Department of Management Sciences, COMSATS University, Islamabad, Pakistan
Received Date: June 28, 2017; Accepted Date: August 08, 2017; Published Date: August 20, 2017
Citation: Imran M (2017) Impact of Intrinsic Factors of Motivation on Employee’s Intention to Leave: A Case Study of Health Department District Okara Punjab, Pakistan. Arabian J Bus Manag Review 7: 308.
Copyright: © 2017 Imran M. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Employees are very vital and valuable asset of an institution. An institution’s success might not be realized without its worker’s support and involvement. This study examined Intrinsic Factors of motivation which are influencing intention to leave among health department’s employees in District Okara (Punjab) Pakistan. The researcher through literature review identified the three factors i.e., training and development opportunities, recognition and peer relations, which can greatly influence intention to leave (ITL). This study has selected a sample size of 214 by targeting the employees of health department, including doctors, nurses and nutrition supervisors. After conducting the survey, 201 accurately filled questionnaires have been received back. The end results of this study indicate that training and development opportunities have very strong inverse relationship with employee’s intention to quit. The rest have negative relationship with intention to leave too. There is a significant inverse relationship of all identified factors with intention to leave. This also offered the suitable recommendations and directions for future study.
Training and development opportunities; Recognition; Peer relations and intention to leave (ITL)
Background of the study
The background of the study is established on most recognized theory of Motivation presented by Herzberg’s “Two Factor Theory (1959, 1966)”. In 1959, Frederick Herzberg with his colleagues conducted a study on the job attitudes for 203 Accountants and Engineers in his book “The Motivation to Work”. In 1966, Herzberg in his second book “Work and Nature of Man” identified two motivation factors, those motivate employees to work. Herzberg provided another way to examine employee’s needs and motivation. He described two types of factors relating to work which influence employee’s performance, productivity, turnover intention and intention to stay i.e., Motivating Factors or Intrinsic Factors and Hygiene Factors or Extrinsic Factors. Motivating Factors or Intrinsic Factors are related to satisfaction and positive feelings of employees about their job; it includes achievement, recognition, the work itself, responsibility and advancement. Hygiene Factors or Extrinsic Factors are related to dissatisfaction and environment of job, it includes organization’s policies, supervision style, salary and reward, working environment and peer relations. According to Herzberg, Hygiene Factors are associated with negative feelings about the job which leads to quit the job. This theory of Herzberg is called Two Factor Theory of Motivation.
The success and growth of any organization depends on its human resources. Employee’s intention to leave is one of the intense challenges for any organization which have long lasting effects. Employee’s turnover is a serious issue especially in the field of HR management . Over the last two decades, the issue of worker turnover still exists among the all other managerial issues of the organizations in the entire world. The rate of workforce turnover is very high even in industrially developed nations. Achievement of higher levels of performance by the employees is associated with their satisfaction regarding working environment of the organization. The organization should follow the vibrant policies to reduce the gap between top level management and middle level management to resolve the issue of worker turnover in organizations .
In many developing as well as developed countries, employee’s intention to quit is giving sleepless nights to HR managers and organizations. World Health Organization (WHO) points out the global issue of scarcity of labour and healthcare personnel; in fact, this phenomenon is vibrant in under developed nations as the Healthcare Performance Indicators are worst. WHO, during the third Global Forum on Human Resources for Health, reported that the entire world by the year 2035 will face 12.9 million of the shortage of healthcare staff .
In recent decades, many countries have been facing problems relating to healthcare system due to shortage of nurses. This problem is very common in developed countries (like USA and UK) but it is also alarming in developing countries. The WHO estimated the entire world needs about two million increases in healthcare workforce to meet the global health goals set by World health Organization. Migration of nurses is an international phenomenon especially in emigration countries. Mostly developed countries are solving this issue of lack of personnel by importing from developing countries. The data collected by World Health Organization revealed that greatest lack of nurses is in Asian region, where dominant countries have large population. The ratio of nurses to population is very low in these countries. Due to insufficient health budgets, it is not possible for developing countries to import nurses . A research study conducted in Pakistan indicated that the rate of turnover among nurses in Pakistan from the year 1996 to 1999 was above 30%. The reasons behind this turnover were emigration of nurses to United Kingdom and United States of America, their resignations due to family problems. In 2001, the Healthcare Advisory Board reported 33% rate of turnover in USA among nurses are satisfied with their work environment while 94% among those who are not satisfied with their jobs. Furthermore USA Board estimated that international nurse’s turnover rate was 15% .
