research on microfinance in ethiopia

Microfinance Institutions in Ethiopia: Their Impact, Growth, and Challenges in Financial Inclusion

The financial landscape of Ethiopia has witnessed significant transformations over the years. Among the various financial institutions, Microfinance Institutions (MFIs) have emerged as pivotal players in promoting financial inclusion, especially in rural and urban areas. This article delves into the role of MFIs in Ethiopia's financial ecosystem, their contribution to the Ethiopian economy, and the challenges they face, based on the National Bank of Ethiopia's Quarterly Bulletin for the third quarter of 2022/23.

Microfinance Institutions (MFIs) in Ethiopia

During the third quarter of 2022/23, the number of Micro Finance Institutions (MFIs) in Ethiopia reached 46. These institutions have been instrumental in mobilizing about Birr 24 billion in saving deposits, marking a 16.9% annual growth. This growth rate underscores the increasing trust and reliance of the Ethiopian populace on MFIs for their financial needs.

Furthermore, the total outstanding credit of these institutions witnessed a surge of 25.8%, reaching Birr 36.3 billion. This growth is a testament to the expanding reach of MFIs and their role in providing credit facilities to individuals and businesses, thereby fostering economic activities and development.

Growing Role in Financial Inclusion

The data from the National Bank of Ethiopia's Quarterly Bulletin highlights the growing role of MFIs in providing access to finance and promoting financial inclusion in both rural and urban areas. Their total assets also saw a significant rise, growing by 26.8% to stand at Birr 51.5 billion.

Financial inclusion is not just about providing banking services but ensuring that these services are accessible and affordable to all individuals, irrespective of their income level. MFIs in Ethiopia have been successful in bridging the gap between the formal banking sector and the unbanked or underbanked population.

Challenges Faced by MFIs

While the growth and contribution of MFIs to the Ethiopian economy are commendable, they are not without challenges. The report, however, does not delve into the specific challenges faced by MFIs in this quarter. It would be essential to consider factors such as regulatory constraints, competition from formal banking institutions, and the need for technological advancements in subsequent parts of this article.

The Financial Landscape and MFIs

The financial landscape of a country is often shaped by various factors, including its economic policies, regulatory environment, and the institutions that operate within it. In Ethiopia, while the National Bank plays a pivotal role in shaping the financial ecosystem, Microfinance Institutions (MFIs) have emerged as significant contributors to financial inclusion.

Electric Power Generation and MFIs

One of the indicators of a country's economic growth and development is its power generation capacity. During the third quarter of 2022/23, Ethiopia generated about 4.6 billion KWH of electric power, marking a 20.4% increase from the previous year. This growth was primarily attributed to a 21.8% rise in electric production from hydropower sources.

Such growth in power generation indicates a thriving industrial and commercial sector, which invariably leads to increased financial activities. MFIs, with their focus on rural and semi-urban areas, can leverage this growth by providing financial services to businesses and individuals involved in these sectors.

Challenges in the Energy Sector and Implications for MFIs

While the energy sector's growth is commendable, it's essential to understand the challenges it faces, as these can indirectly impact MFIs. For instance, fluctuations in the prices of petroleum products can influence transportation costs, which in turn can affect the operational costs of MFIs, especially those operating in remote areas.

During the third quarter of 2022/23, the average retail price of fuel in Addis Ababa rose to Birr 73 per liter from Birr 45.2 per liter a year ago, marking a 61.3% annual increase. Such significant price hikes can strain the operational budgets of MFIs, potentially leading to increased interest rates for borrowers.

Regional Inflation and Its Implications for MFIs

Inflation, both at the national and regional levels, can have profound implications for the financial sector, including MFIs. During the third quarter of 2022/23, the regional average headline inflation increased to 6.8%, up from 6% in the preceding quarter and 5.7% in the same quarter of the previous year. Regions such as Harari, Addis Ababa, Afar, Dire Dawa, and Benishangul Gumuz experienced inflation rates higher than the regional average. The highest inflation was recorded in Harari at 10.22%, while the lowest was in Somali at 3.98%.

Such variations in inflation rates across regions can impact the lending and borrowing activities of MFIs. High inflation can erode the real value of savings, making it less attractive for individuals to save. On the lending side, MFIs might be compelled to increase interest rates to compensate for the reduced purchasing power of money, making borrowing more expensive for clients.

Monetary Developments and Implications for MFIs

The broad money supply (M2) saw a significant expansion of 30.1% annually, reaching Birr 2.06 trillion by the end of the third quarter of 2022/23. This growth was primarily attributed to a 28.5% increase in domestic credit. Such expansions in the money supply can lead to increased liquidity in the economy, which can be both an opportunity and a challenge for MFIs.

Increased liquidity means that there's more money available for lending, which MFIs can capitalize on. However, if this liquidity is not matched with a corresponding increase in investment opportunities, it can lead to inflationary pressures. For MFIs, this means they need to strike a balance between expanding their loan portfolios and ensuring that these loans are productive and can generate returns for borrowers.

Interest Rate Developments

Interest rates play a crucial role in the financial decisions of both individuals and institutions. For the period in review, both the average savings deposit rate and lending rate remained stable at 8.0% and 14.3% respectively. The weighted average time deposit rate was at 7.7%. Stable interest rates can provide a predictable environment for MFIs to operate in, allowing them to plan their lending and borrowing activities more effectively.

Federal Government Fiscal Operations and Implications for MFIs

The fiscal operations of a country can have indirect implications for the financial sector, including MFIs. During the third quarter of 2022/23, the Federal government collected a total revenue and grants amounting to Birr 87.7 billion, marking an 11.1% annual growth. However, the government expenditure stood at Birr 164.3 billion, indicating a 5.6% annual decline. This resulted in an overall fiscal balance (including grants) depicting a deficit of Birr 76.5 billion for the review period.

Such fiscal deficits can lead to increased borrowing by the government, which might crowd out the private sector, including MFIs, from accessing credit. This can potentially increase the cost of borrowing for MFIs and limit their capacity to extend credit to their clients.

Investment Landscape

Investment is a critical driver of economic growth and can influence the demand for financial services. During the third quarter of 2022/23, 9 investment projects with an investment capital of Birr 132.6 million became operational. However, both the number of investment projects and the investment capital showed a decline compared to the previous year, with a 79.1% and 68.5% decrease, respectively.

A slowdown in investment activities can lead to reduced demand for credit, impacting the loan portfolios of MFIs. It also indicates a cautious approach by investors, possibly due to economic uncertainties or other challenges.

Microfinance Institutions in Ethiopia have played a significant role in promoting financial inclusion, especially in underserved areas. Their contribution to the Ethiopian economy is evident in their expanding portfolios and growing customer base. However, like all financial institutions, MFIs operate in a dynamic environment influenced by various macroeconomic factors. Understanding these factors and adapting to them is crucial for MFIs to continue their pivotal role in Ethiopia's financial landscape.

Don't miss out on the latest updates, exclusive insights, and more! Sign up for our newsletter now and be part of our informed community.

Please provide valid email address

Some thing went wrong. Please try again

Thank you for subscribing to our newsletter! You've successfully been added to our mailing list. Stay tuned for the latest updates, news, and exclusive content. We're excited to stay connected with you!

MELSpace Home
Monitoring, Evaluation & Learning Repository
Agricultural Research Knowledge

Ethiopian Micro-Finance Landscape Report

Date Issued

Collections

Agricultural Research Knowledge [12884]

Author(s) ORCID(s)

Agrovoc keywords.

Mission & vision
Strategic Plan
Board of Trustees
Director General
Our Research Experts
Donors and Partners
Annual Reports
Climate Smart Crops
Agrosilvopastoral Systems
Soil Water and Agronomy
Capacity Development
Empowering women and youth
Open Access
Monitoring, Evaluation, and Learning (MEL)
Focused Identification of Germplasm Strategy (FIGS)
Improving Farmers' Livelihoods
INTERNATIONAL NURSERIES
Promoting value chains and policies
ICARDA Genebanks
Integrated Desert Farming
Research Projects
CWANA & Middle East
United Arab Emirates (UAE)
Afghanistan
Central Asia & Caucasus
Publications & Resources
Innovations
In The Media
Latest News
Country Offices
Newsletter Signup

Publications and Resources

Ethiopian Micro-Finance Landscape Report

Finance is one of the key elements addressing development issues in Ethiopia. It plays a leading role in guiding development interventions in the country. Development strategies or programs (poverty reduction strategy, rural development strategy) require finance and financial systems to support implementation. To develop an inclusive financial system in the region, there is a need to have well-functioning financial system and institutions in place. In order to increase outreach, expansion of branches, efficiency, inclusiveness, appropriateness, innovations and sustainability, there is a need for interventions/support by banks, microfinance and RUSSACOs/SACCOS providers.

This assessment focuses on the landscape and performance of microfinances (MFIs) in Ethiopia. Microfinance refers to a broad range of financial services made available to low-income clients, particularly women. The services include loans, saving, insurance, and remittance. The clients of microfinance institutions (MFI), largely belonging to low income households, have limited access to formal financial services. MFIs serve a market segment that is considered ‘high-risk’ by formal banks. Small households have fluctuating incomes, few assets and require very small loans, a high degree of close follow-up and business appraisal. Financial transactions with this client base calls for careful appraisal and close post-disbursement follow-up. MFIs offer much needed financial service mainly to the informal sector which would otherwise depend on exploitative moneylenders.

Stay Informed

The Role Of Microfinance In Poverty Reduction: The Case of Specialized Financial Promotion Institute (SFPI)

Journal title, journal issn, volume title, description, collections.

Systematic Review
Open access
Published: 24 May 2024

Turnover intention and its associated factors among nurses in Ethiopia: a systematic review and meta-analysis

Eshetu Elfios 1 ,
Israel Asale 1 ,
Merid Merkine 1 ,
Temesgen Geta 1 ,
Kidist Ashager 1 ,
Getachew Nigussie 1 ,
Ayele Agena 1 ,
Bizuayehu Atinafu 1 ,
Eskindir Israel 2 &
Teketel Tesfaye 3

BMC Health Services Research volume 24 , Article number: 662 ( 2024 ) Cite this article

325 Accesses

Metrics details

Nurses turnover intention, representing the extent to which nurses express a desire to leave their current positions, is a critical global public health challenge. This issue significantly affects the healthcare workforce, contributing to disruptions in healthcare delivery and organizational stability. In Ethiopia, a country facing its own unique set of healthcare challenges, understanding and mitigating nursing turnover are of paramount importance. Hence, the objectives of this systematic review and meta-analysis were to determine the pooled proportion ofturnover intention among nurses and to identify factors associated to it in Ethiopia.

A comprehensive search carried out for studies with full document and written in English language through an electronic web-based search strategy from databases including PubMed, CINAHL, Cochrane Library, Embase, Google Scholar and Ethiopian University Repository online. Checklist from the Joanna Briggs Institute (JBI) was used to assess the studies’ quality. STATA version 17 software was used for statistical analyses. Meta-analysis was done using a random-effects method. Heterogeneity between the primary studies was assessed by Cochran Q and I-square tests. Subgroup and sensitivity analyses were carried out to clarify the source of heterogeneity.

