role of workplace ergonomics on healthcare

i

ROLE OF WORKPLACE ERGONOMICS ON HEALTHCARE

EMPLOYEES’ PERFORMANCE: A CASE OF MUHIMBILI NATIONAL

HOSPITAL, TANZANIA

BY

VERONICA HELLAR

A Dissertation Submitted in Partial Fulfillment of the Requirements for Award

of the Degree of Master in Business Administration (Corporate Management)

of Mzumbe University

2020

i

CERTIFICATION

We, the undersigned, certify that we have read and hereby recommend for acceptance,

a dissertation entitled “The role of workplace ergonomics on healthcare employees’

performance: a case of Muhimbili National Hospital, Tanzania” in partial

fulfillment of the requirements for award of the degree of Master of Business

Administration in Corporate Management.

________________

Major Supervisor

_______________

Internal Examiner

________________

External Examiner

Accepted for Board of MU-DCC

______________________________________________________

PRINCIPAL/DAR-ES-SALAAM CAMPUS COLLEGE BOARD

ii

DECLARATION

AND

COPYRIGHT

I,Veronica Hellar, declare that this dissertation is my own original work and that it

has not been presented and will not be presented to any other university for a similar

or any other degree award.

Signature: ________________________

Date: __________________________

© 2020

This dissertation is copyright material protected under the Berne Convention, the

Copyright Act of 1999 and other international and national enactments, in that behalf,

on intellectual property. It may not be reproduced by any means, in full or in part,

except for short extracts in fair dealing; for research or private study, critical scholarly

review or discourse with an acknowledgement, without the written permission of

Mzumbe University, on behalf of the author.

iii

ACKNOWLEDGEMENT

Firstly, I give thanks to God Almighty, for endowing upon me the health, strength and

motivation to complete this work.

Secondly, I express my heartfelt appreciation and gratitude to my supervisor Dr.

Felichesmi Lyakurwa for his guidance and advice during the entire period of

undertaking this study whereas he always responded promptly and constructively.

Thirdly, to my parents Christopher and Agnes Hellar who have always supported me

morally and through prayers, I am forever grateful.

Lastly but not least, I must acknowledge the support received from the Management

and staff of the Muhimbili National Hospital without whom I wouldn’t have

completed this work.

iv

DEDICATION

This paper is dedicated to my lovely family; my husband Chediel Msuya who has

always supported me and my beautiful children Reuben, Stewart, Terence and Owen

Msuya who give me the reason for wanting to achieve more.

v

ABBREVIATIONS AND ACRONYMS

IEA International Ergonomics Association

ILO International Labor Organization

GDP Gross Domestic Product

IACs Industrially Advanced Countries

IDCs Industrially Developing Countries

OSHA Occupational Health and Safety Authority

MNH Muhimbili National Hospital

OPRAS Open Performance Appraisal System

HF/E Human Factors Ergonomics

ERFs Ergonomic Risk Factors

MSDs Musculoskeletal Disorders

CDC Centers for Disease Control and Prevention

LBP Lower Back Pain

vi

ABSTRACT

The study explored the role of workplace ergonomics on healthcare employees’

performance using the Muhimbili National Hospital (MNH) as a case study. The

specific objectives of this study were to determine the extent to which workplace

ergonomics influence healthcare employees’ performance at the workplace, to

examine healthcare employees’ awareness about ergonomics design of the

workplaces, to document the barriers towards ergonomic design of workplaces as a

tool for improving employees’ performance in healthcare facilities, the case of MNH.

The study employed case study research design where both qualitative and

quantitative data were collected by distributing questionnaires to 96 staff at MNH.

This included clinical staff, non – clinical staff, nursing staff and management. In

addition, the interview method was also used to complement the data that was

collected through questionnaires especially those that required more qualitative data.

The findings of the study revealed that office size, workplace temperature, airflow and

light, office furniture, workplace environment and level of noise all affect employee’s

performance. Also it was found that 36% of all the respondents were aware about the

workplace ergonomics issues. Lastly, budgetary constraints, technological factors and

old design of the hospital were ranked as the top barriers towards ergonomics design

at MNH. This implies that healthcare facilities need to consider and improve

workplace ergonomics as a tool for improving healthcare employees’ performance.

Furthermore, there is a need to take initiatives for improvement of awareness on

workplace ergonomics in the healthcare facilities.

The study therefore recommends more training on workplace ergonomics aimed at

boosting up employee’s awareness. Also, healthcare facilities need to invest in

technology advancements as well as allocation of more financial resources for

improvement of workplace ergonomics. The study also recommends that healthcare

facilities should be designed in ways that support workplace ergonomics.

vii

TABLE OF CONTENTS

CERTIFICATION ...................................................................................................... i

DECLARATION ........................................................................................................ ii

AND ............................................................................................................................. ii

COPYRIGHT ............................................................................................................. ii

ACKNOWLEDGEMENT ........................................................................................ iii

DEDICATION ........................................................................................................... iv

ABBREVIATIONS AND ACRONYMS .................................................................. v

ABSTRACT ............................................................................................................... vi

LIST OF TABLES ................................................................................................... xii

LIST OF FIGURES ................................................................................................ xiii

CHAPTER ONE ........................................................................................................ 1

PROBLEM SETTING ............................................................................................... 1

1.1 Background of the Study ........................................................................................ 1

1.2 Statement of the Problem ....................................................................................... 6

1.3 Objectives of the Study .......................................................................................... 8

1.3.1 General Objective................................................................................................ 8

1.3.2 Specific Objectives.............................................................................................. 8

1.4 Research Questions ................................................................................................ 8

viii

1.5 Significance of the Study ....................................................................................... 9

1.6 Limitations of the Study ......................................................................................... 9

CHAPTER TWO ..................................................................................................... 11

LITERATURE REVIEW ........................................................................................ 11

2.1 Conceptual Definitions ........................................................................................ 11

2.1.1 Ergonomics ....................................................................................................... 11

2.1.2 Workplace ......................................................................................................... 13

2.1.3 Workplace Ergonomics ..................................................................................... 13

2.1.4 Ergonomics Risk Factors (ERFs) ...................................................................... 13

2.1.5 Musculoskeletal Injury and Disorders (MSD) .................................................. 14

2.1.6 Employee Performance ..................................................................................... 14

2.1.7 Performance Management ................................................................................ 14

2.1.8 Performance Review ......................................................................................... 15

2.2 Theoretical Literature Review.............................................................................. 15

2.2.1 Ergonomics Science Theory ............................................................................. 15

2.2.2 Theories on Employees’ Motivation for performance and Ergonomics ........... 16

2.3. Empirical Review ................................................................................................ 18

2.3.1 Factors Affecting Performance ......................................................................... 18

2.3.2 Ergonomic Considerations at the Workplace .................................................... 20

2.3.4 Workplace ergonomics and Healthcare Employees .......................................... 22

ix

2.3.5 Workplace Ergonomics Awareness .................................................................. 24

2.4 Conceptual Framework ........................................................................................ 25

CHAPTER THREE ................................................................................................. 27

RESEARCH METHODOLOGY ........................................................................... 27

3.1 Study Area ............................................................................................................ 27

3.2 Research Paradigm ............................................................................................... 27

3.3 Research Design ................................................................................................... 28

3.4 Population, Sample method and Sample size ...................................................... 28

3.4.1 Study population ............................................................................................... 28

3.4.2 Sampling procedures ......................................................................................... 29

3.4.3 Sample Size ....................................................................................................... 29

3.5 Types of Data and Data Collection Techniques ................................................... 30

3.5.1 Primary Data ..................................................................................................... 30

3.5.1.1 Questionnaire ................................................................................................. 31

3.5.1.2 Interview ........................................................................................................ 31

3.6 Validity and Reliability ........................................................................................ 31

3.7 Data Measurement and Analysis .......................................................................... 32

3.8 Ethical Issues ........................................................................................................ 32

CHAPTER FOUR .................................................................................................... 34

PRESENTATION OF FINDINGS ......................................................................... 34

x

4.1 Introduction .......................................................................................................... 34

4.2. Socio-demographic data of the respondents ....................................................... 34

4.2.1 Gender of respondents ...................................................................................... 34

4.2.2 Age distribution of respondents ........................................................................ 35

4.2.3 Field of work ..................................................................................................... 35

4.2.4 Level of work .................................................................................................... 36

4.2.5 Department/unit................................................................................................. 36

4.2.6 Working experience .......................................................................................... 37

4.3 Research Question 2: Level of health care employee’s awareness on workplace

ergonomics ................................................................................................................. 37

4.4 Health care employee’s satisfaction with the offices/workplaces........................ 39

4.5 Workplace ergonomics and employee’s health and safety .................................. 41

4.6 Research Question No. 1: Workplace ergonomics and healthcare employee’s

performance................................................................................................................ 45

4.6.1 Correlation......................................................................................................... 48

4.6.2 Regression ......................................................................................................... 49

4.7.1 Old design of the hospital ................................................................................. 50

4.7.2 Old infrastructure of the hospital ...................................................................... 51

4.7.4 Space limitations ............................................................................................... 53

4.7.5 Insufficient staffing ........................................................................................... 53

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4.7.6 Budgetary constraints ........................................................................................ 54

4.7.7 Technological factors ........................................................................................ 55

4.7.8 Respondents’ suggestions on improving comfortability, safety, health and

security at workplace.................................................................................................. 56

CHAPTER FIVE ...................................................................................................... 58

DISCUSSION OF FINDINGS ................................................................................ 58

5.1 Introduction .......................................................................................................... 58

5.2 Workplace ergonomics and healthcare employee’s performance ........................ 58

5.3 Health care employee’s awareness on workplace ergonomics ............................ 60

5.4 Barriers toward ergonomic design of workplaces ................................................ 60

CHAPTER SIX ........................................................................................................ 63

SUMMARY, CONCLUSIONS AND RECOMMENDATIONS ......................... 63

6.1 Introduction .......................................................................................................... 63

6.2 Summary .............................................................................................................. 63

6.3 Conclusion ........................................................................................................... 64

6.4 Recommendations ................................................................................................ 65

6.5 Areas for further study ......................................................................................... 66

REFERENCES ......................................................................................................... 67

APPENDIX II ........................................................................................................... 84

xii

LIST OF TABLES

Table 3. 1: Sample of Informants and its Distribution .............................................. 30

Table 4. 1: Gender of respondents ............................................................................. 34

Table 4. 2: Age distribution of respondents ............................................................... 35

Table 4. 3: Field of work ............................................................................................ 35

Table 4. 4: Level of work ........................................................................................... 36

Table 4. 5: Directorates .............................................................................................. 36

Table 4. 6: Working experience ................................................................................. 37

Table 4. 7: Level of health care employee’s awareness on workplace ergonomics .. 39

Table 4. 8: Level of health care employee’s satisfaction with office......................... 41

Table 4. 9: Healthcare employee’s performance........................................................ 47

Table 4. 10: Model summary of the study ................................................................. 49

Table 4. 11: ANOVAa ................................................................................................ 49

Table 4. 12: Coefficients ............................................................................................ 50

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LIST OF FIGURES

Figure 2. 1: Maslow’s Hierarchy of Needs(Source:(Maslow, 1954)) ........................ 17

Figure 4. 1. Office space and workplace ergonomics (Source: Survey Data,

(2020)) ........................................................................................................................ 41

Figure 4. 2. Office space and workplace ergonomics (Source: Survey Data,

(2020)) ........................................................................................................................ 42

Figure 4. 3. Level of stress (Source: Survey Data, (2020))........................................ 43

Figure 4. 4. Effect on employee’s health (Source: Field Findings, (2020)) .............. 44

Figure 4. 5: Injury (Source: Survey Data, (2020)) ..................................................... 45

Figure 4. 6: Old design of the hospital (Source: Field Findings, (2020)) .................. 51

Figure 4. 7: Old infrastructure of the hospital(Source: Survey Data, (2020)) ........... 51

Figure 4. 8: Patient congestion (Source: Survey Data, (2020)) ................................. 52

Figure 4. 9: Space limitations (Source: Survey Data, (2020)) ................................... 53

Figure 4. 10: Insufficient staffing (Source: Survey Data, (2020) .............................. 54

Figure 4. 11: Budgetary constraints (Source: Survey Data, (2020)) .......................... 55

Figure 4. 12: Technological factors (Source: Survey Data, (2020)) .......................... 56

1

CHAPTER ONE

PROBLEM SETTING

1.1 Background of the Study

Over the past several decades, studies on ergonomics design of workplaces has

attracted high research interests by many researchers in different countries due to its

significant contribution on performance in various industries i.e., manufacturing and

service organizations. This is because workplace ergonomics has been found to be

one of the critical factors for enhancing employees’ performance at workplaces. The

quality of workplace environment has a significant impact on the level of employee’s

motivation and subsequently on their performance (Kingsley, 2012). Furthermore, it

has been established that the level of employee engagement within the organization,

especially with their working environment, has a significant contribution on the

mistakes made, rate of errors, level of motivation and how well the employees interact

and relate amongst themselves at the workplace. It also has an effect on absenteeism

as well as job retention determination within an organization (Al-Anzi, 2009).