Mostly, researchers explained positive impact of these factors on employee’s performance, employee’s commitment and employee’s retention in an organization, but in the present study, the researcher measured negative impact of motivation on employees and how it affected turnover intention among employees. In Pakistan, mostly studies of employee’s turnover intention were conducted in private sector but in this present study the researcher examined it in public sector employees of health department especially by targeting the doctors, nurses and nutrition supervisors.
Statement of the problem
The reason of selection of this topic for research is that in public sector hospitals especially situated in rural areas and small cities, most of the doctors, nurses and nutrition supervisors are not satisfied with their jobs and most of them are quitting their jobs for better job opportunities. The reason of their turnover intention is not their competency but some other factors are affecting the turnover among these employees. The doctors and nurses turnover in developing countries like Pakistan is very high that’s why government is facing problems to provide proper health facilities. It is a crucial need to have very comprehensive studies on these factors which influence the employee intention to leave among health sector employees.
• What are Intrinsic Factors of motivation that influence employee’s intention to leave in health department?
• What is relationship between employees intention to leave in the direction of training and development opportunities?
• What is relationship among employees intention to quit toward recognition?
• What is relationship among employees intention to leave toward peers relations?
Objectives of the study
The objectives of the research study are given below:
General objective: The general objective of the study is to investigate the relationship of Intrinsic Factors of motivation (Training and Development Opportunities, Recognition and Peer Relations) and its relationship with intention to leave among government health sector employees in Pakistan.
Specific objective: (1) To examine the association among training and development and employee’s intention to quit; (2) To examine the association between recognition and employee’s intention to quit; (3) To examine the association among peer relations and employee’s turnover intention.
Significance of the study
The findings of the study will contribute in literature about factors involve in employee’s intention to quit the job. It will enlighten the policy making management of the government health department to develop strategies for employees retention especially doctors. Understanding of these factors may possibly help the government policy makers in reducing the intention of turnover among employees and turnover cost too. Turnover is upsetting and harmful to the organization, regardless of its type because organizations heavily rely on human resource factor . Recruitment, selection and training of new employees are very expensive for the organization . Mostly employees develop contacts and social network with inmates over time but employees turnover will disrupts it . Turnover also impacts the morale of the employees [6,9]. Due to insufficient staffing operational functions of the organization disrupts which leads to overworking in remaining staff. It is essential for the organizations to recognize the probable reasons of turnover. The current study builds up understanding about possible Intrinsic Factors of motivation (Training and Development Opportunities, Recognition, Peer Relations and their impact on intention to leave in government sector employees. Consequently, it will be helpful for management to plan proper program for retention of talent in the organizations.
Concepts and definitions
Intention to leave/turnover intention: Intention to quit is defined as any possible future planning of employees to say good bye to current job or organization and searching for new job in the near future. It is also called turnover intention [10,11]. Intention to turnover defined as thoughts of employee’s or plans to leave an organization voluntarily .
That turnover would be voluntary or involuntary.
Voluntary turnover:When employee quit by his own will. It could be for better opportunity or any conflict with supervisors or coworkers .
Involuntary turnover: When laid off or terminate any employee by the organization as a punishment .
In this research study only voluntary turnover will be considered.
Motivation: The word “Motivation” is came from Latin word “motus” which means to move, to influence and excite . “Motivation is basically an inner force, energy, desire that push someone continuously to perform extra ordinary”. This is the cause for which someone behaves in a certain way to achieve his goals. For example a class student spends more time for study because he or she wishes good marks in class or he/she wants to top in the class. The relevance and importance of motivation in performance can be measured with the help of the following formula:
Performance=Ability × Understanding of the task × Motivation × Environment
According to formula, for a well performing employee the first thing which is required ability to perform task, second understanding of task mean what is work, third is motivation for work and last but not least the work environment should be proper then the performance can be achieved . The person who has some knowledge of Mathematics can easily assesses the importance of Motivation in the above equation. Because the multiple sign in the equation clearly tells us if one of the elements of the equation will be zero, the rest all will be zero too. So without motivation the most talented person will not perform.