This systematic review and meta-analysis incorporated 8 articles, involving 3033 nurses in the analysis. The pooled proportion of turnover intention among nurses in Ethiopia was 53.35% (95% CI (41.64, 65.05%)), with significant heterogeneity between studies (I 2 = 97.9, P = 0.001). Significant association of turnover intention among nurses was found with autonomous decision-making (OR: 0.28, CI: 0.14, 0.70) and promotion/development (OR: 0.67, C.I: 0.46, 0.89).

Conclusion and recommendation

Our meta-analysis on turnover intention among Ethiopian nurses highlights a significant challenge, with a pooled proportion of 53.35%. Regional variations, such as the highest turnover in Addis Ababa and the lowest in Sidama, underscore the need for tailored interventions. The findings reveal a strong link between turnover intention and factors like autonomous decision-making and promotion/development. Recommendations for stakeholders and concerned bodies involve formulating targeted retention strategies, addressing regional variations, collaborating for nurse welfare advocacy, prioritizing career advancement, reviewing policies for nurse retention improvement.

Peer Review reports

Turnover intention pertaining to employment, often referred to as the intention to leave, is characterized by an employee’s contemplation of voluntarily transitioning to a different job or company [ 1 ]. Nurse turnover intention, representing the extent to which nurses express a desire to leave their current positions, is a critical global public health challenge. This issue significantly affects the healthcare workforce, contributing to disruptions in healthcare delivery and organizational stability [ 2 ].

The global shortage of healthcare professionals, including nurses, is an ongoing challenge that significantly impacts the capacity of healthcare systems to provide quality services [ 3 ]. Nurses, as frontline healthcare providers, play a central role in patient care, making their retention crucial for maintaining the functionality and effectiveness of healthcare delivery. However, the phenomenon of turnover intention, reflecting a nurse’s contemplation of leaving their profession, poses a serious threat to workforce stability [ 4 ].

Studies conducted globally shows that high turnover rates among nurses in several regions, with notable figures reported in Alexandria (68%), China (63.88%), and Jordan (60.9%) [ 5 , 6 , 7 ]. In contrast, Israel has a remarkably low turnover rate of9% [ 8 ], while Brazil reports 21.1% [ 9 ], and Saudi hospitals26% [ 10 ]. These diverse turnover rates highlight the global nature of the nurse turnover phenomenon, indicating varying degrees of workforce mobility in different regions.

The magnitude and severity of turnover intention among nurses worldwide underscore the urgency of addressing this issue. High turnover rates not only disrupt healthcare services but also result in a loss of valuable skills and expertise within the nursing workforce. This, in turn, compromises the continuity and quality of patient care, with potential implications for patient outcomes and overall health service delivery [ 11 ]. Extensive research conducted worldwide has identified a range of factors contributing to turnover intention among nurses [ 11 , 12 , 13 , 14 , 15 , 16 , 17 ]. These factors encompass both individual and organizational aspects, such as high workload, inadequate support, limited career advancement opportunities, job satisfaction, conflict, payment or reward, burnout sense of belongingness to their work environment. The complex interplay of these factors makes addressing turnover intention a multifaceted challenge that requires targeted interventions.

In Ethiopia, a country facing its own unique set of healthcare challenges, understanding and mitigating nursing turnover are of paramount importance. The healthcare system in Ethiopia grapples with issues like resource constraints, infrastructural limitations, and disparities in healthcare access [ 18 ]. Consequently, the factors influencing nursing turnover in Ethiopia may differ from those in other regions. Previous studies conducted in the Ethiopian context have started to unravel some of these factors, emphasizing the need for a more comprehensive examination [ 18 , 19 ].

Although many cross-sectional studies have been conducted on turnover intention among nurses in Ethiopia, the results exhibit variations. The reported turnover intention rates range from a minimum of 30.6% to a maximum of 80.6%. In light of these disparities, this systematic review and meta-analysis was undertaken to ascertain the aggregated prevalence of turnover intention among nurses in Ethiopia. By systematically analyzing findings from various studies, we aimed to provide a nuanced understanding of the factors influencing turnover intention specific to the Ethiopian healthcare context. Therefore, this systematic review and meta-analysis aimed to answer the following research questions.

What is the pooled prevalence of turnover intention among nurses in Ethiopia?

What are the factors associated with turnover intention among nurses in Ethiopia?

The primary objective of this review was to assess the pooled proportion of turnover intention among nurses in Ethiopia. The secondary objective was identifying the factors associated to turnover intention among nurses in Ethiopia.

Study design and search strategy

A comprehensive systematic review and meta-analysis was conducted, examining observational studies on turnover intention among nurses in Ethiopia. The procedure for this systematic review and meta-analysis was developed in accordance with the Preferred Reporting Items for Systematic review and Meta-analysis Protocols (PRISMA-P) statement [ 20 ]. PRISMA-2015 statement was used to report the findings [ 21 , 22 ]. This systematic review and meta-analysis were registered on PROSPERO with the registration number of CRD42024499119.

We conducted systematic and an extensive search across multiple databases, including PubMed, CINAHL, Cochrane Library, Embase, Google Scholar and Ethiopian University Repository online to identify studies reporting turnover intention among nurses in Ethiopia. We reviewed the database available at http://www.library.ucsf.edu and the Cochrane Library to ensure that the intended task had not been previously undertaken, preventing any duplication. Furthermore, we screened the reference lists to retrieve relevant articles. The process involved utilizing EndNote (version X8) software for downloading, organizing, reviewing, and citing articles. Additionally, a manual search for cross-references was performed to discover any relevant studies not captured through the initial database search. The search employed a comprehensive set of the following search terms:“prevalence”, “turnover intention”, “intention to leave”, “attrition”, “employee attrition”, “nursing staff turnover”, “Ethiopian nurses”, “nurses”, and “Ethiopia”. These terms were combined using Boolean operators (AND, OR) to conduct a thorough and systematic search across the specified databases.

Eligibility criteria

Inclusion criteria.

The established inclusion criteria for this meta-analysis and systematic review are as follows to guide the selection of articles for inclusion in this review.

Population: Nurses working in Ethiopia.

Study period: studies conducted or published until 23November 2023.

Study design: All observational study designs, such as cross-sectional, longitudinal, and cohort studies, were considered.

Setting: Only studies conducted in Ethiopia were included.

Outcome; turnover intention.

Study: All studies, whether published or unpublished, in the form of journal articles, master’s theses, and dissertations, were included up to the final date of data analysis.

Language: This study exclusively considered studies in the English language.

Exclusion criteria

Excluded were studies lacking full text or Studies with a Newcastle–Ottawa Quality Assessment Scale (NOS) score of 6 or less. Studies failing to provide information on turnover intention among nurses or studies for which necessary details could not be obtained were excluded. Three authors (E.E., T.G., K.A) independently assessed the eligibility of retrieved studies, other two authors (E.I & M.M) input sought for consensus on potential in- or exclusion.

Quality assessment and data extraction

Two authors (E.E, A.A, G.N) independently conducted a critical appraisal of the included studies. Joanna Briggs Institute (JBI) checklists of prevalence study was used to assess the quality of the studies. Studies with a Newcastle–Ottawa Quality Assessment Scale (NOS) score of seven or more were considered acceptable [ 23 ]. The tool has nine parameters, which have yes, no, unclear, and not applicable options [ 24 ]. Two reviewers (I.A, B.A) were involved when necessary, during the critical appraisal process. Accordingly, all studies were included in our review. ( Table 1 ) Questions to evaluate the methodological quality of studies on turnover intention among nurses and its associated factors in Ethiopia are the followings:

Q1 = was the sample frame appropriate to address the target population?

Q2. Were study participants sampled appropriately.

Q3. Was the sample size adequate?

Q4. Were the study subjects and the setting described in detail?

Q5. Was the data analysis conducted with sufficient coverage of the identified sample?

Q6. Were the valid methods used for the identification of the condition?

Q7. Was the condition measured in a standard, reliable way for all participants?

Q8. Was there appropriate statistical analysis?

Q9. Was the response rate adequate, and if not, was the low response rate.

managed appropriately?

Data was extracted and recorded in a Microsoft Excel as guided by the Joanna Briggs Institute (JBI) data extraction form for observational studies. Three authors (E.E, M.G, T.T) independently conducted data extraction. Recorded data included the first author’s last name, publication year, study setting or country, region, study design, study period, sample size, response rate, population, type of management, proportion of turnover intention, and associated factors. Discrepancies in data extraction were resolved through discussion between extractors.

Data processing and analysis

Data analysis procedures involved importing the extracted data into STATA 14 statistical software for conducting a pooled proportion of turnover intention among nurses. To evaluate potential publication bias and small study effects, both funnel plots and Egger’s test were employed [ 25 , 26 ]. We used statistical tests such as the I statistic to quantify heterogeneity and explore potential sources of variability. Additionally, subgroup analyses were conducted to investigate the impact of specific study characteristics on the overall results. I 2 values of 0%, 25%, 50%, and 75% were interpreted as indicating no, low, medium, and high heterogeneity, respectively [ 27 ].

To assess publication bias, we employed several methods, including funnel plots and Egger’s test. These techniques allowed us to visually inspect asymmetry in the distribution of study results and statistically evaluate the presence of publication bias. Furthermore, we conducted sensitivity analyses to assess the robustness of our findings to potential publication bias and other sources of bias.

Utilizing a random-effects method, a meta-analysis was performed to assess turnover intention among nurses, employing this method to account for observed variability [ 28 ]. Subgroup analyses were conducted to compare the pooled magnitude of turnover intention among nurses and associated factors across different regions. The results of the pooled prevalence were visually presented in a forest plot format with a 95% confidence interval.

Study selection

After conducting the initial comprehensive search concerning turnover intention among nurses through Medline, Cochran Library, Web of Science, Embase, Ajol, Google Scholar, and other sources, a total of 1343 articles were retrieved. Of which 575 were removed due to duplication. Five hundred ninety-three articles were removed from the remaining 768 articles by title and abstract. Following theses, 44 articles which cannot be retrieved were removed. Finally, from the remaining 131 articles, 8 articles with a total 3033 nurses were included in the systematic review and meta-analysis (Fig. 1 ).

PRISMA flow diagram of the selection process of studies on turnover intention among nurses in Ethiopia, 2024

Study characteristics

All included 8 studies had a cross-sectional design and of which, 2 were from Tigray region, 2 were from Addis Ababa(Capital), 1 from south region, 1 from Amhara region, 1 from Sidama region, and 1 was multiregional and Nationwide. The prevalence of turnover intention among nurses ‘ranges from 30.6 to 80.6%. Table 2 .

Pooled prevalence of turnover intention among nurses in Ethiopia

Our comprehensive meta-analysis revealed a notable turnover intention rate of 53.35% (95% CI: 41.64, 65.05%) among Ethiopian nurses, accompanied by substantial heterogeneity between studies (I 2 = 97.9, P = 0.000) as depicted in Fig. 2 . Given the observed variability, we employed a random-effects model to analyze the data, ensuring a robust adjustment for the significant heterogeneity across the included studies.