The World Health Organization has established that the workforce is among the six

building blocks of a health system and emphasized on giving the desired focus and

consideration to that valuable resource (WHO, 2010). By recognizing the importance

of workforce, there should be significant consideration on improving workplace

conditions as the motivational factors for employee performance (Tarus, 2011).

Furthermore, WHO recognizes the health workforce to include all employees engaged

in activities or actions whose primary intent is to enhance health services. Among the

motivational factors for health care employees is the setup of the working environment

which includes design and layout of the office, furniture and equipment. In workplace

ergonomics, all these should fit the human i.e. the employee using them (Al-Anzi,

2009).

2

Accordingly, the workplace ergonomics considerations include thermal comfort

which indicates the right combination of temperature, airflow and humidity (Carmen,

2013; Mendis, 2016). There are also many other factors that have a significant

contribution on the level of performance and productivity at the workplace which

include wellness and comfort in the design of the office, availability and design of

machinery and the working tools. Other factors are vibration, noise and hygiene

(Pickson, 2017). The word ergonomics has its origins from Greek and it comes from

the words “ergo” which stands for work and “nomics” which means study (Te-Hsin

and Kleiner, 2001). It is further defined as the science of designing a workplace to fit

the needs of the user (Dul and Weerdmeester, 2008) According to the Washington

State Department of Labour and Industries (2002) a safer and healthy work

environment is created when there are ergonomic improvements to the work

environment and that is the primary use of ergonomics (Kingsley, 2012).

According to the IEA, ergonomics is a scientific study on the interactions and

compatibility between people and other aspects of his life or environment including

machines, tools and systems. It takes into consideration the theories and principles that

aim to design machines, tools and work environment in a way that fits the people using

them in order to optimize performance (Dul and Weerdmeester, 2008). The ergonomic

way of designing the workplace and environment aims at minimizing the risks of

injuries or harm that may occur at the work place by establishing safe, comfortable

and productive workplaces which consider human abilities and limitations into the

design of a workplace (Kingsley, 2012). Matching workplace environment with

employees’ needs is very essential for an organization to obtain their maximum

contribution towards the organizational objectives. Employees’ morale, productivity

and engagement is affected by the workplace environment both positively and

negatively. An unsafe and unhealthy work place environment is exhibited by poorly

designed workstations, unfitting furniture, lack of enough ventilation, poor lighting,

excessive noise, inadequate safety measures in case of fire and other emergencies as

well as lack of protective gear against the various workplace hazard (Mendis, 2016).

3

Ergonomics is one of the strategic tools that can be used to attract and retain well

performing employees in an organization since it applies information about human

behaviour, abilities and limitations and other characteristics to the design of tools,

machines, tasks, jobs and environments for productive, safe, comfortable and effective

human use (McCormick and Sanders, 1992). According to the Ireland Health and

Safety Authority (2015) which has published a number of books and articles on the

subject of ergonomics, in proactive ergonomics emphasis is put on the prevention of

work related musculoskeletal disorders by taking cognizance of and reducing the risk

factors during planning stages of new systems of work and workplaces.

Ergonomics is one of the factors in occupational health and safety. According to the

ILO, occupational health and safety and ergonomic issues are on the rise and from the

2.78 million work-related deaths recorded, 2.4 million are a result of occupational

diseases and injuries (ILO, 2013). Some of the effects of the occupational diseases and

injuries include early retirements, loss of skilled workforce and absenteeism which all

have significant impact on productivity. In the ILO report, occupational accidents and

diseases not only affect the GDPs of the affected countries but also globally, estimated

at a 4 percent loss. According to Alli (2008), the financial impact from the injuries and

deaths arising from occupational health and safety are colossal at the organizational,

national and international levels due to the compensation costs, loss of working time,

medical expenses and production interruptions. The ILO is mandated to ensure that

workers are protected against work related diseases and injuries risk factors by

developing international standards (Shengli, 2010).

The ILO has adopted more than 40 instruments on various health and safety issues

among them is the Working Environment (Air pollution, Noise and Vibration)

Convention No. 148 of 1977. The Convention has been ratified by 46 countries

including the United Republic of Tanzania which has ratified the same on-air pollution

only. Noise and vibration are among the working environment considerations in

ergonomics.

4

Looking at ergonomics in the developed countries, also referred to as the Industrially

Advanced Countries, they are seen to have more advances in the knowledge and

application of ergonomics and its principles. Most of the ergonomics principles were

originally formulated the IACs and there is significant improvement on ergonomics

applications in the countries (Shahnavaz, 2000). This is because of the technological

advancement in the countries, lower levels of poverty and the smallness of their

populations as compared to the IDCs. The level of ergonomic awareness, applications,

advancements in the IACs can be seen through the richness of literature on the subject

and the systematic approach of addressing ergonomics issues including the formation

of ergonomics societies in most of the countries. However, over the past few decades

there has been a significant improvement and interest on ergonomics in the IDCs as

seen through various publications (Huck and Richardson, 2012).

As for developing countries, also referred to as Industrially Developing Countries,

they are mostly characterized by larger populations, higher levels of poverty and lesser

advancements in technology making them to have the greatest needs in improvement

of ergonomics (O’Neil, 2000). The IDCs have challenges of poor infrastructure and

insufficient finances to facilitate and support ergonomic applications and interventions

(Jafry and O'Neil, 2000). These challenges, as suggested by (Mc Neill et.al, 2000) are

the attributes toward low machine utilization, insufficient skills, unmotivated

workforce, excessive environmental hardships and heavy physical loads. Most of the

IDCs rely on agriculture which has extremely difficult conditions including heavy

work and poor working tools. It is suggested that the rate of injuries resulting from

accidents in the workplaces in the IDCs is significantly higher than that of the IACs

(Jafry and O'Neil, 2000).

Tanzania as one of the IDCs has limited knowledge and awareness on the subject of

ergonomics and as a result there is sanctity of research material and publications on

the subject. Like other IDCs, Tanzania faces the same challenges in ergonomics

development as discussed. In cognizance of the issues of employees’ welfare including

safety at the workplace, and the ILO’s efforts to ensure that employers provide

5

workplaces are safe for the employees, the Government of Tanzania has taken

initiatives to improve health and safety. The Occupational Health and Safety Act, No.

5 of 2003 was enacted for the purpose of making provisions for the safety, health and

welfare of employees at their workplaces. The Act has also established the

Occupational Health and Safety Authority (OSHA) which is mandated among other

things to oversee the implementation of the Act and to advise the Government of the

United Republic of Tanzania on issues of health and safety of the workplace. Among

the activities undertaken by OSHA in enhancing health and safety of workers is risk

assessment of workplaces, statutory inspection as well as scrutiny and approval of

workplace drawings and plans.

Furthermore, through the National Employment Policy of 2008, the Government of

United Republic of Tanzania undertakes to continue enforcing health and safety in the

workplaces by ensuring that they are conducive to physical, psychological and social

wellbeing of the workforce (National Employment Policy, 2008). In addition to that,

the National Occupational Health and Safety Policy was developed in 2009. The

Policy emphasizes on the importance of occupational health and safety for sustainable

development enhanced through reduction of occupational accidents and diseases

which have a negative impact on individual, enterprise and national levels. It further

recognizes the positive impact of health and safety of the workers in productivity,

higher morale, job satisfaction and hence industrial harmony (National Occupational

Health and Safety Policy, 2008). The undertaking of the Policy is to improve health

and safety for workers through regular review of legislation and standards as well as

creating awareness on health and safety culture among workers and employers.

The Muhimbili National Hospital (MNH), the case for this study, has its origins going

back to the 1910 to 1920s when it was known as Sewahaji Hospital and 1956 when it

was known as Princess Margareth Hospital, the MNH was established as an

autonomous public institution by the Muhimbili National Hospital Act No. 5 of 2000.

This was after the dissolution of the previously existing Muhimbili Medical Centre

and the establishment of the hospital and the university as two separate entities

6

(Muhimbili National Hospital Act, 2000). The Hospital has a bed capacity of 1,500

beds for inpatients and attends an average of 2000 outpatients per day. The Hospital

has a total of around 2,700 employees of whom about 300 are doctors, 1,200 are nurses

and health attendants while the rest are supporting operational employees (Muhimbili

National Hospital, 2019). The Hospital’s vision is to be a centre of excellence in

specialist and highly specialized services in medicine, training and research by 2022

and the mission is to provide sustainable, effective, efficient and high quality tertiary

specialist services and highly specialized medical services for local and international

referred patients, as well as providing conducive environment for training and research

(Muhimbili National Hospital, 2017).

1.2 Statement of the Problem

Over a period of several years the demand for improved performance in the public

health facilities has been increasing. This started with the integration of private

practice in public institutions whereby they were required to attend private patients as

a means of increasing their financial capacity (Museru and Grobb, 2003). This means

that public health facilities were to compete with private facilities in order to attract

private patients and thus were expected to operate more efficiently similar to private

facilities. Furthermore, the demand for improved performance in public health

facilities has continued to increase whereby public health facilities are expected to

improve performance by introducing new tertiary services which before required

patients to be referred abroad as they were not available in the country.

Despite this increased demand and expectations which reflects the need for

improvement of employees’ performance, public health facilities in Tanzania have not

considered workplace ergonomics as a tool for improvement of employees’

performance. Rather, public institutions’ efforts to improve performance are directed

to appraisals, performance contracts, trainings and monetary incentives. Performance

assessment in the public institutions is currently mostly done by using the Open

Performance Appraisal System (OPRAS) which was introduced by the Tanzania

Government in 2004 (Nchimbi, 2019). However, such traditional tools used for

7

assessment and improving performance have not been very successful as they do not

take into consideration the issue of workplace ergonomics as among the factors which

enhance employee and ultimately organizational performance.

It has been established that a well-designed facility will facilitate the smooth and

quality delivery of services (Haynes, 2008). This will also allow the optimal utilization

of the space, reduce likelihood of injury and ensure safety, which are all favorable

factors for improved performance. However, failure of public health institutions to

consider workplace ergonomics has led to having unfavorable working conditions.

This has resulted in, among others, complaints of musculoskeletal injuries and back

pain, for example, anecdotal evidence shows that back pain is one of the major

complaints among the nursing staff of Muhimbili National Hospital.

These complaints are the cause of many cases of absenteeism and demands for light

duty, and excuse duty which eventually impact the performance. According to

(Yankson, 2012), when studying the effects of health and safety standards on

productivity in the rubber industry in Ghana, employees working in an unfavorable

working environment may be observed to be not as productive as those in favorable

conditions because they have to cope with many hazards and other factors that put

their safety at peril for example too much noise, handling and using dangerous

equipment or machines that may cause injury or health problems to them.

Though the significance of the study of ergonomics is undisputable it has been

observed that there is an insufficient awareness about the subject and its applications

in the diverse occupations and professional groups varying from manual workers to

IT professionals (Pandve, 2016). In a pilot study on ergonomics awareness (Pual,

2012) found that 53% of the nurses were not aware about ergonomics and safety

measures and 75% were not following ergonomics and improper lifting and patient

handling techniques could have led to musculoskeletal injuries among them.

This research aims to study employee and management awareness on the concept of

workplace ergonomics, the extent to which employees are satisfied with the

8

ergonomics at their work stations and thus bring to light the role of workplace

ergonomics in the public health sector so that decision makers (the Hospital’s

Management and the Government) will put more efforts in improving workplace

ergonomics in public health facilities.

1.3 Objectives of the Study

1.3.1 General Objective

The main objective of this study is to assess the role of workplace ergonomics on

healthcare employee’s performance, the case of Muhimbili National Hospital in

Tanzania.

1.3.2 Specific Objectives

The specific objectives for this study are:

i. To determine the extent to which workplace ergonomics influence

healthcare employees’ performance at workplace, the case of

Muhimbili National Hospital.

ii. To examine healthcare employees’ awareness about ergonomics design

of the workplaces, the case of Muhimbili National Hospital.

iii. To document the barriers towards ergonomic design of workplaces as

a tool for improving employees’ performance in healthcare facilities,

the case of Muhimbili National Hospital.

1.4 Research Questions

The study was guided by the following research questions: -

i. To what extent does workplace ergonomics influence the performance of

healthcare employees at Muhimbili National Hospital?

9

ii. Are the healthcare employees aware about ergonomics design of

workplaces, at Muhimbili National Hospital?

iii. What are the barriers towards ergonomic design of the workplaces as a

tool for improving employees’ performanceat Muhimbili National

Hospital?