Intrinsic motivation and its factors: Any activity or action being performed for sake of enjoyment or you enjoys the activity itself is called intrinsic motivation. For example, if someone reading books because he enjoys reading books it will be intrinsic motivation. If he reads books for delivering lecture in any college or university for any reward it will be extrinsic motivation. Following are the factors of intrinsic motivation recognition, training and development, coworkers’ relations, achievement and the work itself .
Training and development: Training and development programs are associated with those specialized skills which are required by the organization from their employees to obtain and achieve organizational goals .
Recognition: It includes monetary and non-monetary benefits provide by the organization to their employees for achievement of organizational goals .
Peers relations: Relations with peers include a relationship in which they have no authority over other workers and have same level in organizational hierarchy .
Association of intrinsic factors and ITL
Impact of training and development opportunities on ITL: When the organization need to retain their employees for long run then the organization must provide training and development opportunities for their future employment and career. Nelson and Catherine , identified that limited training and development opportunities resulted limited promotion and career advancement opportunities which ultimately lead to turnover intention in employees. Roshidi  mentioned promotion opportunities as independent factor of intention to leave so promotion opportunities only possible with training and development in organization. It is suggested by Shahid et al. , employees expecting better salaries, fair appraisal system, sound training and development programs and career growth opportunities within the organizations so they positively attached and chances of leaving organization will minimized. Furthermore, he explained that career growth concerns absolutely associated and influence employee intention to quit. Chang et al.  claimed that if organizations satisfied the career and development needs of employees within the organization then employee’s turnover intentions may decrease. He suggested that managers have to pay more attention to employees career needs and have to introduce well planned training and development programs that will have lower employee’s turnover. Kadiresan et al.  suggested in his study that training and development enhance the productivity and performance of the employees which resulted reduction in employee’s turnover intention in the organizations. Jehanzeb et al.  explored that training and development programs are positively related to organizational commitment and to get their commitment, employees should be strongly recognized with goals, mission and values of the organization through appropriate training programs. It is confirmed strong inverse relationship among organizational commitment and employee’s turnover intention. Hence training and development motivate employees to work and also retain them in the organizations. Choi et al.  explained that training and development opportunities not just the way to obtained competencies but it is necessary for employees to accomplish organization’s goals and objectives. Joarder and Sharif  described that through training and development employees can enhance their knowledge and skills which is needed for standardized performance in this technological changing work environment. According to Kim  explained that turnover intention among workforce decreases when they perceived career advancement opportunities in their current job.
Impact of recognition on ITL: Agyeman and Ponniah  reported that 20% respondents of his research study considered recognition and reward as a major factor which leads to employees retention in the organization. Hence, absence of recognition and appreciation may cause turnover intention among employees. Tizazu  indicated that recognition had a positive and significant effect on employee retention so lack of this factor of motivation may cause turnover intention. Nelson and Catherine  found that mostly participants indicated; if they do a good work they should be rewarded or recognized, so recognition and turnover intention have association. Weldeyohannes  concluded that employees love their job and profession but they have no proper recognition and encouragement so they are seriously thinking about changing their current job. Rewards and recognition plays very important role in ensuring long term relationship of employees with the organizations. Recognition is motivation for employees to serve long-time in the organizations and for better performance. Recognition and appreciation of work also considered non-financial incentive which resulted significant reduction in employee turnover intention . A research study by Arnold  indicated that lack of recognition significantly affects turnover intention among employees. The results of the study showed that 80% participants posited that their boss didn’t appreciate their work. To develop sense of appreciation among employees use tools like spot bonuses, achievement certificates and prizes in front of their co-workers, this strategy will retain employees.