Forest plot showing the pooled proportion of turnover intention among nurses in Ethiopia, 2024

Subgroup analysis of turnover intention among nurses in Ethiopia

To address the observed heterogeneity, we conducted a subgroup analysis based on regions. The results of the subgroup analysis highlighted considerable variations, with the highest level of turnover intention identified in Addis Ababa at 69.10% (95% CI: 46.47, 91.74%) and substantial heterogeneity (I 2 = 98.1%). Conversely, the Sidama region exhibited the lowest level of turnover intention among nurses at 30.6% (95% CI: 25.18, 36.02%), accompanied by considerable heterogeneity (I 2 = 100.0%) ( Fig. 3 ).

Subgroup analysis of systematic review and meta-analysis by region of turnover intention among nurses in Ethiopia, 2024

Publication bias of turnover intention among nurses in Ethiopia

The Egger’s test result ( p = 0.64) is not statistically significant, indicating no evidence of publication bias in the meta-analysis (Table 3 ). Additionally, the symmetrical distribution of included studies in the funnel plot (Fig. 4 ) confirms the absence of publication bias across studies.

Funnel plot of systematic review and meta-analysis on turnover intention among nurses in Ethiopia, 2024

Sensitivity analysis

The leave-out-one sensitivity analysis served as a meticulous evaluation of the influence of individual studies on the comprehensive pooled prevalence of turnover intention within the context of Ethiopian nurses. In this systematic process, each study was methodically excluded from the analysis one at a time. The outcomes of this meticulous examination indicated that the exclusion of any particular study did not lead to a noteworthy or statistically significant alteration in the overall pooled estimate of turnover intention among nurses in Ethiopia. The findings are visually represented in Fig. 5 , illustrating the stability and robustness of the overall pooled estimate even with the removal of specific studies from the analysis.

Sensitivity analysis of pooled prevalence for each study being removed at a time for systematic review and meta-analysis of turnover intention among nurses in Ethiopia

Factors associated with turnover intention among nurses in Ethiopia

In our meta-analysis, we comprehensively reviewed and conducted a meta-analysis on the determinants of turnover intention among nurses in Ethiopia by examining eight relevant studies [ 6 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ]. We identified a significant association between turnover intention with autonomous decision-making (OR: 0.28, CI: 0.14, 0.70) (Fig. 6 ) and promotion/development (OR: 0.67, CI: 0.46, 0.89) (Fig. 7 ). In both instances, the odds ratios suggest a negative association, signifying that increased levels of autonomous decision-making and promotion/development were linked to reduced odds of turnover intention.

Forest plot of the association between autonomous decision making with turnover intention among nurses in Ethiopia2024

Forest plot of the association between promotion/developpment with turnover intention among nurses in Ethiopia, 2024

In our comprehensive meta-analysis exploring turnover intention among nurses in Ethiopia, our findings revealed a pooled proportion of turnover intention at 53.35%. This significant proportion warrants a comparative analysis with turnover rates reported in other global regions. Distinct variations emerge when compared with turnover rates in Alexandria (68%), China (63.88%), and Jordan (60.9%) [ 5 , 6 , 7 ]. This comparison highlights that the multifaceted nature of turnover intention, influenced by diverse contextual, cultural, and organizational factors. Conversely, Ethiopia’s turnover rate among nurses contrasts with substantially lower figures reported in Israel (9%) [ 8 ], Brazil (21.1%) [ 9 ], and Saudi hospitals (26%) [ 10 ]. Challenges such as work overload, economic constraints, limited promotional opportunities, lack of recognition, and low job rewards are more prevalent among nurses in Ethiopia, contributing to higher turnover intention compared to their counterparts [ 7 , 29 , 36 ].

The highest turnover intention was observed in Addis Ababa, while Sidama region displayed the lowest turnover intention among nurses, These differences highlight the complexity of turnover intention among Ethiopian nurses, showing the importance of specific interventions in each region to address unique factors and improve nurses’ retention.

Our systematic review and meta-analysis in the Ethiopian nursing context revealed a significant inverse association between turnover intention and autonomous decision-making. The odd of turnover intention is approximately reduced by 72% in employees with autonomous decision-making compared to those without autonomous decision-making. This finding was supported by other similar studies conducted in South Africa, Tanzania, Kenya, and Turkey [ 37 , 38 , 39 , 40 ].

The significant association of turnover intention with promotion/development in our study underscores the crucial role of career advancement opportunities in alleviating turnover intention among nurses. Specifically, our analysis revealed that individuals with promotion/development had approximately 33% lower odds of turnover intention compared to those without such opportunities. These results emphasize the pivotal influence of organizational support in shaping the professional environment for nurses, providing substantive insights for the formulation of evidence-based strategies targeted at enhancing workforce retention. This finding is in line with former researches conducted in Taiwan, Philippines and Italy [ 41 , 42 , 43 ].

Our meta-analysis on turnover intention among Ethiopian nurses reveals a considerable challenge, with a pooled proportion of 53.35%. Regional variations highlight the necessity for region-specific strategies, with Addis Ababa displaying the highest turnover intention and Sidama region the lowest. A significant inverse association was found between turnover intention with autonomous decision-making and promotion/development. These insights support the formulation of evidence-based strategies and policies to enhance nurse retention, contributing to the overall stability of the Ethiopian healthcare system.

Recommendations

Federal ministry of health (fmoh).

The FMoH should consider the regional variations in turnover intention and formulate targeted retention strategies. Investment in professional development opportunities and initiatives to enhance autonomy can be integral components of these strategies.

Ethiopian nurses association (ENA)

ENA plays a pivotal role in advocating for the welfare of nurses. The association is encouraged to collaborate with healthcare institutions to promote autonomy, create mentorship programs, and advocate for improved working conditions to mitigate turnover intention.

Healthcare institutions

Hospitals and healthcare facilities should prioritize the provision of career advancement opportunities and recognize the value of professional autonomy in retaining nursing staff. Tailored interventions based on regional variations should be considered.

Policy makers

Policymakers should review existing healthcare policies to identify areas for improvement in nurse retention. Policy changes that address challenges such as work overload, limited promotional opportunities, and economic constraints can positively impact turnover rates.

Future research initiatives

Further research exploring the specific factors contributing to turnover intention in different regions of Ethiopia is recommended. Understanding the nuanced challenges faced by nurses in various settings will inform the development of more targeted interventions.

Strength and limitations

Our systematic review and meta-analysis on nurse turnover intention in Ethiopia present several strengths. The comprehensive inclusion of diverse studies provides a holistic view of the issue, enhancing the generalizability of our findings. The use of a random-effects model accounts for potential heterogeneity, ensuring a more robust and reliable synthesis of data.

However, limitations should be acknowledged. The heterogeneity observed across studies, despite the use of a random-effects model, may impact the precision of the pooled estimate. These considerations should be taken into account when interpreting and applying the results of our analysis.

Data availability

Data set used on this analysis will available from corresponding author upon reasonable request.

Abbreviations

Ethiopian Nurses Association

Federal Ministry of Health

Joanna Briggs Institute

Preferred Reporting Items for Systematic review and Meta-analysis Protocols

Kanchana L, Jayathilaka R. Factors impacting employee turnover intentions among professionals in Sri Lankan startups. PLoS ONE. 2023;18(2):e0281729.

Article CAS PubMed PubMed Central Google Scholar

Boateng AB, et al. Factors influencing turnover intention among nurses and midwives in Ghana. Nurs Res Pract. 2022;2022:4299702.

PubMed PubMed Central Google Scholar

Organization WH. WHO Guideline on Health Workforce Development Attraction, Recruitment and Retention in Rural and Remote Areas, 2021, pp. 1-104.

Hayes LJ, et al. Nurse turnover: a literature review. Int J Nurs Stud. 2006;43(2):237–63.

Article PubMed Google Scholar

Yang H, et al. Validation of work pressure and associated factors influencing hospital nurse turnover: a cross-sectional investigation in Shaanxi Province, China. BMC Health Serv Res. 2017;17:1–11.

Article Google Scholar

Ayalew E et al. Nurses’ intention to leave their job in sub-Saharan Africa: A systematic review and meta-analysis. Heliyon, 2021. 7(6).

Al Momani M. Factors influencing public hospital nurses’ intentions to leave their current employment in Jordan. Int J Community Med Public Health. 2017;4(6):1847–53.

DeKeyser Ganz F, Toren O. Israeli nurse practice environment characteristics, retention, and job satisfaction. Isr J Health Policy Res. 2014;3(1):1–8.

de Oliveira DR, et al. Intention to leave profession, psychosocial environment and self-rated health among registered nurses from large hospitals in Brazil: a cross-sectional study. BMC Health Serv Res. 2017;17(1):21.

Article PubMed PubMed Central Google Scholar

Dall’Ora C, et al. Association of 12 h shifts and nurses’ job satisfaction, burnout and intention to leave: findings from a cross-sectional study of 12 European countries. BMJ Open. 2015;5(9):e008331.

Lu H, Zhao Y, While A. Job satisfaction among hospital nurses: a literature review. Int J Nurs Stud. 2019;94:21–31.

Ramoo V, Abdullah KL, Piaw CY. The relationship between job satisfaction and intention to leave current employment among registered nurses in a teaching hospital. J Clin Nurs. 2013;22(21–22):3141–52.

Al Sabei SD, et al. Nursing work environment, turnover intention, Job Burnout, and Quality of Care: the moderating role of job satisfaction. J Nurs Scholarsh. 2020;52(1):95–104.

Wang H, Chen H, Chen J. Correlation study on payment satisfaction, psychological reward satisfaction and turnover intention of nurses. Chin Hosp Manag. 2018;38(03):64–6.

Google Scholar

Loes CN, Tobin MB. Interpersonal conflict and organizational commitment among licensed practical nurses. Health Care Manag (Frederick). 2018;37(2):175–82.

Wei H, et al. The state of the science of nurse work environments in the United States: a systematic review. Int J Nurs Sci. 2018;5(3):287–300.

Nantsupawat A, et al. Effects of nurse work environment on job dissatisfaction, burnout, intention to leave. Int Nurs Rev. 2017;64(1):91–8.

Article CAS PubMed Google Scholar

Ayalew F, et al. Factors affecting turnover intention among nurses in Ethiopia. World Health Popul. 2015;16(2):62–74.

Debie A, Khatri RB, Assefa Y. Contributions and challenges of healthcare financing towards universal health coverage in Ethiopia: a narrative evidence synthesis. BMC Health Serv Res. 2022;22(1):866.

Moher D, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Reviews. 2015;4(1):1–9.

Moher D, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151(4):264–9.

Moher D et al. Group, P.-P.(2015) Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement.

Institute JB. Checklist for Prevalence Studies. Checkl prevalance Stud [Internet]. 2016;7.

Sakonidou S, et al. Interventions to improve quantitative measures of parent satisfaction in neonatal care: a systematic review. BMJ Paediatr Open. 2020;4(1):e000613.

Egger M, Smith GD. Meta-analysis: potentials and promise. BMJ. 1997;315(7119):1371.

