Management Commitment and Occupational Health and Safety Policy as Correlates of Healthcare Worker Well-Being in Lower-Level Health Centres in Bushenyi District, Uganda
Abstract
Management commitment is the organisational mechanism through which occupational health and safety policies become credible workplace protections, yet evidence from Uganda’s lower-level health facilities remains limited. This study examined the relationship between healthcare workers’ perceptions of management commitment and occupational health and safety policy and their multidimensional well-being in government Health Centre II and Health Centre III facilities in Bushenyi District, Uganda. A cross-sectional convergent mixed-methods design was used. Quantitative data were obtained from 98 of 103 sampled healthcare workers (95.1%), while qualitative data were obtained from 21 of 24 purposively selected healthcare administrators (87.5%). A five-point Likert questionnaire measured management commitment and policy as well as physical, psychological, occupational, and social well-being. Quantitative data were analysed using frequencies, percentages, means, standard deviations, Pearson correlation, and a separate simple linear regression. Interview data were analysed thematically and integrated with the statistical results. All six indicators of management commitment and policy were rated poorly; confidential counselling (M = 1.98, SD = 0.94) and penalty-free mental-health breaks (M = 1.85, SD = 0.88) were especially weak. Perceived management commitment and OHS policy had a strong positive relationship with well-being (r = .748, p < .001) and explained 56.0% of its variance when considered alone (R² = .560, F(1, 96) = 121.94, p < .001). Administrators reported that formal counselling was absent, peer discussion substituted for professional help, and workers feared being labelled weak when disclosing distress. The findings show that written rules are insufficient unless leaders visibly enforce OHS, allocate resources and provide confidential psychosocial support. District and facility managers should establish funded OHS plans, confidential referral pathways, non-stigmatising help-seeking arrangements and documented follow-up to reported concerns.