Impact of peers relations on ITL: It is found that there is direct inverse association among peers relations and workers intention to leave. Lacks of peers support increase employee dissatisfaction which leads to turnover intention among employees . Employees share the same physical space during their working life in the organization. Peers relationships are core component of motivation and lack of this relation may cause intention to leave the job. Positive coworker’s relations have motivation for employees but negative relationships with coworkers may experience decline in motivation and intention to quit in employees . It is found that employees supported by supervisors and coworkers were more committed and highly committed employees put more effort in work while less intention to leave the organization . Chang et al.  found intention to leave one’s organization was less among employees who have access to not only coworkers but also social interactions with supervisors than employees who have limited degree of such access. It is showed that peers in working life have a great impact on employee’s attitude to the job. It is known fact that workers spend more time with their coworkers and supervisors. Individuals create environment of the organization form friendship and trust. The outcomes of the study indicated that substantial negative association among coworker trust and turnover intention . Supportive coworker’s relations, created an environment where employees strongly committed to the organization. It could be very difficult for an employee to leave the organization in such a peer’s supportive environment and it has a positive impact for newcomers in the organization for their commitment .
Theoretical Framework of Intrinsic Factors of motivation influencing intention to leave among health Sector Employees in Okara, Pakistan (Figure 1).
The theoretical framework explained the association among Intrinsic Factors (training and development opportunities, recognition and peer relations) towards intention to leave.
Relevance of theoretical model: In this research study, the independent and dependent variables are being selected after extensive study; it has been completed through literature review. Additionally, past researches has been vigilantly studied with the employee intention to quit in accurate and precise way to be research.
The three independent variables are training and development opportunities, recognition and peer relations with one dependent variable which is intention to leave (ITL). The model in the study is derived from detail review of previous researches [29,30,37-40].
The list given below presents the three independent variables with their sources:
From the aforesaid model of research, following hypotheses are developed for the study.
H1: There is significant association among training and development opportunities and intention to leave.
H2: There is significant association among recognition and intention to leave.
H3: There is significant association among peer relations and intention to leave.
Targeted population: These are identified, comprehensive groups which are pertinent to a research study . The current study is carried out in government BHUs, RHCs, THQs and DHQs in District Okara, (Punjab) Pakistan. The objective of this study is to recognize the motivation factors which are influencing intention to leave among health Sector employees in District Okara, Pakistan. Distribution of targeted population is as follows (Table 1).
Table 1: Distribution of targeted population.
Sample size: Sample size explains the number of respondents, included in study out of total available population. Factors like cost and time are main considerations in selecting the sample size . For the purpose of this study the decision about the sample size is made based on the table that has been simplified by Krejcie and Morgan . According to Krejcie and Morgan  the correct sample size of my research is 214. The sample size represents 45% of total population which detail is given below (Table 2).
Table 2: Distribution of targeted sample.
Sampling technique: According to Hair et al. there are two sampling techniques for collection of sample which are probability and non-probability sampling. Probability sampling is defined as a sampling method in which every element of available population has equal chance of selection. The technique used in this study is simple random sampling which is under probability sampling. This sampling procedure is suitable because entire population is identified and their lists are acquired form district office. Secondly, all survey questionnaires are filled in their monthly meetings.
Although 214 sets of questionnaires were handed over to respondents, out of those, only 201 sets were found complete (94% response rate). The rest of the questionnaires have been discarded due to incompleteness. In this section, the researcher presents overview of respondent’s demographic information including gender, job title, ages, level of education and place of posting according to area (Table 3).
|Under 35 years||139||69|
|Above 35 years||62||31|
|Area of posting|
|Urban (DHQs & THQs)||67||33.30|
Table 3: Demographic information of respondents.
The division of area is made on the basis of DHQs and THQs (Urban), RHCs (Suburban) and BHUs (Rural).
Reliability analysis: In present research, Cronbach’s Alpha is used to assess the reliability of all the statements of the questionnaires for accuracy and consistency. The reliability test has been firstly applied on 15 questionnaires to identify the reliability of the instrument. When all questionnaires collected then processed in to SPSS v. 20 for reliability of complete sample results. Findings of reliability test are given below in Table 4.
|Variables||Cronbach's Alpha (Actual)||Results of reliability||Number of items (N)|
|Intention to leave||0.815||Very Good||5|
|Training and development opportunities||0.91||Very Good||5|
Table 4: Cronbach’s Alpha for all variables.