Tura G, Fantahun M, Worku A. The effect of health facility delivery on neonatal mortality: systematic review and meta-analysis. BMC Pregnancy Childbirth. 2013;13:18.

Lin L. Comparison of four heterogeneity measures for meta-analysis. J Eval Clin Pract. 2020;26(1):376–84.

McFarland LV. Meta-analysis of probiotics for the prevention of antibiotic associated diarrhea and the treatment of Clostridium difficile disease. Am J Gastroenterol. 2006;101(4):812–22.

Asegid A, Belachew T, Yimam E. Factors influencing job satisfaction and anticipated turnover among nurses in Sidama zone public health facilities, South Ethiopia Nursing research and practice, 2014. 2014.

Wubetie A, Taye B, Girma B. Magnitude of turnover intention and associated factors among nurses working in emergency departments of governmental hospitals in Addis Ababa, Ethiopia: a cross-sectional institutional based study. BMC Nurs. 2020;19:97.

Getie GA, Betre ET, Hareri HA. Assessment of factors affecting turnover intention among nurses working at governmental health care institutions in east Gojjam, Amhara region, Ethiopia, 2013. Am J Nurs Sci. 2015;4(3):107–12.

Gebregziabher D, et al. The relationship between job satisfaction and turnover intention among nurses in Axum comprehensive and specialized hospital Tigray, Ethiopia. BMC Nurs. 2020;19(1):79.

Negarandeh R et al. Magnitude of nurses’ intention to leave their jobs and its associated factors of nurses working in tigray regional state, north ethiopia: cross sectional study 2020.

Nigussie Bolado G, et al. The magnitude of turnover intention and Associated factors among nurses working at Governmental Hospitals in Southern Ethiopia: a mixed-method study. Nursing: Research and Reviews; 2023. pp. 13–29.

Woldekiros AN, Getye E, Abdo ZA. Magnitude of job satisfaction and intention to leave their present job among nurses in selected federal hospitals in Addis Ababa, Ethiopia. PLoS ONE. 2022;17(6):e0269540.

Rhoades L, Eisenberger R. Perceived organizational support: a review of the literature. J Appl Psychol. 2002;87(4):698.

Lewis M. Causal factors that influence turnover intent in a manufacturing organisation. University of Pretoria (South Africa); 2008.

Kuria S, Alice O, Wanderi PM. Assessment of causes of labour turnover in three and five star-rated hotels in Kenya International journal of business and social science, 2012. 3(15).

Blaauw D, et al. Comparing the job satisfaction and intention to leave of different categories of health workers in Tanzania, Malawi, and South Africa. Global Health Action. 2013;6(1):19287.

Masum AKM, et al. Job satisfaction and intention to quit: an empirical analysis of nurses in Turkey. PeerJ. 2016;4:e1896.

Song L. A study of factors influencing turnover intention of King Power Group at Downtown Area in Bangkok, Thailand. Volume 2. International Review of Research in Emerging Markets & the Global Economy; 2016. 3.

Karanikola MN, et al. Moral distress, autonomy and nurse-physician collaboration among intensive care unit nurses in Italy. J Nurs Manag. 2014;22(4):472–84.

Labrague LJ, McEnroe-Petitte DM, Tsaras K. Predictors and outcomes of nurse professional autonomy: a cross-sectional study. Int J Nurs Pract. 2019;25(1):e12711.

Download references

No funding was received.

Author information

Authors and affiliations.

School of Nursing, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia

Eshetu Elfios, Israel Asale, Merid Merkine, Temesgen Geta, Kidist Ashager, Getachew Nigussie, Ayele Agena & Bizuayehu Atinafu

Department of Midwifery, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia

Eskindir Israel

Department of Midwifery, College of Health Science and Medicine, Wachamo University, Hossana, Ethiopia

Teketel Tesfaye

You can also search for this author in PubMed Google Scholar

Contributions

E.E. conceptualized the study, designed the research, performed statistical analysis, and led the manuscript writing. I.A, T.G, M.M contributed to the study design and provided critical revisions. K.A., G.N, B.A., E.I., and T.T. participated in data extraction and quality assessment. M.M. and T.G. K.A. and G.N. contributed to the literature review. I.A, A.A. and B.A. assisted in data interpretation. E.I. and T.T. provided critical revisions to the manuscript. All authors read and approved the final version.

Corresponding author

Correspondence to Eshetu Elfios .

Ethics declarations

Ethical approval.

Ethical approval and informed consent are not required, as this study is a systematic review and meta-analysis that only involved the use of previously published data.

Ethical guidelines

Not applicable.

Consent for publication

Competing interests.

The authors declare no competing interests.

Additional information

Publisher’s note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ . The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article.

Elfios, E., Asale, I., Merkine, M. et al. Turnover intention and its associated factors among nurses in Ethiopia: a systematic review and meta-analysis. BMC Health Serv Res 24 , 662 (2024). https://doi.org/10.1186/s12913-024-11122-9

Download citation

Received : 20 January 2024

Accepted : 20 May 2024

Published : 24 May 2024

DOI : https://doi.org/10.1186/s12913-024-11122-9

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

Turnover intention
Systematic review
Meta-analysis

BMC Health Services Research

ISSN: 1472-6963

General enquiries: [email protected]

Academia.edu no longer supports Internet Explorer.

To browse Academia.edu and the wider internet faster and more securely, please take a few seconds to upgrade your browser .

Enter the email address you signed up with and we'll email you a reset link.

We're Hiring!
Help Center

THE ROLE OF MICROFINANCE IN POVERTY REDUCTION: The Case of Specialized Financial Promotion Institute (SFPI

Related Papers

Zewdu Teshome

zewdu teshome

Wubishet Sisay

Nigist Woldeselassie

Habtamu Baynes

Dilayehu Daniel

Girme Geday

Desu Negash

Acadamic edu

Gemechu D . Yadata

According to findings of different authors microfinance is providing financial services to unemployed and low income individuals or groups who would have no access to formal banking services. It has positive impact on the living standard of the poor people in particular and alleviating poverty in their household in general. It is not only undermining poverty in the city, but also empowering women through surviving and making their life prosperous with dignity and self reliance by providing financial services. And also Ethiopian Microfinance is facing different challenges in empowering such as lack of collateral assets, lack of information, work burden, production failures, verbal abuse, lack of infrastructure, low institutional capacity and opportunities of women in microfinance are providing startup capital, women empowerment, poverty eradication, social and political empowerment, improved saving skills and the above challenges listed should be take consideration by government and concerned body as well as problem solving study must be conducted. key words, micro finance ,gender and finance

Zelalem Hailu

Microfinance is currently being promoted as a key development strategy for promoting poverty reduction and empowerment of people economically. This is because of its potential to effectively address poverty by granting financial services to households who are not served by the formal banking sector. This study attempted to investigate the effects of MFIs on poverty reduction. The study focused on places located in Addis Ababa, especially in Akaki Kality sub city as a case study. It intended to cover credit facilities provided by the MFIs and clients perception on income improvement and/or reduced poverty levels. The study used descriptive survey design. The target population was one staff/administrators and 50 clients or recipients of the MFIs. The study employed stratified sampling technique to select staff of the selected MFIs and clients. Both qualitative and quantitative data analysis methods were used. The study revealed that as a microfinance institution has been providing microfinance services to different groups of youth specially women - productive or active poor and that the institution uses various strategies to deliver its services such as granting small loans to women to help them start businesses, grow their businesses and educate their children. To enhance client’s business skills to use credit and establish market channels for their products, the study recommends that microfinance institutions can arrange mechanisms to improve technical and business skills of the poorest through training and loan utilization. The study also recommended that MFIs should put in place micro-insurance schemes which could help clients to pool risk or share losses.

Journal of International Development

Gurmeet Singh

Patients’ satisfaction with cancer pain treatment at adult oncologic centers in Northern Ethiopia; a multi-center cross-sectional study

Molla Amsalu 1 ,
Henos Enyew Ashagrie 2 ,
Amare Belete Getahun 2 &
Yophtahe Woldegerima Berhe ORCID: orcid.org/0000-0002-0988-7723 2

BMC Cancer volume 24 , Article number: 647 ( 2024 ) Cite this article

142 Accesses

Metrics details

Patient satisfaction is an important indicator of the quality of healthcare. Pain is one of the most common symptoms among cancer patients that needs optimal treatment; rather, it compromises the quality of life of patients.

To assess the levels and associated factors of satisfaction with cancer pain treatment among adult patients at cancer centers found in Northern Ethiopia in 2023.

After obtaining ethical approval, a multi-center cross-sectional study was conducted at four cancer care centers in northern Ethiopia. The data were collected using an interviewer-administered structured questionnaire that included the Lubeck Medication Satisfaction Questionnaire (LMSQ). The severity of pain was assessed by a numerical rating scale from 0 to 10 with a pain score of 0 = no pain, 1–3 = mild pain, 4–6 = moderate pain, and 7–10 = severe pain Binary logistic regression analysis was employed, and the strength of association was described in an adjusted odds ratio with a 95% confidence interval.

A total of 397 cancer patients participated in this study, with a response rate of 98.3%. We found that 70.3% of patients were satisfied with their cancer pain treatment. Being married (AOR = 5.6, CI = 2.6–12, P < 0.001) and being single (never married) (AOR = 3.5, CI = 1.3–9.7, P = 0.017) as compared to divorced, receiving adequate pain management (AOR = 2.4, CI = 1.1–5.3, P = 0.03) as compared to those who didn’t receive it, and having lower pain severity (AOR = 2.6, CI = 1.5–4.8, P < 0.001) as compared to those who had higher level of pain severity were found to be associated with satisfaction with cancer pain treatment.

The majority of cancer patients were satisfied with cancer pain treatment. Being married, being single (never married), lower pain severity, and receiving adequate pain management were found to be associated with satisfaction with cancer pain treatment. It would be better to enhance the use of multimodal analgesia in combination with strong opioids to ensure adequate pain management and lower pain severity scores.

Peer Review reports

Introduction

Pain is defined as an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage [ 1 ]. The prevalence of pain in cancer patients is 44.5-66%. with the prevalence of moderate to severe pain ranging from 30 to 38%, and it can persist in 5-10% of cancer survivors [ 2 ]. Using the World Health Organization’s (WHO) cancer pain management guidelines can effectively reduce cancer-related pain in 70-90% of patients [ 3 , 4 ]. Compared to traditional pain states, the mechanism of cancer-related pain is less understood; however, cancer-specific mechanisms, inflammatory, and neuropathic processes have been identified [ 5 ]. Uncontrolled pain can negatively affect patients’ daily lives, emotional health, social relationships, and adherence to cancer treatment [ 6 ]. Patients with moderate to severe pain have a higher fatigue score, a loss of appetite, and financial difficulties [ 7 ]. Patients fear the pain caused by cancer more than dying from the disease since pain affects their physical and mental aspects of life [ 8 ]. A meta-analysis of 30 studies stated that pain was found to be a significant prognostic factor for short-term survival in cancer patients [ 9 ]. Many cancer patients have a very poor prognosis. However, adequate pain treatment prevents suffering and improves their quality of life. Although the WHO suggested non-opioids for mild pain, weak opioids for moderate pain, and strong opioids for severe pain, pain treatment is not yet adequate in one-third of cancer patients [ 10 ].