1.5 Significance of the Study

This study aims at assessing the role of ergonomics to the performance of employees

in the healthcare industry with the aim of also assessing the awareness of both the

employees and the management on the subject of ergonomics. The findings from this

study provided the management with the clear picture on the role of ergonomics of the

workplace and the importance of taking it into consideration when developing its

strategies to improve productivity and the institutional performance. The significance

of this study is not only limited to MNH but the health services at large. Being the

national referral Hospital in Tanzania, Muhimbili National Hospital has significance

influence on other public and private hospitals hence any improvement at MNH is

mostly likely to trickle down and impact the health sector in Tanzania.

1.6 Limitations of the Study

The conduction of this research faced some of limitations which were most of the

employees in the public health sector and specifically at the Muhimbili National

Hospital have tight work schedules due to the sensitivity and high demanding nature

of the services being provided by them hence timely response to questionnaires was a

challenge. In addressing this issue, the researcher used online google forms whereby

the questionnaire forms were shared through the google forms link through WhatsApp,

this was only for few respondents who failed to respond timely and found it harder to

fill manual forms. Furthermore, there was scanty local literature on this subject, the

researcher used the available international literature just to fill that gap.

10

1.7 Organization of the Report

This study is organized into five chapters as follows:

Chapter one provides an introduction covering background of the study covering an

overview of workplace ergonomics and how it is being practiced in both developed

countries, developing countries and the situation in Tanzania. The chapter further

presents statement of the research problem, the research objectives, research questions

and significance of the study.

Chapter two presents and examines the various concepts on the subject of workplace

ergonomics by reviewing relevant previous studies’ findings and contributions on the

same. The chapter provides an understanding on the concept of workplace ergonomics

and explores on workplace ergonomics in health delivery. It further provides

theoretical review and critical review on empirical literature in the area of study and

provides the conceptual framework.

Chapter three offers the manner in which sources and information for the study were

obtained. It covers the research design for this study, study area, sample and sampling

procedures, data sources and types, data collection techniques and data analysis.

Chapter four, chapter five, chapter sixoffer the presentation of all the findings from

the field, the discussions of all the findings in relation to theories and empirical studies,

the conclusions, recommendations and areas for further studies respectively.

11

CHAPTER TWO

LITERATURE REVIEW

2.1 Conceptual Definitions

2.1.1 Ergonomics

Ergonomics is a scientific study on the interactions between people and some aspects

in their use including the general environment, equipment and systems (International

Ergonomics Association, 2010). In workplace ergonomics all the aspects in contact or

in use by a person should take into consideration the suitability on such person to allow

easy and smooth implementation of tasks, reduce the likelihood of injuries including

any repetitive movements that strain the body and cause muscular discomfort and

injury. The aim of ergonomics is to facilitate designing of tools, machines,

workstations and systems that are well fitted for human beings and consider human

abilities and limitations (Roeloelofsen, 2002). The IEA uses the word human factors

and ergonomics interchangeably or separately as units because one cannot separate

human factors and ergonomics (IEA, 2012).

Ergonomics is categorized into two braches i.e. macro-ergonomics and micro-

ergonomics. Macro-ergonomics is focused on the wider aspect of social-cultural and

organizational system issues which include culture (attitude, religious beliefs etc.),

infrastructure and climate. On the other hand, micro-ergonomics focuses on the

individual and his/her physiological, psychological and cognitive aspects i.e. the man-

machine interaction (Dul and Weerdmeester, 2008). According to O’Neill and Albin

(2011), office ergonomics should have a holistic approach integrating not only

engineering and cognitive aspects but also a wider aspect of issues that are to be

considered in designing the workplace and the work. The holistic approach to

ergonomics looks into the physical, psychological and social factors in the application

of ergonomics.

12

Figure 2.1: Holistic ergonomics

(Source: (O’Neill and Albin, 2011))

The physical factors of ergonomics relate to physical activity and include the force

used to fulfill the task, duration of the task and frequency of the task. Such activities

include lifting of objects, handling of machines and other materials, working postures

as well as the design, health and safety of the workplace. The psychological or mental

aspects of ergonomics are related to the compatibility of the machines, tools and

systems with the cognitive ability of the user. These factors focus on the user’s human

perception, reasoning and memory and they are sometimes referred to as cognitive

psychological factors. As for the social aspect of ergonomics, this refers to the social

component of employee’s collaboration within the organization and includes factors

like employee’s mentoring and learning, participation in the organization’s systems,

structures, policies and processes (McCormick and Sanders, 1992).

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2.1.2 Workplace

The term workplace generally means the area in which employees perform their work

and it includes the work and non-work area, the equipment and all other facilities used

in the performance of work (Chim, 2017).

2.1.3 Workplace Ergonomics

Workplace ergonomics is the consideration of various human factors in designing

effective, safe work stations and systems of the workplace. These factors include

environmental conditions, sitting postures, movements, weight lifting and body strain.

Various researchers have defined the concept of workplace ergonomics in related

terms. By some it has been defined as a branch of science concerned with the

achievement of optimal relationships between workers and their work environment

(Tayyari and Smith, 1997). On the other hand, according to Fernandez (1995)

workplace ergonomics is about designing the work equipment, machines, tools,

product, environment and systems by taking into account the human’s physical,

physiological, biomechanical, and psychological capabilities in order to optimize the

effectiveness and productivity of work systems while assuring safety, health and

wellbeing of the workers. In general terms, in workplace ergonomics emphasis in

designing is to fit the workplace and work to the individual and not vice versa. It is

further asserted that a variety of conditions of a workplace can affect the worker’s

comfort and health and these include factors like workstation design, tool and machine

design, furniture (chair) design, heavy lifting, motion and other environmental factors

like temperature, noise, vibration and lightning (Jaffar et al. 2011).

2.1.4 Ergonomics Risk Factors (ERFs)

Risk factors can be defined as all those conditions or circumstances that increase the

likelihood of occurrence of an accident or injury. ERFs include repetitive movements,

awkward positioning of the body, heavy lifting and extreme temperatures in the office

or working environment, which if not well addressed may affect performance

(Jagannath and Adalarasu, 2012). A workplace ergonomics design or improvement

14

process removes all of these risk factors that have been found to be the cause of

musculoskeletal injuries and disorders and allows for an improved human

performance and productivity (Chim, 2017).

2.1.5 Musculoskeletal Injury and Disorders (MSD)

Musculoskeletal injuries and disorders are injuries or pains in the musculoskeletal

system of the human body, including joints, ligaments, muscles, nerves, tendons and

the structures that provide support to the limbs, neck and back such as the spinal disks

(Kumar, 2001). According to the Centre for Disease Control and Prevention (CDC),

(2015), injuries can be caused by a sudden or sustained exposure to repetitive motion,

vibration, use of force and awkward positioning of the body. MSDs result from the

human body’s interaction with physical factors, ergonomics and occupational factors

(Gatchel and Kishino, 2011). MSDs have been an issue of increasing concern globally

and it is among the leading causes of disability (ILO, 2013). The risk factors for MSDs

have been categorized into biomechanical factors, individual differences,

psychosocial and occupational factors.

2.1.6 Employee Performance

Employee performance is defined as the level of execution of job related activities

(Karakas, 2010). Normally, every organization has its goals, objectives and activities

and such goals are assigned to the employees in their respective roles which are then

measured to determine performance. Therefore, the dimensions of employee

performance evolve around setting strategic goals, maintaining standards, motivation

and supervision of subordinates to ensure accomplishment of tasks (Tripathy, 2014).

2.1.7 Performance Management

Performance management is the systematic and ongoing process of managing the

achievement of the organizational goals which include planning, monitoring,

evaluating and reviewing the performance. The process involves setting of strategic

objectives, identifying activities and indicators for performance, feedback provision

and review of the results (Pradhan and Jena, 2016). Performance management not only

15

assists an organization in meeting its strategic plans but also in making decisions with

regards to improvement of working conditions, employee development, employee

motivation and the overall management of the human resource (Pulakos, 2004).

2.1.8 Performance Review

This is a method through which organizations measure the implementation of

activities assigned to individual employees on a frequent basis such as semiannual or

annual reviews (DeNisi and Pritchard, 2006). According to Hellriegel (2014),

performance management is an essential part of human resources management and an

effective performance management system is imperative for organizational success.

2.2 Theoretical Literature Review

The following are the theories that relate to this study and help in understanding the

whole concept and relationship between workplace ergonomics and employee

performance in an in-depth and broader understanding.

2.2.1 Ergonomics Science Theory

The theories on ergonomics science started approximately 80 years ago during the

Second World War from the need to address the complex handling of military

equipment when it was realized that use of knowledge on technology and human

sciences was needed, in a systematic and coordinated manner (Sanders, 1992). This

included the use of interdisciplinary approach involving Physiologists, Psychologists,

Anthropologists, Medical Doctors, Engineers and Work Scientists to address the

challenges. After such successful developments, the interest in ergonomics grew fast

especially in the European countries and in 1949 the International Ergonomics

Association with representation from more than 40 countries was established (Ghosh

et al. 2011). This theory has significantly contribution and is what later led to what is

called workplace ergonomics. Based on the ergonomics science theory, several

ergonomic recommendations have been suggested in various empirical studies in

respect of conditions of work places and have been providing guidance in designing

of workplaces, systems and operations (Pickson, 2017).

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2.2.2 Theories on Employees’ Motivation for performance and Ergonomics

It is important to understand the role of motivation on employee performance, since

workplace ergonomics has been identified as one of the motivational factors for

performance (Tarus, 2011). The following theories on employee’s motivation are

discussed in relation to workplace ergonomics and performance.

Maslow’s Theory of Hierarchy of Needs

This theory which is also referred to as Maslow’s Triangle was developed by Abraham

Maslow, it suggests that people are motivated with needs categorized in five levels

which are physiological needs, safety, belonging, esteem and self-actualization in the

same hierarchy (Maslow, 1954). The two basic level needs in the theory are relevant

in understanding the relationship between workplace ergonomics and employee

performance which are physiological and safety needs. As shown in figure 1, the

physiological level are the basic needs for sustaining human life such as food, water,

shelter, health, clothes and sleep. These according to Maslow are what are considered

in internal motivation. The theory further states that people are compelled to have

these needs fulfilled first before pursuing other higher level needs (Deckers, 2018). It

is suggested that once the physiological needs are fulfilled, the safety needs are next

in importance and these include among others safety needs against accidents, injuries

and illnesses which are the important factors in employee performance.

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Figure 2. 1: Maslow’s Hierarchy of Needs

Source: (Maslow, 1954))

Herzberg’s Two Factor Theory

The two-factor theory also known as the motivation-hygiene theory was developed by

Frederick Herzberg and it states that there are two sets of factors at the workplace i.e.

those which motivate employees and bring job satisfaction (satisfiers) and those which

demotivate them and cause dissatisfaction(dissatisfiers) (Herzberg, 1959). The

satisfiers are related to the job and include factors such as recognition, challenging

work and responsibility. The dissatisfiers on the other hand include factors such as

working conditions, job security, salary and fringe benefits. These do not bring

motivation to the employees if present but their absence brings dissatisfaction

Herzberg, 1974). This theory was developed in order to provide an opportunity for

employees to take part in the planning, performing and evaluating their work (Shultz

and Sydney, 2010).The theory is connected with this research in the sense that

workplace ergonomics i.e. the appropriate designing and use of the workstations or

offices, equipment and tools will improve the workplace environment because the

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=imgres&cd=&cad=rja&uact=8&ved=0ahUKEwjT3pnpxuHQAhVCrRQKHXpDCH4QjRwIBw&url=https://en.wikipedia.org/wiki/Maslow's_hierarchy_of_needs&psig=AFQjCNEiDmOQBjvEeKHH5g7n2_wHWJoFjw&ust=1481181932294609

18

absence of such favourable environment may bring dissatisfaction to employees and

affect their performance.

Both theories concentrate on the human factors i.e. the physiological and

psychological factors which motivate employees to perform optimally. For instance,

motivation is considered as an important element in the design and creation of working

equipment (Maslow, 1954). Since workplace ergonomics is all about having a

workplace that meets the needs of the user i.e. the employee, the theories help in

providing a deeper understanding of the importance of workplace ergonomics on

employees’ motivation and performance.

2.3. Empirical Review

Several studies have been made on the science of workplace ergonomics and its

implications on employee performance in the various sectors. This is because it is

undisputable that employees are the most valuable asset in any organization or

company and most employers would want to address any factors that may hinder the

optimization of the human resource. As stated in the theoretical review, some scholars

tried to establish the factors enhancing or affecting performance by trying to

understand what motivates them to perform and what demotivates them.

2.3.1 Factors Affecting Performance

It is important in this study to review literature of employee performance and factors

affecting it. Some studies have indicated the existence of a strong relationship between

the work environment, including work place design and use of machines and tools,

and the level of employee performance. Mendis (2016) in a study on operational level

employees in the apparel industry of Sri Lanka, found that improvement of work place

ergonomics (equipment, workplace layout, lighting and ventilation) resulted into

increased performance of the employees. In yet another study, Al Anzi (2009)

concluded that employee performance is affected by two categorized factors namely

the management driven factors and factors related to the office or factory design. The

management driven factors include organizational plans, job descriptions and

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management support while those related to the premises include availability of work

space, furniture ventilation and humidity as well as temperature.

