and contract type showed significant differences in satisfaction. Compared with Afram Plains North, working in Kwahu East was associated with higher career satisfaction (AOR=2.70; 95% CI: 1.14–6.41). Older age strongly predicted career satisfaction: workers ≥40 years had higher odds than those aged 20–29 (AOR=13.56; 95% CI: 3.71–49.56). Permanent employment was associated with lower satisfaction relative to temporary contracts (career satisfaction AOR=0.05; 95% CI: 0.01–0.44). Satisfaction with rewards (AOR=4.35; 95% CI: 2.23–8.50) and communication (facility recommendation AOR=1.98; 95% CI: 1.23–3.19) were pivotal positive determinants. Sex and marital status were not significantly associated with satisfaction. Conclusions: In Ghana’s deprived districts, comprehensive reward systems and effective workplace communication are central to improving job satisfaction and retention. The inverse association between permanent contracts and satisfaction suggests a need to review employment terms and career development pathways for rural posts. Tailored, context-specific interventions addressing rewards, communication, and progression opportunities may enhance morale and support sustained service delivery in underserved areas
Sedzro et al. (2025) studied this question.