Patient satisfaction with pain management is a valuable measure of treatment effectiveness and outcome. It could be used to evaluate the quality of care [ 11 , 12 , 13 ]. Patient satisfaction affects treatment compliance and adherence [ 12 ]. Studies have reported that 60-76% of patients were satisfied with pain treatment, and a variety of factors were found associated with levels of satisfaction [ 3 , 14 , 15 , 16 ]. Studies conducted in Ethiopia reported the prevalence of pain ranging from 59.9 to 93.4% [ 17 , 18 ]. These studies indicate that cancer pain is inadequately treated. Assessment of pain treatment satisfaction can help identify appropriate treatment modalities and further its effectiveness. We conducted this study since there was limited research-based evidence on cancer pain management in low-income countries like Ethiopia. Our research questions were: how satisfied are adult cancer patients with pain treatment, and what are the factors associated with the satisfaction of adult cancer patients with pain treatment?

Methodology

Study design, area, period, and population.

A multi-center cross-sectional study was conducted at four cancer care centers in Amhara National Regional State, Northern Ethiopia from March to May 2023. Those cancer care centers were found in the University of Gondar Comprehensive Specialized Hospital (UoGCSH), Felege-Hiwot Comprehensive Specialized Hospital (FHCSH), Tibebe-Ghion Comprehensive Specialised Hospital (TGCSH) and Dessie Comprehensive Specialized Hospital (DCSH). We selected these centers as they were the only institutions providing oncologic care in the region during the study period.

The UoGCSH had 28 beds in its adult oncology ward and serves 450 cancer patients every month. Three specialist oncologists and 12 nurses provide services in the ward. The FHCSH had 22 beds and provides services for 325 cancer patients every month. Two specialist oncologists, two oncologic nurses, and 7 comprehensive nurses provide services. The TGCSH had eight beds and serves 300 cancer patients every month. There were three specialist oncologists and four oncologic nurses at the care center. The cancer care center at DCSH had 10 beds. It serves 350 cancer patients every month. There was one specialist oncologist, three oncologic nurses, and three comprehensive nurses.

All cancer patients who attended those cancer care centers were the source population, and adult (18+) cancer patients who were prescribed pain treatment for a minimum of one month were the study population. Unconscious patients, patients with psychiatric problems, patients with advanced cancer who were unable to cooperate, and patients with oncologic emergencies were excluded from this study.

Variables and operational definitions

The outcome variable was patient satisfaction with cancer pain treatment, which was measured by the Lubeck Medication Satisfaction Questionnaire. The independent variables were sociodemographic (age, sex, marital status, monthly income, and level of education), clinical (site of tumor, stage of cancer, metastasis), cancer treatment (surgery, chemotherapy, radiotherapy), level of pain, and analgesia (type of analgesia, severity of pain, adequacy of pain treatment, adjuvant analgesic).

Patient satisfaction

perceptions of the patients regarding the outcome of pain management and the extent to which it meets their needs and expectations. It was measured by a 4-point Likert scale (1 = strongly disagree, 2 = disagree, 3 = agree, 4 = strongly agree) using the LMSQ which has 18 items within 6 subscales that have 3 items in each (effectivity, practicality, side-effects, daily life, healthcare providers, and overall satisfaction) [ 19 ]. Final categorization was done by dichotomizing into satisfied and dissatisfied by using the demarcation threshold formula.

\((\frac{\text{T}\text{o}\text{t}\text{a}\text{l}\,\,\text{h}\text{i}\text{g}\text{h}\text{e}\text{s}\text{t}\,\,\text{s}\text{c}\text{o}\text{r}\text{e} - \text{T}\text{o}\text{t}\text{a}\text{l}\,\, \text{l}\text{o}\text{w}\text{e}\text{s}\text{t}\,\, \text{s}\text{c}\text{o}\text{r}\text{e} }{2}\) ) + Total lowest score [ 20 ]. The highest patient satisfaction score was 70 and the lowest satisfaction score was 26. A score < 48 was classified as dissatisfied, and a score ≥ 48 was classified as satisfied.

The Numeric rating scale (NRS) is a validated pain intensity assessment tool that helps to give patients a subjective feeling of pain with a numerical value between 0 and 10, in which 0 = no pain, 1–3 = mild pain, 4–6 = moderate pain, 7–10 = severe pain [ 21 ].

The Adequacy of cancer pain treatment was measured by calculating the Pain Management Index (PMI) according to the recommendations of the WHO pain management guideline [ 22 ]. The PMI was calculated by considering the prescribed most potent analgesic agent and the worst pain reported in the last 24 h [ 23 ]. The prescribed analgesics were scored as follows: 0 = no analgesia, 1 = non-opioid analgesia, 2 = weak opioids, and 3 = strong opioids. The PMI was calculated by subtracting the reported NRS value from the type of most potent analgesics administered. The calculated values of PMI ranged from − 3 (no analgesia therapy for a patient with severe pain) to + 3 (strong opioid for a patient with no pain). Patients with a positive PMI value were considered to be receiving adequate analgesia, whereas those with a negative PMI value were considered to be receiving inadequate analgesia.

Sample size determination and sampling technique

A single population proportion formula was used to determine the sample size by considering 50% satisfaction with cancer pain treatment and a 5% margin of error at a 95% confidence interval (CI). A non-probability (consecutive) sampling technique was employed to attain a sample size within two months of data collection period. After adjusting the proportional allocation for each center and adding 5% none response, a total of 404 study participants were included in the study: 128 from the University of Gondar Comprehensive Specialized Hospital, 99 from Dessie Comprehensive Specialized Hospital, 92 from Felege Hiwot Comprehensive Specialized Hospital, and 85 from Tibebe Ghion Comprehensive Specialized Hospital.

Data collection, processing, and analysis

Ethical approval.

was obtained from the Ethical Review Committee of the School of Medicine at the University of Gondar ( Reference number: CMHS/SM/06/01/4097/2015) . Data were collected using an interviewer-administered structured questionnaire and chart review during outpatient and inpatient hospital visits by four trained data collectors (one for every center). Written informed consent was obtained from each participant after detailed explanations about the study. Informed consent with a fingerprint signature was obtained from patients who could not read or write after detailed explanations by the data collectors as approved by the Ethical Review Committee of the School of Medicine, at the University of Gondar.

Questions to assess the severity of pain and pain relief were taken from the American Pain Society patient outcome questionnaire [ 24 ]. Patients were asked to report the worst and least pain in the past 24 h and the current pain by using a numeric rating scale from 0 to 10, with a pain score of 0 = no pain, 1–3 = mild pain, 4–6 = moderate pain, 7–10 = severe pain.

The Pain Management Index (PMI) based on WHO guidelines, was used to quantify pain management by measuring the adequacy of cancer pain treatment [ 25 ]. The following scores were given (0 = no analgesia, 1 = non-opioid analgesia, 2 = weak opioid 3 = strong opioid). Pain Management Index was calculated by subtracting self-reported pain level from the type of analgesia administered and ranges from − 3 (no analgesic therapy for a patient with severe pain) to + 3 (strong opioid for a patient with no pain). The level of pain was defined as 0 with no pain, 1 for mild pain, 2 for moderate pain, and 3 for severe pain. Patients with negative PMI scores received inadequate analgesia.

The pain treatment satisfaction was measured by the Lübeck Medication Satisfaction Questionnaire (LMSQ) consisting of 18 items [ 19 ]. Lübeck Medication Satisfaction Questionnaire (LMSQ) has six subclasses each consisting of equally waited and similar context of three items. The subclass includes satisfaction with the effectiveness of pain medication, satisfaction with the practicality or form of pain medication, satisfaction with the side effect profile of pain medication, satisfaction with daily life after receiving pain treatment, satisfaction with healthcare providers, and overall satisfaction. Satisfaction was expressed by a four-point Likert scale (4 = Strongly Agree, 3 = Agree, 2 = Disagree, 1 = Strongly Disagree). The side effect subclass was phrased negatively, marked with Asterix, and reverse-scored in STATA before data analysis.

Data were collected with an interviewer-administered questionnaire. The reliability of the questionnaire was assessed by using 40 pretested participants and the reliability coefficient (Cronbach’s alpha value) of the questionnaire was 91.2%. The collected data was checked for completeness, accuracy, and clarity by the investigators. The cleaned and coded data were entered in Epi-data software version 4.6 and exported to STATA version 17. The Shapiro-Wilk test, variance inflation factor, and Hosmer-Lemeshow test were used to assess distribution, multicollinearity, and model fitness, respectively. Descriptive, Chi-square and binary logistic regression analyses were performed to investigate the associations between the independent and dependent variables. The independent variables with a p-value < 0.2 in the bivariable binary logistic regression were fitted to the final multivariable binary logistic regression analysis. Variables with p-value < 0.05 in the final analysis were considered to have a statistically significant association. The strength of associations was described in adjusted odds ratio (AOR) at a 95% confidence interval.

Sociodemographic and clinical characteristics

A total of 397 patients were involved in this study (response rate of 98.3%). Of the participants, 224 (56.4%) were female, and over half were from rural areas ( n = 210, 52.9%). The median (IQR) age was 48 (38–59) years [Table 1 ]. The most common type of cancer was gastrointestinal cancer 114 (28.7%). Most of the study participants, 213 (63.7%), were diagnosed with stage II to III cancer. The majority of the participants were taking chemotherapy alone (292 (73.6%)) [Table 2 ]. Over 90% of patients reported pain; 42.3% reported mild pain, 39.8% reported moderate pain, and 10.1% reported severe pain. Pain treatment adequacy was assessed by self-reports from study participants following pain management guidelines, and 17.1% of patients responded to having inadequate pain treatment. The majority of patients, 132 (33.3%), were prescribed combinations of non-opioid and weak opioid analgesics for cancer pain treatment. Only 34 (8.6%) cancer patients used either strong opioids alone or in combination with non-opioid analgesics.

Patients’ satisfaction with cancer pain treatment and correlation among the subscales

Most participants strongly agree (243, (61.2%)) with item LMSQ18 in the “overall satisfaction” subscale and strongly disagree (206, (51.9%)) for item LMSQ2 in the “side-effect” subscale respectively [Table 3 ]. The highest satisfaction score was observed in the side-effect subscale, with a median (IQR) of 10 (9–11) [Table 4 ].

Two hundred and seventy-nine (70.3%) cancer patients were found to be satisfied with cancer pain treatment (CI = 65.6−74.6%). The highest satisfaction rate was observed in the “side-effects” subscale, to which 343 (86.4%) responded satisfied [Fig. 1 ]. A Spearman’s correlation test revealed that there were correlations among the subscales of LMSQ; and the strongest positive correlation was observed between effectivity and healthcare workers subscale (r s = 0.7, p < 0.0001). The correlation among the subscales is illustrated in a heatmap [Fig. 2 ].