However, Al Anzi (2009) did not consider cognitive factors to be equally important

factors affecting performance but concentrated only on managerial issues and

premises which by themselves only may not enhance performance. This is because

even the best premises and equipment must be complemented with the employee’s

cognitive skills in optimizing them. The cognitive skills include correct reasoning and

judgment as well as a good memory and perception. This approach was also taken by

Leblebici (2012) who considered the factors affecting performance in two categories

of physical components and behavioural components. The physical components are

office layout and space, ventilation, temperature, physical security and overall comfort

of the employee. The behavioural components on the other side include the

employee’s level of interaction and distraction with the physical environment and

equipment.

In a study on the effect of ergonomics on employee performance in the butchering and

trimming line of canned food in Ghana, Pickson et al. (2017), established that there

was a positive correlation between workplace ergonomics and employee performance.

Furthermore, it was found that the physical environment and comfort of the workplace

had a direct link to the office occupants’ performance, although it was observed that

comfortability could be subjective and that there was no clear and generally accepted

description of what a comfortable workplace would be assessed (Haynes, 2008).

However, there are several studies on what would be regarded as a comfortable work

place as seen through various publications including those by the IEA and other

ergonomic associations around the world which provide the dimensions of a

comfortable work place, furniture, equipment and even the job itself (Fernandez,

1995).

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2.3.2 Ergonomic Considerations at the Workplace

It has been suggested that a workplace which has considered ergonomic principles in

its design will result in less musculoskeletal discomfort, increased performance and

efficiency, reduce operational costs and even enhance more utilization of the human

resources (Al-Anzi, 2009). According to Carmen (2013) ergonomic considerations

include the overall comfortability of the workplace with regards to temperature,

humidity and airflow. The ergonomic considerations and interventions should be able

to address both macro-ergonomic factors and micro-ergonomic factors hence

ergonomic interventions should address the factors discussed below.

Work stations Design

Work station refers to the overall location in which employees perform their work and

includes all facilities and equipment used for performing the work. In most offices the

work station would include the layout, space, desk, chair, space, and a computer set

up (Chinyere, 2014). All these should be designed and fitted to the physical and

psychological comfort of the employees and enhance their performance (Olabode et

al. 2017).

Working Posture

Posture is the automatic and unconscious body positioning assumed for purposes of

providing body balance when in space (Carini et al. 2017). The IEA has established

that working postures and movement are among the issues in physical ergonomics

when addressing musculoskeletal health, together with material handling and

workplace layout. Working postures and movement are considered important factors

in occupational health and must be considered in the physical exertions that cause

musculoskeletal disorders (Vieira and Kumar, 2004). According to Kumar (2001),

“awkward, constrained, asymmetric, repeated and prolonged posture can overload

tissues and exceed their thresholds of tolerable stress, causing injury due to

overexertion or imbalance”.

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Although Mc Neill et al. (2000) argued that awkward posture may vary from culture

to culture giving an example of sitting posture which are considered normal in the

Indian culture, a posture cannot be ideal if it poses as a risk factor in musculoskeletal

injury. It has been emphasized in literature that although there may not be an “ideal”

working posture, there are inarguably postures that are healthier and more comfortable

than others (Marmaras and Nathanael, 2016). In a study on safe postures in manual

lifting work for construction workers, Adeyemi et al. (2014), revealed that safe posture

among the workers who handle manual lifting work was very low and had significant

impact in musculoskeletal stress.

Noise

Noise is any unwanted and unpleasant sound that is disruptive to the human being.

There are many factors that affect human performance among them being the working

conditions including noise (Kahya, 2007). Noise is among the factors that constitute

the working environment and noise management is a significant factor in ergonomics

considerations (Qutubuddin et al. 2012). Nassiri et al. (2013) found that the impact of

noise was significant in reducing human performance and responsible for making

difficult working environment conditions at the workplace.

Manual Lifting

Lifting is defined as the act of carrying or moving something from one position to

another (Coenen et al. 2014). It has been established in some studies that there is a

strong association between manual frequent lifting and incidences of LBP and that

lifting more than 25kgs potentially increased the rate of LBP incidences by 4.3%

(Coenenet al. 2014). Manual lifting of objects and patients was found to be the leading

factors of LBP among nurses in a cross sectional study in the Benghazi Medical Centre

in Libya whereas it was found that half of the nurses cited LBP as the reason for their

absenteeism and low performance (Mukhtad, 2017). In a study on employees at a

medical warehouse at a hospital in Belgium it was concluded that proper lifting

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techniques can help in reducing the time spent on postures that are harmful for the

back which increase incidences of LBP (Matthys et al. 2019).

2.3.4 Workplace ergonomics and Healthcare Employees

Health/healthcare is one of the most important sectors in any society as it has a

significant contribution to the economic development as it is indisputable that a

healthy population is a productive population. It has been argued that health

improvement is one of the determinants and methods to facilitate the economic

development and poverty reduction in any society (Husain, 2010). According to the

WHO, health workforce is among the six pillars of a successful health delivery system

and it is of utmost importance. Hospitals and health services facilities generally

provide health services, patient care and other supportive non- health services hence

hospital workforce comprises of diverse groups of professions (Janowitz et al. 2006).

It has been reported in various studies that hospital employees face various risks which

expose them to work related injuries and diseases such as MSDs especially those who

are involved in direct patient care.

Hospital employees are exposed to greater risks of muscles strains such as back strains

and other MSDs caused by their work, at a higher rate than employees working in the

manufacturing, mining and construction industries (Kim, 2017). In assessing

ergonomics risks for Hospital employees, Jagannath and Adalarasu (2012) concluded

that workers had multiple musculoskeletal issues which had a significant effect on the

performance of their activities and life. Some of the reasons sighted for poor

performance included improper work plans, lack of enough professions to meet

requirements of high patients’ admissions, inappropriate furniture and quality of

equipment.

Empirically, it has been found that consideration of workplace ergonomic factors in

design and operationalization of equipment, systems, processes and jobs led to

increased patient safety (Carayon et al. 2013). Some reports have shown that factors

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related to workplace conditions had a direct influence on the errors in the health

service delivery. Consequently, workplace ergonomics has been recognized as a

mitigation factor in reducing errors and elimination of hazards (Ulmer et al. 2008). In

addition to that, workplace ergonomics applications in health care domain has been

found to maximize the overall performance while ensuring the health, safety and

comfort of not only the health worker but also the patient (Gurses et al. 2009).

Furthermore, some studies found that the benefits of good workplace ergonomics were

seen not only on the health worker’s performance but also the workers’ quality of life

improved due to the reduced work load and body discomfort (Smith et al. 2009).

In the hospitals, apart from office ergonomics for which considerations are to be made

in office set up, furniture, computers and work stations set up, noise and temperatures,

workplace ergonomics are diverse according to the nature of work. In addressing

workplace ergonomics in hospitals, a holistic approach is needed to look into the

nature of each work and its risk factors. For example, for nurses, patients handling

including lifting and reposition are important factors while for laboratory, surgeons

and other theatre workers the workplace ergonomics issues would include static and

awkward postures and repetitive movements. In a study by Davis and Kotowski

(2015), nurses and nursing aides were found to have been exposed to lower back,

shoulder and neck pains which in many studies have been linked with patient handling

especially lifting and repositioning heavy patients. In the nursing work, especially in

the developing countries which have challenges in keeping up with advancements in

technology, patient turning and lifting cannot be avoided. It was concluded by

Driessen et al (2009) that Information Technology applications can fundamentally

impact the nature of some work in healthcare and reduce physical strains that may lead

to MSDs.

The risk factors in hospital workplace ergonomics can be removed by putting more

efforts on the reliable measures, it is important that organizations take the measures

appropriate to address each risk factor. Kim (2017) recommended that management

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of workplace ergonomics risk factors in health care should have a “holistic,

multidimensional handling, evidence-based models of causation that consider a

combination of hazards”. The same should be supported by considerable empirical

evidence on the cause and effect of the existing problem that can support the

management to make the correct interventions. In a study on workplace ergonomics

in theatres, involving surgeons, Shiromani et al. (2016) found that musculoskeletal

complaints and frequent absence from work was present among surgeons whereas out

of 127 respondents, 56 had musculoskeletal complaints and 30 had had such

complaints in previous times.

In another study on MSDs among obstetrics and gynaecology professionals, Jadhav et

al. (2019), found that there was a high prevalence of the MSDs among the

professionals, which was related to inappropriate and awkward body postures. In that

study it was found that 85% of the doctors had experienced MSDs in a period of 12

months. It was recommended that increased awareness of ergonomics including

knowledge on appropriate working postures and assessing the ergonomic risk factors

would help eliminate work related injuries.

2.3.5 Workplace Ergonomics Awareness

Despite the importance of workplace ergonomics as observed in various research,

awareness on the subject is still low for various professional groups (Pandve, 2016).

The importance of increasing efforts to create and improve workplace ergonomics

awareness cannot be over emphasized. Several measures have to be taken in increasing

workplace ergonomics awareness for employees especially at management level

(Deros et al. 2015). Proper training and awareness on office design to fit the needs of

the employee, manual handling of materials, lifting techniques which do not strain the

body and comfortable working postures have been found to have significance in

reducing MSDs. It has been recommended in some studies that orientation and training

on workplace ergonomics through seminars and conferences should be an ongoing

activity so that employees would be aware of its benefits (Olabode et al. 2017).

25

According to Ismaila (2010), the limited level of awareness on workplace ergonomics

observed among employees was attributed to the fact that most employees, regardless

of educational background and qualification, do not know of its benefits both on their

work and human daily activities. The management, however, is expected to take active

and aggressive role in enhancing awareness and therefore it should itself possess

sufficient awareness on the subject. In an assessment of the role of workplace

ergonomics for employees in the health sector in Kenya, Kahare (2012) concluded that

management awareness and support on workplace ergonomics were critical in

enhancing employees’ performance.

2.4 Conceptual Framework

From the critical review of both theoretical and empirical literature, the relationship

between the variables in this research can be illustrated in the conceptual framework

provided below in Figure 3 below whereas office design or set up, furniture,

equipment and working tools, posture and manual lifting, noise and other

environmental factors are independent variables which affect employee performance.

Figure 2.3: Conceptual framework

Independent Variables Dependent Variable Independent Variables

Office Set up/Design

Furniture

Noise

Workplace environment

Light

Temperature

Air flow

EMPLOYEE

PERFORMANCE Office/Workspace Size

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Source: (Developed by the Researcher’s from literature review, 2020)

From the theoretical an empirical literature reviewed, it is clear that employees’

performance and specifically for this study healthcare employees’ performance is

influenced by various factors which are all important. The conceptual framework

depicted above shows the relation between the dependant variable which is

employees’ performance and various ergonomic factors which are the independent

variables. The independent variables which may affect employee’ performance that

were considered in reaching the findings for this study are office design and set up,

furniture, equipment and working tools, working postures, manual lifting, noise level

and the general work environment factors which would normally include thermal

comfortability of the workplace and illumination which should be suitable to allow

optimal performance.

As seen from the various literatures reviewed as stated in this chapter, these factors

were found to have an impact on employee performance in various industries. In this

research which looks into role of workplace ergonomics in the health service delivery,

the researcher examined the role which each of the mentioned independent variables

has on the working environment at MNH and how they affect the healthcare

employees’ performance at the Hospital.

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CHAPTER THREE

RESEARCH METHODOLOGY

3.1 Study Area

This study was conducted at the MNH located in Upanga, Ilala District, Dar es Salaam.

The Hospital was chosen as it is the national referral Hospital and it is expected to set

the desired standard when it comes to healthcare delivery for both private and public

hospitals. Also as the national referral Hospital, MNH helps in the development or

improvement in Policies and Guidelines that are relevant in improving healthcare

delivery in both private and public sectors.

These are the justifications for choosing MNH as the case study in this research. MNH

has 8 directorates namely Medical services, Surgical Services, Nursing & Quality

Services, Clinical Support Services, Human Resources, Finance and Planning,

Technical Services, and Information & Communications Technology and a workforce

of around 2,700 employees who are a mix of clinical and supportive employees, all

termed as healthcare employees (World Health Organization , 2010).

Apart from being the national referral hospital, MNH offers the ideal choice of using

it as the case study for analyzing the workplace ergonomics on healthcare employee’s

performance simply because of the nature and capacity of that hospital both in terms

of working environment facilities and human capital resources. The findings of this

research can be generalized to understand the role of workplace ergonomics in health

service delivery.

3.2 Research Paradigm

Research paradigm can be defined as the general consideration of knowledge,

perceptions, beliefs, and awareness of different theories and practices used to carry

out a scientific research (Cohen et al., 2007). This study followed the

interpretivist/constructivist paradigm which is used to understand the human

experience or viewpoint of the subjects being studied (Kivunja and Kuyini, 2017).