This analysis is used to draw the conclusion generally, about the study and it also explains association between dependent and independent variables . The detail of inferential analysis is given below:-
Pearson’s correlation: It is considered an appropriate way for explaining the association of the independent variables with and on dependent one. This statistical tool commonly used to explain the degree to which each independent variable is linearly associated with dependent variable . With the help of collected data through survey questionnaire, correlation tool is applied to find the extent to which all factors like training and development opportunities, recognition and peer relations has relationship with intention to leave (Table 5).
|Training and development opportunities||Recognition||Peer relations||ITL|
|Training and development opportunities||1|
**Correlation is significant at the 0.01 level (1-tailed)
Table 5: Pearson correlations.
The Table 5 indicates the correlation analysis among dependent variable i.e., intention to leave and the following independent variables; training and development opportunities, recognition, peer relations. The relationship among all independent variables with intention to leave (DV) has significant negative with values (-0.745, -0.651 and -0.598, respectively). A significant inverse association has been found among all three factors and intention to leave. It also reflects that all independent variables are positively correlated with each other.
It shows that correlation among training and development opportunities and recognition with intention to leave (DV) is strong which falls in the range ± 0.61 to ± 0.80. Thus only one independent variable peer relations has association with intention to leave is moderate value (-0.598) which falls in the range of ± 0.41 to ± 0.60.
Hence, with the help of Pearson’s Correlation results, it is concluded that all these factors have significant inverse association with employee intention to leave. It is also indicates that one unit increase in independent variable factors corresponds decrease in intention to leave values (-0.745, -0.651 and -0.598, respectively).
Multiple regression analysis:
Model summary: Table 6 explains the value of correlation coefficient R and the co-efficient of determination R square. Based on the above model summary the value of R square is 0.689 which is 68.9%. This means that impact of independent variables on employee’s intention to leave is only 68.9%. The independent variables refer to training and development opportunities, recognition and peer relations which explains that 31.1 percent (100–68.9) of the dependent variable i.e., Intention to Leave (ITL) is described by other factors which could not be considered in the present study.
|Model||R||R square||Adjusted R square||Std. error of the estimate|
aPredictors: (Constant), Peer Relation, Recognition, Training and development Opportunities; bDependent Variable: Intention to Leave (ITL)
Table 6: Multiple regression model summaryb.
ANOVA: Table 7 indicates p-value is 0.000 which is less than Alpha-value 0.01. Hence, the value of F-statistic is significant at 145.339. Resultantly, this study model is good descriptor of the association between the predictor variables and dependent variable. So, independent variables are significantly explains the variance of the intention to leave (ITL).
|Model||Sum of squares||d.f||Mean square||F||Sig.|
aPredictors: (Constant), Peer Relation, Recognition, Training and development Opportunities; bDependent Variable: Intention to Leave (ITL)
Table 7: ANOVA model summaryb.
Multiple regression coefficients analysis: Table 8 describes all independent variables i.e., training and development opportunities, recognition and peer relations are making a significant contribution to the regression equation (P<0.05).
|Unstandardized coefficients||Standardized coefficients|
|Training and develop.||-0.402||0.043||-0.467||-9.355||0|
Table 8: Coefficient.
The value of beta computed in Table 8, training and development opportunities has the highest Beta (β=-0.467) that denotes it is most important contributor to intention to leave. Followed by recognition with (β=-0.294) and peer relations with (β=-0.250), respectively.
The Unstandardized coefficients values explain the contribution of all independent variables to the dependent variable. All independent variables have an inverse association with intention to leave (ITL). Therefore, the relationship among all independent variables with intention to leave (ITL) can be explained by the following equation:-
Multiple Regression equation:
Y=C+βX1+βX2+βX3 +…..+ βXn
Y= Predict relationship of variables toward intention to leave.
β= Unstandardized coefficient.
X= Dimension of independent variables
X1=Training and development opportunities
Based on the above mentioned Table 1, the following equation is derived:
Intention to leave=5.709 - 0.402 (training and development) -0.371 (recognition) -0.253 (peer relations)
Hypothesis testing: The multiple regression results in Table 8 indicate different values against each of the three independent variables, which help in accepting and rejecting the hypotheses. Detail of each hypothesis given below:
H1: There is significant association between training and development opportunities and intention to leave
In case of training and development opportunities, the Beta value is -0.467 and p-value is 0.000 which is less than 0.05; it shows that there is an inverse association between training and development opportunities and intention to leave (ITL). Hence, hypothesis 1 is accepted.