Patient satisfaction with cancer pain treatment with each LMSQ subclass, n = 397

A heatmap showing the Spearman correlation of each subclass of pain treatment satisfaction, n = 397

Factors associated with patient satisfaction with cancer pain treatment

In the bivariable binary logistic regression analysis, marital status, stage of cancer, types of cancer treatment, severity of pain in the last 24 h, current pain severity, types of analgesics, and pain management index met the threshold of P-value < 0.2 to be included into the final multivariable binary logistic regression analysis. In the final analysis, marital status, current pain severity, and pain management index were significantly associated with patient satisfaction (P-value < 0.05). Married and single cancer patients had higher odds of being satisfied with cancer pain treatment compared to divorced patients (AOR = 5.6, CI, 2.6–12.0, P < 0.001), (AOR = 3.5, CI = 1.3–9.7, P = 0.017), respectively. The odds of being satisfied with cancer pain treatment among patients who received adequate pain management were more than two times greater than those who received inadequate pain management (AOR = 2.4, CI = 1.1–5.3, P = 0.03). Patients who reported a lesser severity of current pain were nearly three times more likely to be satisfied with cancer pain treatment (AOR = 2.6, CI = 1.5–4.8, P < 0.001) [Table 5 ].

The objective of the present study was to assess patients’ satisfaction with cancer pain treatment at adult oncologic centers. Our study revealed that most cancer patients (70.3%) have been satisfied with cancer pain treatment. This is consistent with studies done by Kaggwa et al. and Mazzotta et al. [ 16 , 26 ]. Whereas, it is a higher rate of satisfaction compared to other studies that reported 33.0% [ 27 ] and 47.7% [ 28 ] of satisfaction. The differences might be possibly explained by the use of different pain and satisfaction assessment tools, the greater inclusion (about 70%) of patients with advanced stages of cancer, the duration of cancer pain treatment, and the adequacy of pain management. In the current study, only 19.6% of patients have been diagnosed with stage IV cancer: patients should take treatment at least for a month, and over 80% of patients have received adequate pain management according to PMI. However, some studies have reported higher rates of satisfaction with cancer pain treatment [ 15 , 29 ]. The possible reason for the discrepancy might be the greater (over 40%) use of strong opioid analgesics in the previous studies. Strong opioids were prescribed only for 8.6% of patients in our study. Due to the complex pathophysiology, cancer pain involves multiple pain pathways. Hence, multimodal analgesia in combination with strong opioids is vital in cancer pain management [ 30 ]. Furthermore, the use of epidural analgesia could be another reason for higher rates of satisfaction [ 29 ].

Regarding satisfaction with subscales of LMSQ, about 80% of patients were satisfied with the information provided by the healthcare providers [ 27 ]. In our study; 67.8% of patients were satisfied with the education provided by healthcare providers about their disease and treatment. In contrast, a higher proportion of participants were satisfied with information provision in a study conducted by Kharel et al. [ 29 ]. Furthermore, we observed the lowest satisfaction rate in the daily life subscale. About 48% of cancer patients were not satisfied with their daily lives after receiving analgesic treatment for cancer pain.

Married and single (never married) cancer patients were found to have higher odds of being satisfied with cancer pain treatment as compared to divorced cancer patients. These findings could be explained by the presence of better social support from family or loved ones. Better social support can enhance positive coping mechanisms, increase a sense of well-being, and decrease anxiety and depression. It also improves a sense of societal vitality and results in higher patient’ satisfaction [ 31 , 32 ].

Patients who had a lower pain score were satisfied compared to those who reported a higher pain score, and this is supported by multiple previous studies [ 16 , 26 , 27 , 29 , 33 , 34 ]. This could be explained by the negative impacts of pain on physical function, sleep, mood, and wellbeing [ 35 ]. Moreover, higher pain severity scores could increase financial expenses because of unnecessary or avoidable emergency department visits; and has a consequence of dissatisfaction [ 23 ]. On the contrary, there are studies that state pain severity does not affect patients’ satisfaction [ 36 , 37 ].

Positive PMI scores were significantly associated with cancer pain treatment satisfaction. Patients who received adequate pain management were highly likely to be satisfied with cancer pain treatment. This finding is similar to that of a study done in Taiwan [ 38 ]. However, a study conducted by Kaggwa et al. has denied any association between PMI scores and cancer pain satisfaction [ 16 ].

Satisfaction with healthcare workers and effectivity of analgesics

This study showed that there was a moderately positive correlation between satisfaction with healthcare workers and satisfaction with patients’ perceived effectiveness of analgesics. This might be explained by a positive relationship between healthcare professionals and patients receiving cancer pain treatment. Healthcare providers who provide health education regarding the effectiveness of analgesics may improve patients’ adherence to the prescribed analgesic agent and improve patients’ perceived satisfaction with the effectiveness of analgesics. A systematic review showed that the hope and positivity of healthcare professionals were important for patients to cope with cancer and increase satisfaction with care [ 39 ]. Increased patient satisfaction with care provided by healthcare workers may change attitude of patients who accepted cancer pain as God’s wisdom or punishment and create a positive attitude toward the effectiveness of analgesics [ 40 ]. Another study supported this finding and stated that healthcare providers who deliver health education regarding the prevention of drug addiction, side effects of analgesics, timing, and dosage of analgesics improve patient attitude and cancer pain treatment [ 41 ].

Correlation of each subclass of cancer pain treatment satisfaction

A Spearman correlation was run to assess the correlation of each subclass of LMSQ using the total sample. There was strong positive correlation (r s = 0.5–0.64) between most of LMSQ subclass at p < 0.01.

A cross-sectional study stated that the effectiveness of analgesic, efficacy of medication and patient healthcare provider communication were associated with patient satisfaction [ 42 ]. In this study, 58.2% of patients were satisfied with the practicability of analgesic medications. Comparable to this study, a cross-sectional study stated that patients who were prescribed convenient, fast-acting medications were more satisfied [ 43 ]. Another study stated that 100% of patients who received sufficient information on analgesic treatment and 97.9% of patients who received sufficient information about the side effects of analgesic treatment were satisfied with cancer pain management [ 44 ]. Patients who were satisfied with their pain levels reported statistically lower mean pain scores (2.26 ± 1.70) compared to those not satisfied (4.68 ± 2.07) or not sure (4.21 ± 2.21) [ 27 ]. This may be explained by the impact of pain on daily activity. Patients who report a lower average pain score may have a lower impact of pain on physical activity compared to those who report a higher mean pain score. Another study also supports this evidence and states that patients who reported a severe pain score and lower quality of life had lower satisfaction with the treatment received [ 45 ].

As a secondary outcome, only 16% of patients were diagnosed to have stage I cancer. This finding could indirectly indicate that there were delays in cancer diagnosis at earlier stage. Further studies may be required to underpin this finding.

In this study, baseline pain before analgesic treatment was not assessed and documented. As a cross-sectional study, we could not draw a cause-and-effect conclusion. Since questions that were used to measure oncologic pain treatment satisfaction were self-reported, answers to each question might not be trustful. The expectation and opinion of the interviewer also might affect the result of the study. These could be potential limitations of the study.

Conclusions

Despite the fact that most cancer patients reported moderate to severe pain, there was a high rate of satisfaction with cancer pain treatment. It would be better if hospitals, healthcare professionals, and administrators took measures to enhance the use of multimodal analgesia in combination with strong opioids to ensure adequate pain management, lower pain severity scores, and better daily life. We also urge the arrangement of better social support mechanisms for cancer patients, the improvement of information provision, and the deployment of professionals who have trained in pain management discipline at cancer care centres.

Data availability

Data and materials used in this study are available and can be presented by the corresponding author upon reasonable request.

Abbreviations

Adjusted Odds Ratio

Crude Odds Ratio

Confidence Interval

Dessie Compressive and Specialized Hospital

Felege-Hiwot Compressive and Specialized Hospital

Inter-quartile Range

Lubeck Medication Satisfaction Questionnaire

Numerical Rating Scale

Pain Management Index

Standard Deviation

Tibebe-Ghion Compressive and Specialized Hospital

University of Gondar Compressive and Specialized Hospital

World health organization

Raja SN, Carr DB, Cohen M, Finnerup NB, Flor H, Gibson S, et al. The revised International Association for the study of Pain definition of pain: concepts, challenges, and compromises. Pain. 2020;161(9):1976–82.

Article PubMed PubMed Central Google Scholar

Brown MR, Ramirez JD, Farquhar-Smith P. Pain in cancer survivors. Br J pain. 2014;8(4):139–53.

Hochstenbach LM, Joosten EA, Tjan-Heijnen VC, Janssen DJ. Update on Prevalence of Pain in Patients With Cancer: Systematic Review and Meta-Analysis. Journal of pain and symptom management. 2016;51(6):1070-90.e9.

Snijders RAH, Brom L, Theunissen M, van den Beuken-van Everdingen MHJ. Update on Prevalence of Pain in patients with Cancer 2022: a systematic literature review and Meta-analysis. Cancers. 2023;15(3).

Falk S, Dickenson AH. Pain and nociception: mechanisms of cancer-induced bone pain. J Clin Oncol. 2014;32(16):1647–54.

Article CAS PubMed Google Scholar

Gibson S, McConigley R. Unplanned oncology admissions within 14 days of non-surgical discharge: a retrospective study. Support Care Cancer. 2016;24:311–7.

Article PubMed Google Scholar

Oliveira KG, von Zeidler SV, Podestá JRV, Sena A, Souza ED, Lenzi J, et al. Influence of pain severity on the quality of life in patients with head and neck cancer before antineoplastic therapy. BMC Cancer. 2014;14(1):39.

Smith MD, Meredith PJ, Chua SY. The experience of persistent pain and quality of life among women following treatment for breast cancer: an attachment perspective. Psycho-oncology. 2018;27(10):2442–9.

Zylla D, Steele G, Gupta P. A systematic review of the impact of pain on overall survival in patients with cancer. Support Care Cancer. 2017;25(5):1687–98.

Greco MT, Roberto A, Corli O, Deandrea S, Bandieri E, Cavuto S, et al. Quality of cancer pain management: an update of a systematic review of undertreatment of patients with cancer. J Clin Oncol. 2014;32(36):4149–54.

Baker TA, Krok-Schoen JL, O’Connor ML, Brooks AK. The influence of pain severity and interference on satisfaction with pain management among middle-aged and older adults. Pain Research and Management. 2016;2016.

Baker TA, O’Connor ML, Roker R, Krok JL. Satisfaction with pain treatment in older cancer patients: identifying variants of discrimination, trust, communication, and self-efficacy. J Hospice Palliat Nursing: JHPN: Official J Hospice Palliat Nurses Association. 2013;15(8).

Naidu A. Factors affecting patient satisfaction and healthcare quality. Int J Health care Qual Assur. 2009.

Davies A, Zeppetella G, Andersen S, Damkier A, Vejlgaard T, Nauck F, et al. Multi-centre European study of breakthrough cancer pain: pain characteristics and patient perceptions of current and potential management strategies. Eur J Pain. 2011;15(7):756–63.

Thinh DHQ, Sriraj W, Mansor M, Tan KH, Irawan C, Kurnianda J et al. Patient and physician satisfaction with analgesic treatment: findings from the analgesic treatment for cancer pain in Southeast Asia (ACE) study. Pain Research and Management. 2018;2018.