28

3.3 Research Design

Research design is the arrangement of conditions for collection and analysis of data in

a manner that aims to combine relevance to the research purpose (Kothari, 2004). This

study adopted a descriptive case study design which is defined as an empirical research

method used to investigate a contemporary phenomenon on the dynamics of the case,

within its real life context (Yin, 2003). Case studies are conducted with various goals

including description or testing of theories and in this study helped the researcher to

investigate the theories on role of workplace ergonomic on healthcare employees’

performance.

Furthermore, Harrison et al. (2017) argued that case study research design is

pragmatic, flexible research design that is capable of giving out the comprehensive in-

depth understanding of various phenomenon. Case study design is used for researches

which aim to get understanding of a phenomenon by answering the “how” and the

“why” (Baxter and Jack, 2008). Following that, the research design chosen is suitable

for this research which aims to establish how workplace ergonomics has an impact on

health service delivery. Apart from the intention of gaining the deep understanding of

workplace ergonomic factors, the adoption of the case study research design allowed

the flexibility in data collection methods whereby both qualitative and quantitative

techniques for data collection were used.

3.4 Population, Sample method and Sample size

3.4.1 Study population

This study’s target population was all healthcare employees who are working at MNH

located in Upanga, Ilala District, Dar es Salaam. This means that the population of this

study comprised of employees who are working in clinical and the supportive

functions. Generally, MNH has employed a workforce of around 2,700 employees,

this number include both clinical and supportive employees.

The reason for targeting all employees who are working in the clinical and supportive

functions was mainly because the delivery of standard healthcare services is facilitated

29

to a significant extent by the performance of the supportive services such as

administration, human resource management, finance, procurement, engineering

works and information and communication technology in particular area.

3.4.2 Sampling procedures

In this research, a small group of respondents were involved in order to offer opinions

or views of the others (Kothari, 2004). The study sample was obtained mainly using

non – probability sampling technique, this basically involved the use of purposive

sampling technique where by convenient sampling techniques and judgmental

sampling technique were employed. Convenient sampling techniques involves

contacting respondents due to their availability and accessibility, on the other hand

judgmental sampling technique which involved respondents depending on the

researchers’ assumption that they fit into the study due to their knowledge and their

deep understanding on underlined ergonomic factors in the relation employee’s

performance.

3.4.3 Sample Size

The portion chosen to represent the population is the sample size from which a

researcher obtained primary data (Milanzi, 2009). By using this number as the total

population of the study, then the targeted sample to be used in this study was

determined by using the following formula which was proposed by (Israel, 1992) as a

simplified formula in calculating sample size.

n =

n = Sample size

N = Population 2,700

N

1+N (e2)

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e = Level of precision (sampling error) 10 percent or 0.1

n= 2,700/1+2,700(0.01)

n =2,700/1+27

n=2,700/28

n=96.4285 = 96

The determined sample size was 96 respondents.

Using provided formula,the sample size of this study included 96 respondents,

whereas 16 respondents were from the Management (Directors and Heads of

Department), 20 were non-clinical staff, 30 nursing staff and 30 clinical staff of

various cadres.

Table 3. 1: Sample of Informants and its Distribution

Target Population Sample Size

Management 16

Non-clinical staff 20

Nursing staff 30

Clinical staff 30

Total 96

Source: Researcher’s own construct, 2020

3.5 Types of Data and Data Collection Techniques

In order to undertake this study, the collection of primary data was involved.

3.5.1 Primary Data

The study’s primary data was gathered from the field targeting employees who are

working at MNH in Dar es Salaam. The primary data collection techniques that were

used in this study were questionnaires and interviews.

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3.5.1.1 Questionnaire

Questionnaire involves setting up of questions which are printed or typed and mailed

to the participants with the expectation that the said participants will read, understand

and respond to those questions (Kothari, 2004). The questions were designed to

address workplace ergonomics variables which assisted in determination of the extent

to which workplace ergonomics influence healthcare employees’ performance, the

awareness about workplace ergonomics design and in identification of the barriers that

are hindering workplace ergonomics design of the workplaces in healthcare facilities.

In order to achieve all these, the questionnaire guide for this study comprised of both

structured and unstructured questions for purposes of giving a room of obtaining clear

understanding of the variables under this study.

Questionnaire is the set of questions printed or typed and mailed to respondents who

are expected to read, understand and reply on the questions stated in the particular

form (Kothari, 2004).

3.5.1.2 Interview

Interview method is a series of questions usually open-ended questionnaire used on

one to one dialogue like discussion between the researchers and respondents in order

to gather information about a certain issue (Foddy, 1994). The main reason of using

interview in undertaking this study is to complement the data collected through the

use of questionnaire method.

3.6 Validity and Reliability

Validity as the accuracy of information that were used by this study was assured by

the use of multiple data collection tools and multiple respondent samples (Best and

Khan 1993). Therefore, in assuring validity of data the study used questionnaire and

interview guides in order to supplement information that was collected from different

respondents. Reliability of the study findings was ensured by conducting the intensive

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literature review on issues related to workplace ergonomics variables and healthcare

employee’s performance.

3.7 Data Measurement and Analysis

The methods that were adopted in collecting data relating to the pointed research

questions gave out both qualitative and quantitative data. The data obtained from the

Respondents on the variables was measured by using the nominal and ordinal scales

of measurement. Furthermore, the quantitative data relating to the influence of

workplace ergonomics factors to healthcare employees’ performance and the

awareness about workplace ergonomics design were analyzed descriptively by using

tabulation analysis, which has been presented through charts, tables and graphs.

On the other hand, qualitative information relating to identification of those factors

that are hindering workplace ergonomics design of the workplaces in healthcare

facilities were analyzed by using content analysis and this was mainly from the

responses that were obtained from unstructured questions and interview method.

In addition, the relationship between workplace ergonomics variables and healthcare

employees’ performance was analyzed by the use of correlation and multiple

regression analysis, the study used SPSS version 25 to present the frequencies, tables

and charts analyzed by the program.

3.8 Ethical Issues

Academic researches must adhere to the ethical principle that guide the way of

conducting and disseminating of research findings (Akaranga, 2016). Permission to

conduct this study was granted from Mzumbe University and from MNH which is the

study area. Consent to collect information from respondents was sought from

respondents after they were provided with full information about the purposes of this

study and their rights to engage or not to engage in the study. Confidentiality was

observed whereas respondents’ identity was kept anonymous and protected against

33

any harm. Before actual data collection respondents were made aware of the purposes

of the study.

34

CHAPTER FOUR

PRESENTATION OF FINDINGS

4.1 Introduction

This chapter presents the analysis of the findings that were collected by using

questionnaire method whereby the total of 96 questionnaires were distributed to MNH

staff. The questions were designed to address workplace ergonomics variables in

relation to healthcare employees’ performance, to determine the workplace

ergonomics design awareness among MNH staff and to identify those factors that are

hindering workplace ergonomics design of the workplaces in healthcare facilities. In

completing the questionnaire method, the findings from those few staff who were

contacted through interview method were also presented. This chapter has been

divided into two sections which are respondents’ characteristics and data findings on

the specific questions.

4.2. Socio-demographic data of the respondents

This section presents the general profile of all the respondents who were engaged in

the conduction of this study.

4.2.1 Gender of respondents

Out of 96 respondents, 45 respondents which is equivalent to 47% were male and on

the other hand, 51 respondents which is equivalent to 53% were female.

Table 4. 1: Gender of respondents

Variable measure Frequency (N) Valid Percent (%)

Male 45 47%

Female 51 53%

Total 96 100%

Source: Survey Data, (2020)

35

4.2.2 Age distribution of respondents

Out of 96 respondents, 19 respondents equivalent 20% were in the age range of 20 –

29 years, 38 respondents equivalent to 40% were falling into age range of 30-39 years,

25 respondents equivalent to 26% were falling into age range of 40-49 years while 14

respondents equivalent to 15% were falling into age range of 50 years and above.

Table 4. 2: Age distribution of respondents


20 – 29 19 20%

30 – 39 38 40%

40 – 49 25 26%

50 and Above 14 15%

Total 96 100%


4.2.3 Field of work

Out of 96 respondents, 65 respondents which is equivalent to 68% were falling into

the category of clinical staff while 31 respondents equivalent to 32% were falling into

the category of non – clinical staff.

Table 4. 3: Field of work


Clinical 65 68%

Non - Clinical/Supportive 31 32%

Other 96 100%


36

4.2.4 Level of work

Out of 96 respondents, 24 respondents equivalent 25% were in junior staff level, 34

respondents equivalent to 35% were in middle level, 22 respondents equivalent to 23%

were in senior level while 16 respondents equivalent to 17% were in managerial level.

Table 4. 4: Level of work

Variable measure Frequency (N) Valid Percent (%) Junior Staff 24 25% Middle Level Staff 34 35% Senior Staff 22 23% Management 16 17% Total 96 100%


4.2.5 Department/unit

Out of 96 respondents, 32 respondents equivalent 33% were working in Nursing and

quality services, 32 respondents equivalent to 33% were working in clinical support

services, 6 respondents equivalent to 6% were working in technical services, 5

respondents equivalent to 5% were working in medical services, 5 respondents

equivalent to 5% were working in finance and planning, 5 respondents equivalent to

5% were working in surgical services and 5respondents equivalent to 5% were

working in information and communication technology.

Table 4. 5: Directorates

Variable measure Frequency (N) Valid Percent (%) Nursing & Quality Services 32 33% Clinical Support Services 32 33%

Human Resource 6 6% Technical Services 6 6% Medical services 5 5%

Finance and Planning 5 5% Surgical Services 5 5% Information and Communication Technology 5 5%

Total 96 100%


37

4.2.6 Working experience

Out of 96 respondents, 22 respondents equivalent 23% have been in that service for

the range of 1 – 3 years, 27 respondents equivalent to 28% have been in that service

for the range of 4 -6 years, 31 respondents equivalent to 32% have been in that service

for the range of 7 – 10 years while 16 respondents equivalent to 17% have been in that

service for more than 10years.

Table 4. 6: Working experience

Variable measure Frequency (N) Valid Percent (%) 1 - 3 years 22 23%

4 - 6 years 27 28% 7 - 10 years 31 32%

More than 10 years 16 17% Total 96 100%


4.3 Research Question 2: Level of health care employee’s awareness on

workplace ergonomics

Table 4.7 presents the findings on level of awareness to these employees concerning

ergonomics issues at the workplace. Ergonomic variables which were discussed were

office set up, equipment and workplace, office furniture, environment, working

posture and manual lifting and level of noise. The findings revealed that out of all 96

respondents, 32 respondents equivalent to 33% agreed that the office set up and design

should consider workplace ergonomics, 58 respondents equivalent to 60% were

neutral 6 respondents equivalent to 6% disagreed on the same statement. The overall

results show that, 33% of all the respondents were aware about the consideration of

office set and design towards workplace ergonomics.

The respondents were asked whether the working equipment should consider

workplace ergonomics to allow for the comfortability to the worker and minimization

of risks and accidents. Out of all 96 respondents, 6 respondents equivalent to 6%

agreed that equipment and working tools should consider the workplace

ergonomics,10 respondents equivalent to 10% strongly agreed on the same while 80

38

respondents equivalent to 83% were neutral on the same statement. The overall results

show that, 17% of all the respondents were aware about the consideration of

equipment and working tools towards workplace ergonomics.

The respondents were asked whether the office furniture should consider workplace

ergonomics to allow for the comfortability to the worker. Out of all 96 respondents,

27 respondents equivalent to 28% agreed that office furniture should consider the

workplace ergonomics, 57 respondents equivalent to 59% were neutral while

12respondents equivalent to 13% disagreed on the same statement. The overall results

that, 28% of all the respondents were aware about the consideration of office furniture

towards workplace ergonomics.

The respondents were asked whether the environment issues like ventilation and

illumination should be considered in the design of rooms/offices in observing

workplace ergonomics. Out of all 96 respondents, 37 respondents equivalent to 39%

agreed that the environment should consider the workplace ergonomics, 59

respondents equivalent to 61% were neutral on the same statement. The overall results

show that 39 % of all the respondents were aware about the consideration of the

environment and the workplace ergonomics.

The respondents were asked whether the working posture and manual lifting should

consider workplace ergonomics and their awareness on the health effect they have if

not well designed. Out of all 96 respondents, 36 respondents equivalent to 38% agreed

that working posture and manual lifting should consider the workplace ergonomics,

39 respondents equivalent to 41% were neutral while 21 respondents equivalent to

22% were disagreed on the same statement. The overall results that, 38% of all the

respondents were aware about the consideration of working posture and manual lifting

towards workplace ergonomics.

The respondents were asked whether the workplace that is subjected to excessive noise

can cause lack of concentration and health effects. Out of all 96 respondents, 52

respondents equivalent to 54% agreed that they were aware about the level of noise

39

and workplace ergonomics, 10 respondents equivalent to 10% strongly agreed while

34 respondents equivalent to 35% were neutral. The overall results that, 65% of all the

respondents were aware about the consideration of level of noise towards workplace

ergonomics.

