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Meta-Analysis
. 2024 May 24;24(1):662.
doi: 10.1186/s12913-024-11122-9.

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

Eshetu Elfios  1 , Israel Asale  2 , Merid Merkine  2 , Temesgen Geta  2 , Kidist Ashager  2 , Getachew Nigussie  2 , Ayele Agena  2 , Bizuayehu Atinafu  2 , Eskindir Israel  3 , Teketel Tesfaye  4
Affiliations
Meta-Analysis

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

Eshetu Elfios et al. BMC Health Serv Res. .

Abstract

Background: 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.

Methods: 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.

Result: 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 (I2 = 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.

Keywords: Ethiopia; Meta-analysis; Nurses; Systematic review; Turnover intention.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram of the selection process of studies on turnover intention among nurses in Ethiopia, 2024
Fig. 2
Fig. 2
Forest plot showing the pooled proportion of turnover intention among nurses in Ethiopia, 2024
Fig. 3
Fig. 3
Subgroup analysis of systematic review and meta-analysis by region of turnover intention among nurses in Ethiopia, 2024
Fig. 4
Fig. 4
Funnel plot of systematic review and meta-analysis on turnover intention among nurses in Ethiopia, 2024
Fig. 5
Fig. 5
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
Fig. 6
Fig. 6
Forest plot of the association between autonomous decision making with turnover intention among nurses in Ethiopia2024
Fig. 7
Fig. 7
Forest plot of the association between promotion/developpment with turnover intention among nurses in Ethiopia, 2024
See this image and copyright information in PMC

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