Kaggwa AT, Kituyi PW, Muteti EN, Ayumba RB. Cancer-related Bone Pain: patients’ satisfaction with analgesic Pain Control. Annals Afr Surg. 2022;19(3):144–52.

Article Google Scholar

Adugna DG, Ayelign AA, Woldie HF, Aragie H, Tafesse E, Melese EB et al. Prevalence and associated factors of cancer pain among adult cancer patients evaluated at the Oncology unit in the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. Front Pain Res.3:231.

Tuem KB, Gebremeskel L, Hiluf K, Arko K, Hailu HG. Adequacy of cancer-related pain treatments and factors affecting proper management in Ayder Comprehensive Specialized Hospital, Mekelle, Ethiopia. Journal of Oncology. 2020;2020.

Matrisch L, Rau Y, Karsten H, Graßhoff H, Riemekasten G. The Lübeck medication satisfaction Questionnaire—A Novel Measurement Tool for Therapy satisfaction. J Personalized Med. 2023;13(3):505.

Bayable SD, Ahmed SA, Lema GF, Yaregal Melesse D. Assessment of Maternal Satisfaction and Associated Factors among Parturients Who Underwent Cesarean Delivery under Spinal Anesthesia at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2019. Anesthesiology research and practice. 2020;2020:8697651.

Breivik H, Borchgrevink P-C, Allen S-M, Rosseland L-A, Romundstad L, Breivik Hals E, et al. Assessment of pain. BJA: Br J Anaesth. 2008;101(1):17–24.

Tegegn HG, Gebreyohannes EA. Cancer Pain Management and Pain Interference with Daily Functioning among Cancer patients in Gondar University Hospital. Pain Res Manage. 2017;2017:5698640.

Shen W-C, Chen J-S, Shao Y-Y, Lee K-D, Chiou T-J, Sung Y-C, et al. Impact of undertreatment of cancer pain with analgesic drugs on patient outcomes: a nationwide survey of outpatient cancer patient care in Taiwan. J Pain Symptom Manag. 2017;54(1):55–65. e1.

Gordon DB, Polomano RC, Pellino TA, Turk DC, McCracken LM, Sherwood G, et al. Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R) for quality improvement of pain management in hospitalized adults: preliminary psychometric evaluation. J Pain. 2010;11(11):1172–86.

Thronæs M, Balstad TR, Brunelli C, Løhre ET, Klepstad P, Vagnildhaug OM, et al. Pain management index (PMI)—does it reflect cancer patients’ wish for focus on pain? Support Care Cancer. 2020;28:1675–84.

Mazzotta M, Filetti M, Piras M, Mercadante S, Marchetti P, Giusti R. Patients’ satisfaction with breakthrough cancer pain therapy: A secondary analysis of IOPS-MS study. Cancer Manage Res. 2022:1237–45.

Golas M, Park CG, Wilkie DJ. Patient satisfaction with Pain Level in patients with Cancer. Pain Manage Nursing: Official J Am Soc Pain Manage Nurses. 2016;17(3):218–25.

Tang ST, Tang W-R, Liu T-W, Lin C-P, Chen J-S. What really matters in pain management for terminally ill cancer patients in Taiwan. J Palliat Care. 2010;26(3):151–8.

Kharel S, Adhikari I, Shrestha K. Satisfaction on Pain Management among Cancer patient in selected Cancer Care Center Bhaktapur Nepal. Int J Med Sci Clin Res Stud. 2023;3(4):597–603.

Breivik H, Eisenberg E, O’Brien T. The individual and societal burden of chronic pain in Europe: the case for strategic prioritisation and action to improve knowledge and availability of appropriate care. BMC Public Health. 2013;13:1–14.

Gonzalez-Saenz de Tejada M, Bilbao A, Baré M, Briones E, Sarasqueta C, Quintana J, et al. Association between social support, functional status, and change in health‐related quality of life and changes in anxiety and depression in colorectal cancer patients. Psycho‐oncology. 2017;26(9):1263–9.

Yoo H, Shin DW, Jeong A, Kim SY, Yang H-k, Kim JS, et al. Perceived social support and its impact on depression and health-related quality of life: a comparison between cancer patients and general population. Jpn J Clin Oncol. 2017;47(8):728–34.

Hanna MN, González-Fernández M, Barrett AD, Williams KA, Pronovost P. Does patient perception of pain control affect patient satisfaction across surgical units in a tertiary teaching hospital? Am J Med Qual. 2012;27(5):411–6.

Naveh P. Pain severity, satisfaction with pain management, and patient-related barriers to pain management in patients with cancer in Israel. Number 4/July 2011. 2011;38(4):E305–13.

Google Scholar

Black B, Herr K, Fine P, Sanders S, Tang X, Bergen-Jackson K, et al. The relationships among pain, nonpain symptoms, and quality of life measures in older adults with cancer receiving hospice care. Pain Med. 2011;12(6):880–9.

Kelly A-M. Patient satisfaction with pain management does not correlate with initial or discharge VAS pain score, verbal pain rating at discharge, or change in VAS score in the emergency department. J Emerg Med. 2000;19(2):113–6.

Lin J, Hsieh RK, Chen JS, Lee KD, Rau KM, Shao YY, et al. Satisfaction with pain management and impact of pain on quality of life in cancer patients. Asia-Pac J Clin Oncol. 2020;16(2):e91–8.

Su W-C, Chuang C-H, Chen F-M, Tsai H-L, Huang C-W, Chang T-K, et al. Effects of Good Pain Management (GPM) ward program on patterns of care and pain control in patients with cancer pain in Taiwan. Support Care Cancer. 2021;29(4):1903–11.

Prip A, Møller KA, Nielsen DL, Jarden M, Olsen M-H, Danielsen AK. The patient–healthcare professional relationship and communication in the oncology outpatient setting: a systematic review. Cancer Nurs. 2018;41(5):E11.

Orujlu S, Hassankhani H, Rahmani A, Sanaat Z, Dadashzadeh A, Allahbakhshian A. Barriers to cancer pain management from the perspective of patients: a qualitative study. Nurs open. 2022;9(1):541–9.

Uysal N. Clearing barriers in Cancer Pain Management: roles of nurses. Int J Caring Sci. 2018;11(2).

Beck SL, Towsley GL, Berry PH, Lindau K, Field RB, Jensen S. Core aspects of satisfaction with pain management: cancer patients’ perspectives. J Pain Symptom Manag. 2010;39(1):100–15.

Wada N, Handa S, Yamamoto H, Higuchi H, Okamoto K, Sasaki T, et al. Integrating Cancer patients’ satisfaction with Rescue Medication in Pain assessments. Showa Univ J Med Sci. 2020;32(3):181–91.

Antón A, Montalar J, Carulla J, Jara C, Batista N, Camps C, et al. Pain in clinical oncology: patient satisfaction with management of cancer pain. Eur J Pain. 2012;16(3):381–9.

Valero-Cantero I, Casals C, Espinar-Toledo M, Barón-López FJ, Martínez-Valero FJ, Vázquez-Sánchez MÁ. Cancer Patients’ Satisfaction with In-Home Palliative Care and Its Impact on Disease Symptoms. Healthcare. 2023;11(9):1272.

Download references

Acknowledgements

We would like to acknowledge the University of Gondar Comprehensive Specialized Hospital, Tibebe-Ghion Comprehensive Specialized Hospital, Felege-Hiwot Comprehensive Specialized Hospital, Dessie Comprehensive Specialized Hospital. We would also want to acknowledge Ludwig Matrisch from the Department of Rheumatology and Clinical Immunology, Universität zu Lübeck, 23562 Lübeck, Germany for supporting us on the utilization of the Lübeck Medication Satisfaction Questionnaire (LMSQ) [email protected],

This study was supported by University of Gondar and Debre Birhan University with no conflict of interest. The support did not include publication charges.

Author information

Authors and affiliations.

Department of Anesthesia, Debre Birhan University, Debre Birhan, Ethiopia

Molla Amsalu

Department of Anaesthesia, University of Gondar, Gondar, Ethiopia

Henos Enyew Ashagrie, Amare Belete Getahun & Yophtahe Woldegerima Berhe

You can also search for this author in PubMed Google Scholar

Contributions

‘’M.A. has conceptualized the study and objectives; and developed the proposal. Y.W.B., H.E.A., and A.B.G. criticized the proposal. All authors had participated in the data management and statistical analyses. Y.W.B, M.A., and H.E.A. have prepared the final manuscript. All authors read and approved the final manuscript.‘’.

Corresponding author

Correspondence to Yophtahe Woldegerima Berhe .

Ethics declarations

Ethics approval and consent to participate.

Ethical approval was obtained from the Ethical Review Committee of the School of Medicine, at the University of Gondar ( Reference number: CMHS/SM/06/01/4097/2015, Date: March 24, 2023 ). Permission support letters were obtained from FHCSH, TGCSH, and DCSH. Written informed consent was obtained from each participant after detailed explanations about the study. Informed consent with a fingerprint signature was obtained from patients who could not read or write after detailed explanations by the data collectors as approved by the Ethical Review Committee of the School of Medicine, at the University of Gondar.

Consent for publication

Not applicable; this article does not include any personal details of any participant.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Cite this article.

Amsalu, M., Ashagrie, H.E., Getahun, A.B. et al. Patients’ satisfaction with cancer pain treatment at adult oncologic centers in Northern Ethiopia; a multi-center cross-sectional study. BMC Cancer 24 , 647 (2024). https://doi.org/10.1186/s12885-024-12359-7

Download citation

Received : 17 October 2023

Accepted : 08 May 2024

Published : 27 May 2024

DOI : https://doi.org/10.1186/s12885-024-12359-7

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

Cancer pain treatment
Treatment satisfaction
Cancer pain

ISSN: 1471-2407

Submission enquiries: [email protected]
General enquiries: [email protected]

IMAGES

(PDF) Microfinancing and Poverty Reduction in Ethiopia
Entrepreneurship Development through Microfinance: Evidence from Amhara
Ethiopia
Deputy Branch Manager (New Jobs in Ethiopia 2021) in 2021
(PDF) The Performance of Ethiopian Microfinance Institutions in
The impact of microfinance on living standards, empowerment and poverty

VIDEO

ብድር በቀላሉ ያለምንም የቁጠባ ጊዜ የሚያገኙበት ድርጅት| Credit in Ethiopia| SILE BUSINESS
ያለዋስትና ብድር ተጀመረ! መልካም ዜናለስራ ፈጣሪዎች!
ABF Governing in a Digital World Roundtable
Asirvad Microfinance Ltd Vacancy
The experience as a women as entrepreneurs in Ethiopia
Baking Injera