The overall findings on Table 4.7 show that, the employees were aware about

workplace ergonomics variables at different levels. The results shows 33% of the all

respondents were aware of the office set up and design towards workplace

ergonomics, 17% of all the respondents were aware of the equipment and working

tools towards workplace ergonomics, 28% of all the respondents were aware about the

office furniture and workplace ergonomics, 39% of all the respondents were aware

about the environment issues and workplace ergonomics, 38% of all the respondents

were aware of working posture and manual lifting and 65% of the all respondents were

aware of noises effects towards workplace ergonomics. In total, the average of 36%

of all respondents were aware about the workplace ergonomics issues.

Table 4. 7: Level of health care employee’s awareness on workplace ergonomics

Variable measure Frequency(N) Level of agreement

1 2 3 4 5

Office set up/Design 96 0 6 58 32 0

Equipment and Working tools 96 0 0 80 6 10

Furniture 96 0 12 57 27 0

Environment 96 0 0 59 37 0

Working Posture and manual lifting 96 0 21 39 36 0

Noise 96 0 0 34 52 10

Five Point Likert Scale

1=very unsatisfied, 2=Unsatisfied, 3=Neutral, 4=Satisfied, 5=Vet satisfied


4.4 Health care employee’s satisfaction with the offices/workplaces

Table 4.8 presents level of satisfaction of heath care employees with the

office/workplaces. Out of 96 respondents, 23 respondents were very unsatisfied with

40

the existence general design of the office, 17 respondents were unsatisfied, 30

respondents were neutral, 14 respondents were satisfied and 12 respondents were very

satisfied. On the state and suitability of office furniture, 23 respondents were very

unsatisfied with the office furniture, 25 respondents were unsatisfied, 15 respondents

were neutral, 24 respondents were satisfied and 9 respondents were very satisfied.

On the size of the space allocated to their workplace, 31 respondents were very

unsatisfied with the size of the space allocated, 21 respondents were unsatisfied, 7

respondents were neutral, 25 respondents were satisfied and 12 respondents were very

satisfied. On the state of working equipment, 31 respondents were very unsatisfied

with the working equipment, 21 respondents were unsatisfied, 7 respondents were

neutral, 25 respondents were satisfied and 12 respondents were very satisfied.

Concerning room temperature, airflow and illumination, 15 respondents were very

unsatisfied with the room temperature, airflow and illumination, 30 respondents were

unsatisfied, 19 respondents were neutral, 23 respondents were satisfied and 9

respondents were very satisfied. On level of noise, 16 respondents were very

unsatisfied with the noise level in the particular workplace, 23 respondents were

unsatisfied, 20 respondents were neutral, 13 respondents were satisfied and 24

respondents were very satisfied.

The overall satisfaction level shows that, out of 96 respondents, 42% were unsatisfied

with the general design of the office while 27% were satisfied, 50% of the respondents

were unsatisfied with the state and suitability of the office furniture while 34% were

satisfied, 56% of the respondents were unsatisfied with the size of space allocated to

their workplace while 35% were satisfied, 54% of the respondents were unsatisfied

with state of working equipment while 39% were satisfied, 47% of the respondents

were unsatisfied with the room temperature, airflow and illumination while 33% were

satisfied, 41% of the respondents were unsatisfied with level of noise while 39% were

satisfied.

41

Table 4. 8: Level of health care employee’s satisfaction with office

Variable measure Frequency (N) Level of agreement

1 2 3 4 5

General Design of the office 96 23 17 30 14 12

State and suitability of office furniture 96 23 25 15 24 9

Size of space allocated to your workplace 96 26 28 8 22 12

State of the working equipment 96 31 21 7 25 12

Room temperature and airflow and illumination 96 15 30 19 23 9

Level of noise 96 16 23 20 13 24


1=very unsatisfied, 2=Unsatisfied, 3=Neutral, 4=Satisfied, 5=Vet satisfied


4.5 Workplace ergonomics and employee’s health and safety

Figure 4.1 presents the impact of the present state of workplace ergonomics towards

the employee’s health and safety whereby out of 96 respondents, 58 respondents

equivalent to 60% agreed that the office space is insufficient, 12 respondents

equivalent to 13% were neutral and 26 respondents equivalent to 27% agreed that the

space is sufficient.

Figure 4. 1. Office space and workplace ergonomics


Figure 4.2 presents manual lifting and workplace ergonomics whereby out of 96

respondents, 32 respondents agreed that their work involves heavy manual lifting of

materials, 31 respondents agreed that not much of their works involves manual lifting

60%13%

27%

Insufficiently Spaced

Neutral

Sufficiently Spaced

42

while 33 respondents said their work is very much subjected to the heavy lifting of

materials and other objects.

Figure 4. 2. Office space and workplace ergonomics


Figure 4.3 presents the level of stress resulted from the workplace environment such

as design, set up, furniture, air conditioning and noise. Out of 96 respondents, 40

respondents equivalent to 42% were not stressed by workplace environment, 13

respondents equivalent to 13% were neutral and 43respondents equivalent to 45%

were very much stressed.

33%

32%

35%

Never

Not much

Very much

43

Figure 4. 3. Level of stress


On the other hand, a respondent had the following view:

…there is no enough space for movement, and in addition, the kind of tasks that I am

performing involves standing or sitting for a long time during operations (surgeries)

and when working on my computer.

Figure 4.4 presents office/workplace environment and its effect on the employee’s

health. The findings show that 89 respondents equivalent to 93% were not affected, 5

respondents equivalent to 5% were affected while 2 respondents equivalent to 2%

were very affected.

42%

13%

45%Not stressed

Neutral

Very much stressed

44

Figure 4. 4. Effect on employee’s health

Source: Field Findings, (2020)

On the other hand, a respondent had the following view:

… The chairs and desks are not comfortable at all and this cause some people to

experience back and neck pains when they sit for long time.

Figure 4.5 presents the issues of any injury or disorder that employees have suffered

due to the workplace conditions. The findings show that 62 respondents equivalent to

65% had never been injured, 23 respondents equivalent to 24% were injured once

while 11 respondents equivalent to 11% had been injured more than once.

93%

5%

2%

Not affected

Affected

Very affected

45

Figure 4. 5: Injury


A respondent had the following view:

…I personally experienced back and neck strains that was caused by a disc

dislocation.

4.6 Research Question No. 1: Workplace ergonomics and healthcare employee’s

performance

Table 4.9 presents results on the influence of workplace ergonomics towards

healthcare employee’s performance whereby concerning the workplace environment

and healthcare employee’s performance, the findings revealed that out of 96

respondents, 27 respondents equivalent to 28% agreed that they were very

uncomfortable and unsupported by the present state of office/workplace environment

towards their performance, 21 respondents equivalent to 22% agreed that it was

uncomfortable and unsupportive while 10 respondents equivalent to 10% were neutral

on the same statement. 20 respondents equivalent to 21% agreed that the presence state

of workplace is comfortable and supportive while 18 respondents equivalent to 19%

agreed that it is very comfortable and supportive.

65%

24%

11%

Never

Once

More than once

46

Concerning office furniture and healthcare employee’s performance, the findings

revealed that out of 96 respondents, 25 respondents equivalent to 26% agreed that they

were very uncomfortable and unsupported by the present state of office furniture

which hinders their performance, 27 respondents equivalent to 28% agreed that it is


on the same. Further, 26 respondents equivalent to 27% agreed that the present state

of office furniture is comfortable and supportive while 11 respondents equivalent to

11% agreed that it is very comfortable and supportive.

Concerning space size allocated in the office and healthcare employee’s performance,

the findings revealed that out of 96 respondents, 28 respondents equivalent to 29%

agreed that they were very uncomfortable and unsupported by their office space which

hinders their performance, 30 respondents equivalent to 31% agreed that it was


on the same. Further, 21 respondents equivalent to 22% agreed that the present office

space was comfortable and supportive while 11 respondents equivalent to 11% agreed

that it was very comfortable and supportive.

Concerning the level of noise and healthcare employee’s performance, the findings

revealed that out of all 96 respondents, 10 respondents equivalent to 10% agreed that

they were very uncomfortable and unsupported by level of noise and it hinders their

performance at work, 13 respondents equivalent to 14% agreed that it is uncomfortable

and unsupportive while 36 respondents equivalent to 38% were neutral on the same

statement. Furthermore, 13 respondents equivalent to 14% agreed they were

comfortable with the level of noise at their workplaces while 24 respondents

equivalent to 25% agreed that it was very comfortable and supportive.

Concerning workplace temperature, airflow and light flow and healthcare employee’s

performance, the findings shows that out of all 96 respondents, 23 respondents

equivalent to 24% agreed that they were very uncomfortable and with the workplace

temperature, airflow and light flow and it also was not supportive of their performance

at work, 30 respondents equivalent to 31% agreed that it was uncomfortable and

47

unsupportive while 10 respondents equivalent to 10% were neutral on the same

statement. 23 respondents equivalent to 24% agreed they were comfortable workplace

temperature, airflow and light flow while 10 respondents equivalent to 10% agreed

that it was very comfortable and supportive.

Table 4. 9: Healthcare employee’s performance

Variable measure Frequency(N) Level of agreement

1 2 3 4 5

Office/workplace environment 96 27 21 10 20 18

Furniture 96 25 27 7 26 11

Size of space allocated to your office 96 28 30 6 21 11

Level of noise 96 10 13 36 13 24

Workplace temperature, airflow and light flow 96 23 30 10 23 10


1=Very uncomfortable and unsupportive, 2=uncomfortable and unsupportive, 3=Neutral,

4=Comfortable and supportive, 5=Very comfortable and supportive


Figure 4.6 presents the healthcare employees performance on the level of

measurement from those who are very much affected with the present state of

workplace ergonomics at MNH. Out of 96 respondents, 11 respondents equivalent to

11% were very much affected, 40 respondents equivalent to 42% were affected while

45 respondents equivalent to 47% were not affected.

48

Figure 4. 10: Healthcare employee’s performance


4.6.1 Correlation

Table 4.10 shows that there is correlation between dependent variable and independent

variables under this study. The correlation coefficient of 0.830 shows that there is a

high correlation between employees’ performance and the all five independent

variables which are workplace temperature, airflow and light flow, level of noise, size

of space allocated to your office, office/workplace environment and furniture. The R

square of 0.688 means that 68.8% of variations in dependent variable has been

explained by the independent variables under this study, this indicates that only 31.2%

of the variations in dependent variables depends on the other variables that are not

covered in this study.

11%

42%

47%

Very much affected

Affected

Not affected

49

Table 4. 10: Model summary of the study

Model R R Square Adjusted R Square Std. Error of the Estimate

1 .830a .688 .671 .39011

a. Predictors: (Constant), Workplace temperature, airflow and light flow, Level of noise, Size of space

allocated to the office, Office/workplace environment, Furniture

b. Dependent Variable: Healthcare employees’ performance

4.6.2 Regression

Table 4.11 presents the significance of independent variables in predicting the

outcome in dependent variable. Following this analysis, it was found that all the five

independent variables which are workplace environment in terms of temperature,

airflow and light flow, level of noise, size of space allocated to the office,

office/workplace set up and design and furniture were significant in predicting the

outcome in dependent variable which is employee’s performance at the significance

level of .000

Table 4. 11: ANOVAa Model Sum of Squares df Mean Square F Sig.

1 Regression 30.262 5 6.052 39.769 .000b

Residual 13.697 90 .152

Total 43.958 95

a. Dependent Variable: Healthcare employees’ performance

b. Predictors: (Constant), Workplace temperature, airflow and light flow, Level of noise, Size of

space allocated to your office, Office/workplace environment, Furniture

Source – Survey Data, 2020.

Table 4.12 presents the coefficients of each independent variables and their influence

towards the performance of employees at MNH. Office/workplace set up and design

as an independent variable has positive influence towards employee’s performance at

the significance level of 0.123, furniture as an independent variable has a positive

influence towards employee’s performance at the significance level of 0.093, size of

space allocated has a negative influence towards employee’s performance at the

significance level of 0.590, level of noise has a positive influence towards employee’s

performance at the significance level of 0.006 while workplace temperature, airflow

50

and light flow has a negative influence towards employee’s performance at the

significance level of 0.961.

Table 4.12: Coefficients

Model

Unstandardized

Coefficients Standardized

Coefficients t Sig. B Std. Error Beta

1 (Constant) 1.042 .127 8.219 .000

Office/workplace set up

and design .131 .084 .290 1.559 .123

Furniture .283 .167 .585 1.695 .093

Size of space allocated to

the office -.038 .071 -.079 -.540 .590

Level of noise .090 .032 .169 2.796 .006

Workplace temperature,

airflow and light flow -.006 .120 -.012 -.049 .961

a. Dependent Variable: Healthcare employees’ performance

4.7 Research Question 3: Barriers toward ergonomic design of workplaces

All the respondents were asked to rate their understanding on the barriers that hinder

the ergonomics design of the workplace at MNH. The factors under the discussion

were old design of the hospital, old infrastructure of the hospital, patient congestion,

space limitations, insufficient staffing, budgetary constraints and technological

factors.