H2: There is significant association between recognition and intention to leave.
The Beta value of recognition is -0.294 and p-value is 0.000 which is less than 0.05 (p<0.05); it reflects a significant inverse association among recognition and intention to leave (ITL). Hence, hypothesis 2 is accepted.
H3: There is a significant association between peer relations and intention to leave.
In case of peer relations, the beta value is -0.250 and p-value is 0.000 which is greater than 0.05 (p<0.05); it indicates the association between peer relations and intention to quit is significant. So, hypothesis 3 is also accepted.
Discussion on major findings
The major aim of the study is to investigate the Intrinsic Factors of Motivation which influencing the intention to leave among the health department employees of District Okara (Punjab) in Pakistan (Table 9).
|H1: There is significant association among training & development opportunities and intention to leave||r=-0.745
(p < 0.05)
|H2: There is significant association among recognition and intention to leave||r=-0.651
(p < 0.05)
|H3: There is significant association among peer relations and intention to leave||r =-0.598
(p < 0.05)
Table 9: Results summary.
The first independent variable is “Training and Development Opportunities which have significant impact of employee’s intention to leave. It means if health department may manage and create enough opportunities for training and development of doctors as well as other employee, it may reduce intention to leave. These findings are consistent with  which explain that institutions where employees do not find enough opportunities for their career development prefer to leave the existing organization as soon as they find better opportunity. This result is supported by other researcher’s findings such as Roshidi Hassan  and Gieter et al.  explained that growth and development opportunities are associated with intention to quit negative and significant.
Second independent variable is “Recognition” which has immense importance and significant impact of employee’s intention to leave. Doctors and other employees of public sector would be extra motivated to carry on their services if they are properly appreciated and recognized. These findings are consistent with Rafique and Ihsan  which described recognition system of an institution plays a significant part in ensuring long run employment relation with the organization. This result is consistent with Arnold  explained that reward and recognition has significant impact of employee intention to quit.
Third independent variable “Peer Relations” is also negatively correlated with intention to leave and it is significant contribution to explain intention to leave among health Sector Employees. This factor also has influence on health sector employee’s decision of turnover intention. These findings are consistent with Balkan et al.  findings; there is negative significance association among peer relations and intention to leave. These results also consistent with Saira and Mehmood  explained that there is significant inverse association found between coworker’s behavior and intention to quit the job.
Limitations of the study
No research study is faultless and it is always a possibility of mistake and bias in sampling and in measurement. Sample which represents population is very vital in quantitative researchers. This research is conducted on a small sample size of one district, so it might be possible the results are not universally generalized. The actual behavior and customs of Pakistani employees could be different from employees of other districts, provinces or even from other countries. This research study is conducted in public sector employees so these results could be vary from private sector employees. The researcher analyzed and measured intention to leave rather than actual turnover so these findings could be different with actual turnover when it will occur. The other limitation of study is that R square of this study is 0.689; therefore 68.9% variance in intention to leave is described by 3 independent variables. Though, still there are 31.1% in intention to leave variance unexplained in present study. It is indicated that, other potential factors can affect the variance of intention to leave.
Implications of the study
The findings of the research show that there is negative association among Intrinsic Factors of motivation and intention to leave among employees of health department of the District Okara (Punjab) Pakistan. The government and health department authorities should be taken serious steps to reduce continuous migration and turnover of physicians as well as other healthcare personnel. If timely steps are not taken by the government this catastrophic circumstances could be more damaging for the already unstable healthcare structure. This study helps the policy making authorities to review their policies and strategies for retaining their employees. Pakistan is one of the countries where doctor’s turnover is very high so management should focus on these factors which causing turnover, so our health standards could meet international standards.
According to the above-stated Table 6, the value of R square is 0.689 (68.9%) which indicates that only 68.9% of intention to leave had been explained by the 3 independent variables (training and development, recognition and peer relations). There are some other Intrinsic Factors of motivation including achievement, interesting work, work itself and autonomy that should be explored in the future researches. There are some constraints need to be resolved in order to get more accurate results about employee’s intention to leave. It is suggested for future researchers that to determine the impact of Intrinsic Factors on intention to leave in diverse culture, the research should be conducted in other districts and provinces of Pakistan.