COMMENTS

(PDF) Microfinance Provision in Ethiopia
Email: [email protected]. Microfinance Provision in Ethiopia. 2 of 9. ABSTRACT: the main objective of this study is to analyze the microfinance market in. Ethiopia, the Study will start with ...
Performance of Microfinance Institutions in Ethiopia: Integrating
Since their inception in the 1970s, microfinance institutions (MFIs) have received increasing attention both from policymakers and academic circles. Using unbalanced panel data (2000-2017) from ...
PDF A Review of Ethiopian Microfinance Institutions and their Role in
1.1 Research problem Even though, micro finance is said to be an effective tool to mitigate several social and economical problems of rural mass, still there is a huge gap to bridge between the targeted ... The sketch out the present scenario of micro finance institutions in Ethiopia 3. To establish a link between woman, micro finance and ...
Performance of Microfinance Institutions in Ethiopia: Integrating
Since their inception in the 1970s, microfinance institutions (MFIs) have received increasing attention both from policymakers and academic circles. Using unbalanced panel data (2000-2017) from Ethiopia, in this paper, we investigated the performance of MFIs and its determinants on the one hand and whether or not mission drift exists on the other hand. To this end, we employed seemingly ...
Role of Microfinance Institutions in Ethiopian Economy: A Review
The developed framework was applied to MFIs operating in Ethiopia, which have head offices in all regional capitals of the country and report to the Association of Ethiopian Microfinance ...
Microfinance Institutions in Ethiopia: Their Impact, Growth, and
Microfinance Institutions (MFIs) in Ethiopia. During the third quarter of 2022/23, the number of Micro Finance Institutions (MFIs) in Ethiopia reached 46. These institutions have been instrumental in mobilizing about Birr 24 billion in saving deposits, marking a 16.9% annual growth. This growth rate underscores the increasing trust and reliance ...
The role of microfinance institutions on poverty reduction in Ethiopia
The purpose of this study is to assess the contribution of Oromia Credit and Saving Share Company microfinance institution on poverty alleviation in Welmera district, Oromia Special Zone Surrounding Finfine, Oromia Regional State, Ethiopia. Both random and purposive sampling techniques were used for data collection. Three hundred and fifty-seven respondents were selected from twelve different ...
Ethiopian Micro-Finance Landscape Report
This assessment focuses on the landscape and performance of microfinances (MFIs) in Ethiopia. Microfinance refers to a broad range of financial services made available to low-income clients, particularly women. The services include loans, saving, insurance, and remittance. The clients of microfinance institutions (MFI), largely belonging to low ...
Ethiopian Microfinance Assessment Report: A case for ...
in Ethiopia, the data from the Association of Ethiopian Microfinance Institutions (AEMFI) from March 2018 can be used. This data shows that there are 34 MFIs in Ethiopia. These MFIs have a total capital of close to 12 billion Ethiopian birr (ETB) serving around 4.5 million clients in all parts of Ethiopia. The conventional services
PDF Microfinance Institutions in Ethiopia: The Escalation and challenges
The three largest micro finance institutions account for 65% of the market share in terms of borrowing clients, and 74% by loan provision. These are Amhara (ACSI), Dedebit (DECSI) and Oromia (OCSSCO) Credit and Savings Institutions. Microfinance institutions are decisive way outs from the vicious circle of poverty particularly for the rural and ...
Assessment of Financial Performance of Microfinance Institutions in
The purpose of this study was to assess the Assessment of Financial Performance of Microfinance Institutions in Ethiopia. More specifically, the study has attempted to investigate the effect of security administration, loan lending, and loan product management on financial performance of micro finance institutions. The study used mixed research approach in which both qualitative and ...
PDF The role of microfinance institutions on poverty reduction in Ethiopia
in Ethiopia, to the best of the author's knowledge, this is the first research to access the contribution of microfinance institutions in poverty alleviation in this study area. Therefore, this research's broad aim is to assess the contribution of Oromia Credit and Saving Share Company in poverty reduction at Welmera dis-
The performance of Micro Finance Institutions in Ethiopia: A case of
Research Design and Methodology 1.5.1 Target Population Currently there are more than 27 microfinance institutions in Ethiopia, who are serving the ethiopian people neglected by conventional financial institutions such as commercial banks. of the 27 MFIs 6 microfinance institutions were selected to participate in the study and The paper was ...
(Pdf) Credit Provision and Savings Mobilization of Microfinance
The study has employed both descriptive and econometric model to achieve the objective of this research. The study has used non experimental data-the propensity score matching was employed in the econometric part of the study to estimate the impact of the credit on outcome variable in research. ... In Ethiopia, microfinance came to inexistence ...
Ethiopian Micro-Finance Landscape Report
This assessment focuses on the landscape and performance of microfinances (MFIs) in Ethiopia. Microfinance refers to a broad range of financial services made available to low-income clients, particularly women. The services include loans, saving, insurance, and remittance. The clients of microfinance institutions (MFI), largely belonging to low ...
(PDF) Microfinance Institutions in Ethiopia: Poverty Outreach and
PDF | On Sep 6, 2023, Adane Debessa published Microfinance Institutions in Ethiopia: Poverty Outreach and Financial Sustainability | Find, read and cite all the research you need on ResearchGate
PDF FACTORS THAT AFFECT THE PERFORMANCES OF ...
shows that the role of microfinance institution is significant in many aspects. The loan given by MFIs for micro and small enterprises contributes for the acceleration of the development process of the country. Based on the proclamation on microfinance business, micro finance
PDF Microfinancing and Poverty Reduction in Ethiopia*
Therefore, this study is designed to fill this gap. 1.3 Objectives and Research Questions. The general objective of this research is to analyze the impact of MFIs on poverty reduction in the AmharaRegion of Ethiopia through both qualitative and quantitative data gathered from the study area. "Man is a chooser.
The Role Of Microfinance In Poverty Reduction: The Case of Specialized
Ethiopia is also one of the countries where microfinance has been given due consideration as a safety net for the poor to help them overcome the adversities of poverty. ... In deed the research is both quantitative and qualitative by its nature. The contribution of Microfinance is analyzed based on income, living condition, asset accumulation ...
The Role of Microfinance Institutions in Poverty Reduction and ...
The total number of active borrowing clients of the microfinance institutions in Ethiopia reached over 2.4 million customers in 2011 whereas the total credit extended by all microfinance institutions amounted to Birr 6.9 billion. Of the total credit granted, the share of the three largest Microfinance institutions is Birr 5.1 billion (Ibid).
Role of Microfinance Institutions in Financing Micro and Small
National Bank of Ethiopia Annual Report. Addis Ababa: NBE. NBE (2018/19). National Bank of Ethiopia Annual Report. Addis Ababa: NBE. Nguse, T. (2019). Role of Microfinance Institutions on Women Empowerment in case of Wisdom Microfinance Institution, Dilla Town - Ethiopia. Journal of Advanced Research in Technology and Management Sciences, 1(4 ...
Sustainability
Green innovation is an effective driving force for high-quality development in the new era. As a new financial service model, digital inclusive finance provides a new way to solve the financing dilemma of green innovation. In order to investigate the impact of digital financial inclusion on the green innovation of small and medium-sized enterprises (SMEs), based on the panel data of SMEs in ...
(PDF) ROLE OF MICROFINANCE INSTITUTIONS IN FINANCING ...
Report, Ethiopia scor ed 3.4 out of 10, and rank ed 109 out of 137 countries in terms of f inanc ial ma rket development (Inter nation al Fina nce Corpora tion, 2019 ).
Turnover intention and its associated factors among nurses in Ethiopia
Nurses turnover intention, representing the extent to which nurses express a desire to leave their current positions, is a critical global public health challenge. This issue significantly affects the healthcare workforce, contributing to disruptions in healthcare delivery and organizational stability. In Ethiopia, a country facing its own unique set of healthcare challenges, understanding and ...
(PDF) THE ROLE OF MICROFINANCE IN POVERTY REDUCTION: The Case of
And also Ethiopian Microfinance is facing different challenges in empowering such as lack of collateral assets, lack of information, work burden, production failures, verbal abuse, lack of infrastructure, low institutional capacity and opportunities of women in microfinance are providing startup capital, women empowerment, poverty eradication ...
Comparison of GCMs Under CMIP5 and CMIP6 in Reproducing Observed
Model selection over a region known with data scarcity is crucial to get a substitute to study trends, variability and projections. This study was concerned with the comparison of 12 General Circulation Models (GCMs) under CMIP5 and CMIP6 relative to Climate Research Unit (CRU) precipitation in Ethiopia from 1966 to 2005. The comparison between GCMs was made using correlation, root mean ...
Patients' satisfaction with cancer pain treatment at adult oncologic
Patient satisfaction is an important indicator of the quality of healthcare. Pain is one of the most common symptoms among cancer patients that needs optimal treatment; rather, it compromises the quality of life of patients. To assess the levels and associated factors of satisfaction with cancer pain treatment among adult patients at cancer centers found in Northern Ethiopia in 2023.

Microfinance Institutions in Ethiopia: Their Impact, Growth, and Challenges in Financial Inclusion

Microfinance Institutions (MFIs) in Ethiopia

Growing Role in Financial Inclusion

Challenges Faced by MFIs

The Financial Landscape and MFIs

Electric Power Generation and MFIs

Challenges in the Energy Sector and Implications for MFIs

Regional Inflation and Its Implications for MFIs

Monetary Developments and Implications for MFIs

Interest Rate Developments

Federal Government Fiscal Operations and Implications for MFIs

Investment Landscape

Ethiopian Micro-Finance Landscape Report

Date Issued

Collections

Author(s) ORCID(s)

Ethiopian Micro-Finance Landscape Report

The Role Of Microfinance In Poverty Reduction: The Case of Specialized Financial Promotion Institute (SFPI)

Turnover intention and its associated factors among nurses in Ethiopia: a systematic review and meta-analysis

Conclusion and recommendation

Study design and search strategy

Eligibility criteria

Exclusion criteria

Quality assessment and data extraction

Data processing and analysis

Study selection

Study characteristics

Pooled prevalence of turnover intention among nurses in Ethiopia

Subgroup analysis of turnover intention among nurses in Ethiopia

Publication bias of turnover intention among nurses in Ethiopia

Sensitivity analysis

Factors associated with turnover intention among nurses in Ethiopia

Recommendations

Ethiopian nurses association (ENA)

Healthcare institutions

Policy makers

Future research initiatives

Strength and limitations

Data availability

Abbreviations

Author information

Contributions

Corresponding author

Ethics declarations

Ethical guidelines

Consent for publication

Additional information

Rights and permissions

About this article

Share this article

BMC Health Services Research

THE ROLE OF MICROFINANCE IN POVERTY REDUCTION: The Case of Specialized Financial Promotion Institute (SFPI

Related Papers

RELATED PAPERS

Patients’ satisfaction with cancer pain treatment at adult oncologic centers in Northern Ethiopia; a multi-center cross-sectional study

Introduction

Methodology

Variables and operational definitions

Sample size determination and sampling technique

Data collection, processing, and analysis

Sociodemographic and clinical characteristics

Patients’ satisfaction with cancer pain treatment and correlation among the subscales

Factors associated with patient satisfaction with cancer pain treatment

Satisfaction with healthcare workers and effectivity of analgesics

Correlation of each subclass of cancer pain treatment satisfaction

Conclusions

Data availability

Abbreviations

Acknowledgements

Author information

Contributions

Corresponding author

Ethics declarations

Consent for publication

Competing interests

Additional information

Rights and permissions

About this article

Share this article

IMAGES