Influence of Psycho-Social Factors on The Wellbeing of Healthcare Workers: Case of Level Four Health Facilities in Kajiado County, Kenya

Abstract

This study examined the psychosocial and socioeconomic determinants of healthcare workers’ mental well-being in Level Four health facilities in Kajiado County, Kenya. The objectives were to evaluate psychosocial factors, determine the prevalence of depression, anxiety, and stress, and assess the moderating influence of education level and years of experience on the relationship between psychosocial conditions and well-being. A mixedmethods design was employed, targeting 135 healthcare workers through structured questionnaires and key informant interviews. Quantitative data were analyzed using descriptive statistics, Pearson correlation, and multiple regression, while qualitative data were analyzed thematically. The findings revealed persistent psychosocial strain characterized by high job demands, emotional exhaustion, low job satisfaction, inadequate remuneration, and inconsistent supervisory support. Descriptive results indicated that 81.5% of respondents frequently felt emotionally exhausted, 85.2% experienced workloadrelated stress, and 83.7% reported poor work–life balance. Remuneration satisfaction was low, with 65.9% disagreeing that their salary met personal needs and 78.5% citing delayed pay as a source of financial strain. Although supervisory support was moderately positive, 53.3% of respondents reported inadequate staffing levels. Results from the DASS-21 scale revealed a severe burden of psychological distress, with no respondents within the normal range: 1.5% reported mild, 73.3% moderate, 17.8% severe, and 7.4% extremely severe distress. Anxiety was the most prevalent condition, followed by depression and stress, with nurses being the most affected cadre. Correlation analysis indicated significant negative relationships between psychosocial factors and mental well-being: psychosocial strain (r = −0.604, p < .01), job demand (r = −0.369, p < .01), job satisfaction (r = −0.374, p < .01), and remuneration (r = −0.463, p < .01). Conversely, education level (r = 0.824, p < .01) and years of experience (r = 0.744, p < .01) were positively correlated with well-being, suggesting that education and tenure enhanced coping and resilience. The regression model was highly predictive, R = 0.913, R² = 0.833, adjusted R² = 0.825, F(5, 129) = 106.27, p < .001. Psychosocial strain, job satisfaction, and remuneration significantly reduced wellbeing, while education and experience exerted strong positive effects. Qualitative findings corroborated the quantitative results, highlighting chronic fatigue, anxiety before emergencies, financial strain, and a lack of institutional psychosocial support. Peer support and spirituality emerged as informal coping mechanisms. The study concluded that healthcare workers in Kajiado County experienced high psychological distress driven by workload pressure, low job satisfaction, and financial challenges, with education and experience providing partial protection. The findings supported the Job Demands– Resources model and the Conservation of Resources theory, demonstrating that excessive demands depleted emotional reserves while accumulated resources enhanced resilience. It was recommended that health institutions redistribute workloads, improve remuneration and staffing, promote continuous professional development, and institutionalize psychosocial support within occupational policy frameworks to strengthen resilience, retention, and service quality.