4.7.1 Old design of the hospital

According to findings in Figure 4.6, Out of all 96 respondents, 38 respondent

equivalent to 39% strongly agreed that old design of the hospital hinders the

ergonomics design of the workplace, 21 respondents equivalent to 22% agreed on the

same while 10 respondents equivalent to 10% were neutral on the same statement. On

the other hand, 19 respondents equivalent to 20% disagreed while 9 respondents

equivalent to 9% strongly disagreed on that argument.

51

Figure 4. 6: Old design of the hospital

Source: Field Findings, (2020)

4.7.2 Old infrastructure of the hospital

Figure 4. 7: Old infrastructure of the hospital


Figure 4.7 presents that out of all 96 respondents, 19 respondents equivalent to 20%

strongly agreed that old infrastructure of the hospital hinders the ergonomics design

9%

20%

10%

22%

39%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

Strongly

Disagree

Disagree Neutral Agree Strongly

Agree

15%

29%

6%

30%

20%

0%

5%

10%

15%

20%

25%

30%

35%

Strongly

Disagree


Agree

52

of the workplace, 29 respondents equivalent to 30% agreed on the same while 6

respondents equivalent to6% were neutral on the same statement. On the other hand,

28 respondents equivalent to 29% disagreed while 14 respondents equivalent to 15%

strongly disagreed on that argument.

4.7.3 Patient congestion


strongly agreed that patient congestion hinders the ergonomics design of the

workplace, 22 respondents equivalent to 23% agreed on the same while 8 respondents

equivalent to 8% were neutral on the same statement. On the other hand, 28

respondents equivalent to 29% disagreed while 26 respondents equivalent 27%


Figure 4. 8: Patient congestion


27%29%

8%

23%

13%

0%

5%

10%

15%

20%

25%

30%

35%

Strongly

Disagree

Disagree Neutral Agree Strongly Agree

53

4.7.4 Space limitations

Figure 4.9 presents that out of all 96 respondents, 38 respondents equivalent40%

strongly agreed that space limitations hinder the ergonomics design of the workplace,

12 respondents equivalent to 13% agreed on the same while 20 respondents equivalent

to 21% were neutral on the same statement. On the other hand, 15 respondents

equivalent to 16% disagreed while 11 respondents equivalent to 11% strongly

disagreed on that argument.

Figure 4. 9: Space limitations


4.7.5 Insufficient staffing


strongly agreed that insufficient staffing hinders the ergonomics design of the

workplace, 26 respondents equivalent to 27% agreed on the same while 10

respondents equivalent to 10% were neutral on the same statement. On the other hand,

25 respondents equivalent to 26% disagreed while 21 respondents equivalent to 22%


11%

16%

21%

13%

40%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

Strongly

Disagree


Agree

54

Figure 4. 10: Insufficient staffing


4.7.6 Budgetary constraints


strongly agreed that budgetary constraints hinder the ergonomics design of the


equivalent to 4% were neutral on the same statement. On the other hand, 2 respondents

equivalent to 2% disagreed while 1 respondent equivalent to 1% strongly disagreed

on that argument.

22%

26%

10%

27%

15%

0%

5%

10%

15%

20%

25%

30%

Strongly

Disagree


Agree

55

Figure 4. 11: Budgetary constraints


4.7.7 Technological factors


strongly agreed that technological factors hinder the ergonomics design of the


equivalent to 8% were neutral on the same statement. On the other hand, 5 respondents

equivalent to 5% disagreed while 1 respondent equivalent to 1% strongly disagreed

on that argument.

1% 2% 4%

25%

68%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Strongly

Disagree


Agree

56

Figure 4. 12: Technological factors


4.7.8 Respondents’ suggestions on improving comfortability, safety, health and

security at workplace

Respondents were asked to provide some suggestions on the ways that will improve

the comfortability, safety, health and security. The data were collected through

questionnaire and interview and respondents had the following suggestions.

Construction of new administrative offices with modern ergonomically designed

furniture and other facilities. This should go along with demolishing of the old

structures of some building to allow for the creation of the modern facilities that

considers the workplace ergonomics.

Reorganizing the healthcare services by putting all the health requirement services in

one building with the modern facilities like lifting aids ad more adjustable beds. This

will facilitate the convenient and more efficient provision of services.

The government and the management of the MNH should allocate more budget for

improving working conditions at MNH. This will allow for the changes that will have

the positive impacts on the employees’ health and safety issues.

1%5%

8%

24%

61%

0%

10%

20%

30%

40%

50%

60%

70%

Strongly

Disagree


Agree

57

There should be the continuous provision of seminars and trainings so as to create

more awareness to all employees regarding workplace ergonomics. This should be

aligned with the formulation of rules and regulations that will provide the guidance

for the employees to comply.

58

CHAPTER FIVE

DISCUSSION OF FINDINGS

5.1 Introduction

This chapter provides the interpretations and discussions on the findings that were

realized based on the research questions under this study. The core issue on this

chapter is to interpret and discuss the findings in relation to theoretical and empirical

results. The findings on all research objectives were discussed and interpreted

accordingly. This research was designed to provide answers for the following

objectives; to determine the extent to which workplace ergonomics influence

healthcare employees’ performance at workplace, the case of MNH, to examine

healthcare employees’ awareness about ergonomics design of the workplaces, the case

of MNH and document the barriers towards ergonomic design of workplaces as a tool

for improving employees’ performance in healthcare facilities, the case of MNH.

5.2 Workplace ergonomics and healthcare employee’s performance

The respondents were asked about the influence of workplace ergonomics towards

healthcare employee’s performance. The questions were designed to assess each

workplace ergonomics variable and its influence on the employee’s performance. The

findings revealed that out of 96 respondents,48 respondents equivalent to 50% agreed

that they were uncomfortable with the present state of office/workplace environment

and hence it has affected their performance while 38 respondents equivalent to 40%

disagreed on the same. The findings on the present state of office furniture and its

influence on the performance revealed that out of all 96 respondents, 52 respondents

equivalent to 54% of the respondents agreed that they were uncomfortable with the

present state of office furniture and hence it affected their performance while 37

respondents equivalent to 38% disagreed on the same.

59

The findings on the size of office space and its influence on the performance revealed

that out of all 96 respondents, 58 respondents equivalent to 60% agreed that they were

uncomfortable with office space and hence it affected their performance while 33

respondents equivalent to 33% disagreed on the same. The findings on the level of

noise and its influence on the performance revealed that out of all 96 respondents, 23

respondents equivalent to 24% agreed that they were uncomfortable with level of noise

and hence it affected their performance while 37 respondents equivalent to 39%

disagreed on the same.

The findings on the workplace temperature, airflow and light flow and its influence

on the performance revealed that out of all 96 respondents, 53 respondents equivalent

to 55% agreed that they were uncomfortable with workplace temperature, airflow and

light flow and hence it affected their performance while 33 respondents equivalent to

34% disagreed on the same. In ranking these variables according to the level of their

influence on performance, it can be concluded that office size, workplace temperature,

airflow and light, office furniture, workplace environment and level of noise all affect

employees’ performance.

According to motivation-hygiene theory which was developed Frederick Herzberg,

two sets of factors were identified and grouped into satisfiers factors and dissatisfiers

factors. Relating to these findings, all the workplace ergonomics variables were

identified to have the significant impact on healthcare employee’s performance.

The findings of this study supports the findings by Mendis (2016) in a study of

operational level employees of the apparel industry in Sri Lanka where it was found

that the improvement of work place ergonomics such as equipment, workplace layout,

lighting and ventilation resulted into increased performance of the employees.

Leblebici (2012) highlighted that the physical components which are office layout and

space, ventilation, temperature, physical security and overall comfort of the employee

are among factors which affect the performance of employees. In addition, Pickson et.

al. (2017) identified a positive correlation between workplace ergonomics and

employee performance.

60

5.3 Health care employee’s awareness on workplace ergonomics

The findings on healthcare employee’s awareness on workplace ergonomics revealed

that, 32 respondents equivalent to33% of the all respondents were aware of the office

set up and design in workplace ergonomics, 16 respondents equivalent to 17% of all

the respondents were aware of the equipment and working tools in workplace

ergonomics, 27 respondents equivalent to 28% of all the respondents were aware about

the office furniture and workplace ergonomics, 37 respondents equivalent to 39 % of

all the respondents were aware about the environment issues and workplace

ergonomics, 36 respondents equivalent to 38% of all the respondents were aware of

working posture and manual lifting and 62 respondents equivalent to 65% of the all

respondents were aware of noises effects towards workplace ergonomics. In total, the

average of 35 respondents equivalent to 36% of all respondents were aware about the

workplace ergonomics elements.

According to Maslow’s theory of Hierarchy of Needs, developed by Abraham

Maslow, which categorized five levels of needs which includes physiological needs,

safety, belonging, esteem and self-actualization. The findings revealed that 36% of all

respondents were aware about the workplace ergonomics issues, this was congruent

with the theory as it shows that employees are aware about their needs at the workplace

especiallyphysiological and safety needs as stipulated by the theory. However, the low

rate on employee awareness supports the findings in the study byPandve, (2016) where

it was revealed that awareness on the importance of workplace ergonomics was still

very low for various professional groups. In addition, Olabode et al., (2017

recommended that orientation and training on workplace ergonomics through

seminars and conferences should be an ongoing activity so that employees would be

aware of its benefits.

5.4 Barriers toward ergonomic design of workplaces

The study considered various barriers that hinder the ergonomics design of the

workplace at MNH, the factors on considerations were old design of the hospital, old

infrastructure of the hospital, patient congestion, space limitations, insufficient

61

staffing, budgetary constraints and technological factors. Findings revealed that, out

of all 96 respondents, 59 respondents equivalent to 61% agreed that old design of the

hospital hinders the ergonomics design of the workplace while, 28 respondents

equivalent to 29% disagreed on that argument.

Out of all 96 respondents, 48 respondents equivalent to 50% agreed that old

infrastructure of the hospital hinders the ergonomics design of the workplace while 42

respondents equivalent to 44% disagreed on that argument. Out of all 96 respondents,

34 respondents equivalent to 36% agreed that patient congestion hinders the

ergonomics design of the workplace while 54 respondents equivalent to 56%

disagreed on that argument. Out of all 96 respondents, 50 respondents equivalent to

53% agreed that space limitations hinder the ergonomics design of the workplace

while 26 respondents equivalent to 27% disagreed on that argument. Out of all 96

respondents, 40 respondents equivalent to 42% agreed that insufficient staffing

hinders the ergonomics design of the workplace while 46 respondents equivalent to

48% disagreed on that argument.

Out of all 96 respondents, 89 respondents equivalent to 93% agreed that budgetary

constraints hinder the ergonomics design of the workplace while 3 respondents

equivalent to 3% disagreed on that argument. Out of all 96 respondents, 82

respondents equivalent to 85% agreed that technological factors hinder the ergonomics

design of the workplace while 6 respondents equivalent to 6% disagreed on that

argument. In ranking these barriers towards ergonomics design, it can be concluded

that budgetary constraints, technological factors, old design of the hospital, space

limitations, old infrastructure of the hospital, insufficient staffing and patient

congestion are barriers towards work place ergonomics design at MNH.

According to motivation-hygiene theory which was developed Frederick Herzberg,

the two sets of factors were identified and grouped into satisfiers factors and

dissatisfiers factors. Relating to these findings, barriers identified under this study fall

within the dissatisfiers factors that hinder the ergonomic design of the workplaces.The

findings in this study concur with those of Rasmussen et al., (2017) who listed

62

insufficient financial resources as among the barriers towards workplace ergonomics

design. Furthermore, the study validated the observations on factors hindering

ergonomics applications in the developing countries particularly lesser advancements

in technology (O’Neil, 2000). As also found in this study, poor infrastructure of the

Hospital inhibited by the old design was among the barriers toward workplace

ergonomic considerations confirming one of the challenges toward ergonomics

applications in the developing countries being poor infrastructure to facilitate and

support ergonomic applications and interventions (Jafry and O'Neil, 2000).

63

CHAPTER SIX

SUMMARY, CONCLUSIONS AND RECOMMENDATIONS

6.1 Introduction

This chapter presents the summary of the study findings, conclusions,

recommendations, and areas for further research.

6.2 Summary

The main objective of this study was to assess the role of workplace ergonomics on

healthcare employee’s performance, the case of Muhimbili National Hospital in

Tanzania.The specific objectives of the study were: to determine the extent to which

workplace ergonomics influence healthcare employees’ performance at workplace, to

examine healthcare employees’ awareness about ergonomics design of the workplaces

and to document the barriers towards ergonomic design of workplaces as a tool for

improving employees’ performance in healthcare facilities.

The study employed quantitative collection of data whereas questionnaires were

distributed to 96 respondents, who are employees at MNH. The collected data were

descriptively analyzed through the use of frequencies which were presented in tables,

figures and histograms.

The findings of the study revealed that the employee’s performance is affected by

office size, workplace temperature, airflow and light, office furniture, workplace

environment and level of noise. Also it was found that the average of 35 respondents

equivalent to 36% of all the respondents were aware about the workplace ergonomics

issues. Lastly, the budgetary constraints, technological factors and old design of the

hospital were ranked as the top barriers towards ergonomics design at MNH.

64

6.3 Conclusion

Workplace ergonomics and healthcare employee’s performance, following the

assessment that was done regarding the role of workplace ergonomics on healthcare

employees’ performance. It has been found that employees’ performance is affected

by the following workplace ergonomics factors such as office size, workplace

temperature, airflow and light, office furniture, workplace environment and level of

noise. All of these factors were having a significantly impact on the performance of

employees and this calls for various stakeholders to put into consideration on these

factors in making decision concerning general performance of the institutions and the

employees’ welfare.

Health care employee’s awareness on workplace ergonomics, it has been found

that the level of workplace ergonomics awareness among the employees is slightly

low. This has been the case for many developing countries whereby poverty and

technological backwardness hinders the process. In order to address this problem, all

stakeholders must emphasize on the need to conduct trainings and seminars to

employers and employees so as to create strong awareness that will guide and bring

positive changes to the workplace ergonomics issues.

Barriers toward ergonomic design of workplaces, it has been found that budgetary

constraints, technological factors and old design of the hospital were ranked as the top

barriers towards ergonomics design at MNH. In order to make sure that the workplace

ergonomics design is adhered, the management of MNH should allocate the enough

budget and invest much in technological innovation so as to make the improvement

on the required state of the ergonomics considerations.

Maslow’s theory of Hierarchy of Needs, Abraham Maslow categorized five levels of

needs among them are physiological needs and safety needs, these needs were

identified to have a direct connection with workplace ergonomics considerations. In

Motivation-hygiene, Frederick Herzberg identified two factors which are satisfiers and

dissatisfiers which were also related to work place ergonomics variables and

65

healthcare employee’s performance. The findings from this study imply that there is a

need for improvement of workplace ergonomics in healthcare facilities and

development of awareness on ergonomic design of workplaces in the facilities. Further

there is a need for more investment on technological advancement to support

workplace ergonomics and allocation of sufficient financial resources to facilitate

ergonomic design of workplaces. The study calls for the considerations of workplace

ergonomics design so as to improve performance of employees. These findings attract

the attention of all the stakeholders especially in healthcare institutions to factor in

workplace ergonomics variables in appraising the performance of their employees.

6.4 Recommendations

Following the objectives of this study and the findings that were revealed from the

assessment that was conducted on role of workplace ergonomics on healthcare

employee’s performance by using the case of MNH in Tanzania. The study provides

recommendations the healthcare service providers in the country as follows.

The study recommends more training that will boost up the employee’s awareness on

workplace ergonomics especially in the healthcare industry. This has been the case for

most of the industrially developing countries whereby most people have been found

to be unaware of the workplace ergonomics issues hence it exposed them to some

health and safety risks in their performance at work.

Investment on technology and allocation of more financial and human resources on

improvement of workplace ergonomics. Healthcare institutions should invest more on

the adoption of reliable and modern technology that will enhance the improvement of

workplace ergonomics. This should go together will allocation of more and enough

resources on implementation of the workplace ergonomics strategies.

Lastly, healthcare facilities should be designed in a way that considers and supports

the existence of modern facilities, provides enough space that allow the flexibility and

convenient movement of the workers, tools and equipment. The building designs must

66

also consider and support for the natural control of working environment issues such

as temperature, airflow and illumination.

6.5 Areas for further study

This study was conducted to assess the role of workplace ergonomics on healthcare

employee’s performance and other related issues. The findings show that there is

significant impact of workplace ergonomics on healthcare employee who are working

at MNH which is a public hospital in Tanzania. Despite these findings, this study

offers a need for further studies to be carried on investigate more or the same

workplace ergonomics variables for the employees who are working in the private

health sector. Following this, it will be easy to make the relevant conclusions for the

whole health sector in the country.

67

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77

APPENDIX I

QUESTIONNAIRE FOR DATA COLLECTION

TOPIC: ROLE OF WORKPLACE ERGONOMICS ON HEALTHCARE

EMPLOYEES’ PERFORMANCE; A CASE OF MUHIMBILI NATIONAL

HOSPITAL, TANZANIA

INTRODUCTION:

This is an academic work aimed at collecting primary data to assist in the findings of

the research study titled above. Your voluntary cooperation by providing open, correct

and honest answers will assist the researcher in coming with true and correct findings

and will be highly appreciated. Thank you very much in advance.

Please tick the correct response

PART A: SOCIO-DEMOGRAPHIC DATA OF THE RESPONDENT

1. Gender 1. Male [ ] 2. Female [ ]

2. Age 1. 20-29 years [ ] 2. 30-39 years [ ] 3. 40-49 years [ ] 4.

50 years and above [ ]

3. Field of work 1. Clinical [ ] 2. Non-

clinical/supportive [ ]

4. Level of work 1. Junior staff [ ] 2. Middle level staff [ ] 3. Senior Staff [ ] 4.

Management [ ]

5. Department/Unit

_____________________________________________________

78

6. Working experience at MNH 1. 1-3 years [ ] 2. 4-6 years [ ] 3.

7-10 years [ ] 4. More than 10 years [ ]

PART B: LEVEL OF HEALTH CARE EMPLOYEE’S AWARENESS ON

WORKPLACE ERGONOMICS

7. Ergonomics is defined as a scientific study on the interactions and

compatibility between people and other aspects of his life or environment

including machines, tools and systems; the same applies to workplace

ergonomics.

Please indicate your level of awareness on the ergonomics design of the

workplace from 1 to 5 by rating your agreement on the following statements

about ergonomic design of workplaces:

Variable Measure Level of Awareness

1 2 3 4 5

Employers should consider workplace ergonomics when

designing work and workplaces

Work stations should have ergonomic considerations to

allow comfortability to the worker and avoid risks and

accidents

Working equipment should have ergonomic considerations

to allow comfortability to the worker and avoid risks and

accidents

Office furniture should have ergonomic considerations to

allow comfortability to the worker

Well ventilated rooms/offices affects workers performance

Manual lifting work may have health effects to workers if

not well designed

Some tasks may lead the workers to sit in awkward postures

which may have health effects if not well designed

79

Office/Workplace that is subjected to excessive noise can

cause lack of concentration and even health effects to the

workers

1=Strongly Disagree; 2=Disagree; 3=Neutral; 4= Agree; 5=Strongly Agree;

PART C: LEVEL OF HEALTH CARE EMPLOYEE’S SATISFACTION WITH

OFFICE DESIGN AND ENVIRONMENT

8. Please indicate your level of satisfaction with workplace ergonomics elements

of your workplace as indicated below:

Workplace Ergonomics Elements Level of Satisfaction

1 2 3 4 5

General design of the office

State and suitability of office furniture

Size of space allocated to your workplace

State of the working equipment

Room temperature

And air flow and illumination

Level of noise (from speech or equipment)

1= Very Unsatisfied; 2= Unsatisfied; 3= Neutral; 4= Satisfied; 5=; Very Satisfied

PART D: WORKPLACE ERGONOMICS AND EMPLOYEE’S HEALTH AND

SAFETY

9. Does your office have enough space for easy movement while working?

1. Insufficiently spaced [ ] 2. Neutral [ ] 3. Sufficiently spaced [ ]

80

10. Does your work involve heavy manual lifting of materials and other objects?

1. Never [ ] 2. Not much [ ] 3. Very much [ ]

11. Have you ever felt stressed by your workplace environment (design, set up,

furniture, air conditioning, noise etc)

1. Not stressed [ ] 2. Stressed [ ] 3. Very Stressed [ ]

If stressed why?

___________________________________________________________

___________________________________________________________

__

12. Do you feel that your office/workplace environment (chair, desk, and

computer) has affected your health in any way?

1. Not Affected [ ] 2. Affected [ ] 3. Very Affected [ ]

If affected, how?

______________________________________________________________

______________________________________________________________

__

13. Do you feel that how you handle your work (posture, lifting, and necessary

bending) has affected your health in any way?

1. Not Affected [ ] 2. Affected [ ] 3. Very much affected [ ]

If affected, how?

______________________________________________________________

____________________________________________________

81

14. Have you ever suffered any injury/disorder due to your current work or

workplace conditions?

1. Never[ ] 2.[ ] Once 3. More than once [ ]

If you have suffered any injury or disorder please state, the nature of illness/disorder

and the attributed cause:

____________________________________________________________________

_______________________________________________________________

15. To what extent did the illness/disorder affect your job performance?

1. Not affected [ ] 2. Affected [ ] 3. Very much affected [ ]

Please elaborate how your job performance was affected by the illness/disorder

suffered:

____________________________________________________________________

____________________________________________________________________

16. Have you ever been absent from work because of an injury/illness you suffered

at work?

1. Once [ ] 2. Never 3. More than once [ ]

82

PART E: PHYSICAL WORKPLACE ENVIRONMENT ON EMPLOYEE’S

PERFORMANCE

17. Please indicate the level of performance on the following elements of the

physical workplace environment descriptions.

Description of physical workplace environment description

toward employee’s performance

Level of Agreement

1 2 3 4 5

Office/workplace environment

Furniture

Size of space allocated to your office/workplace

Level of noise at your office/workplace

Office/Workplace temperature

And air flow and illumination

Air and light flow at your office/workplace

1= Very uncomfortable and unsupportive; 2= Uncomfortable and unsupportive; 3=

Neutral; 4= Comfortable and supportive; 5= Very comfortableand supportive;

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PART F: BARRRIERS TOWARD ERGONOMIC DESIGN OF

WORKPLACES AT MNH

18. Please indicate your understanding on what factors could be hindering the

ergonomics design of the workplace at MNH from 1 to 5 by rating your

agreement on the following:

Factors Level of Agreement

1 2 3 4 5

Old design of the Hospital

Old infrastructure of the Hospital

Patient congestion

Space limitations

Insufficient staffing

Budgetary constraints

Technological factors

1=Strongly Disagree; 2=Disagree; 3=Neutral; 4= Agree; 5=Strongly Agree;

19. Please offer any suggestions that will improve your comfortability, safety,

health and security at the workplace:

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

THANK YOU VERY MUCH FOR YOUR COOPERATION AND RESPONSES!

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APPENDIX II

INTERVIEW GUIDE

1. Which department do you work in?

2. Are you in clinical or supportive services?

3. How long have you been working at MNH?

4. Are you aware of the concept of workplace ergonomics?

5. Do you agree that it is important for employers to consider workplace ergonomics

in designing workplaces and jobs to fit the workers?

6. Do you agree that work stations should provide comfortability to the workers and

avoid the likelihood of injury/illness?

7. Do you agree that office furniture should provide comfortability to the worker to

allow smooth performance?

8. Do you agree that manual lifting of objects or patients can cause health risks to the

workers?

9. Do you agree that some working postures may cause health risks to the workers?

10. Do you agree that excessive noise in the working area may have effect on

performance?

11. Are you satisfied with the following in your working environment?

i. General design of the office

ii. State and suitability of office furniture

iii. Size of space allocated to your workplace

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iv. State and suitability of the working equipment

v. Room temperature

vi. And air flow and illumination

vii. Level of noise (from speech or equipment)

12. Does your office have enough space for easy movement while working?

13. Does your work involve heavy manual lifting of materials and other objects?

14. Have you ever felt stressed by your workplace environment (design, set up,

furniture, air conditioning, noise etc)

If stressed why?

15. Do you feel that your office/workplace environment (chair, desk, and computer)

has affected your health in any way?

If affected, how?

16. Do you feel that how you handle your work (posture, lifting, and necessary

bending) has affected your health in any way?

If affected, how?

17. Have you ever suffered any injury/disorder due to your current work or workplace

conditions?

If you have suffered any injury or disorder please state, the nature of illness/disorder

and the attributed cause:

18. To what extent did the illness/disorder affect your job performance?

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Please elaborate how your job performance was affected by the illness/disorder

suffered:

19. Have you ever been absent from work because of an injury/illness you suffered at

work?

20. How do you feel the following factors provide comfortability and support toward

your performance?

i. Office/workplace environment

ii. Furniture

iii. Size of space allocated to your office/workplace

iv. Level of noise at your office/workplace

v. Office/Workplace temperature

vi. And air flow and illumination

vii. Air and light flow at your office/workplace

21. What do you think could be the barriers toward ergonomics design of the

workplace at MNH

22. Please offer any suggestions that will improve your comfortability, safety, health

and security at the workplace:

role of workplace ergonomics on healthcare

Documents