Impact of hospital safety culture and workplace sexual harassment on turnover intention of nursing professionals in Upper East Region, Ghana.

BACKGROUND: The global nursing professionals' shortfall is alarming, reaching 4.81 million by 2030, with Africa and South-East Asia disproportionately affected. While improved organizational safety culture promotes worker retention, unsafe work environments, including sexual harassment, contribute to high turnover rates and associated decrease in healthcare service quality. However, the literature is limited on how hospital safety culture and sexual harassment of nursing professionals affect their turnover intention rates in rural settings. METHODS: We conducted a cross-sectional study to evaluate the relationships among safety culture, sexual harassment, and turnover intention among nursing professionals (N = 812) in the Upper East Region of Ghana. Participants completed an online survey that included the 25-item Airline Safety Culture Index, the 17-item Sexual Experience Questionnaire, and the 6-item Turnover Intention Scale. Descriptive statistics summarized participants' characteristics and the variables under study. Chi-square test assessed bivariate associations, and multivariable binary logistic regression estimated the association between safety culture, sexual harassment and turnover intention, adjusting for years of working experience and sex. Sex-stratified analysis was also performed. RESULTS: Results indicate that 7.5%, 63.1% and 29.4% of the workers rated their hospitals as having a low, moderate, and high safety culture, respectively. Overall prevalence of workplace sexual harassment was 30.7%; gender harassment 27.3%, unwanted sexual harassment 50.9%, and sexual coercion 49.8%, with 48.2% of these workers intending to leave their current positions in the very near future. Perception of safety culture within healthcare facilities, years of work experience, sexual harassment, and sex are associated with turnover intention among nursing professionals. Among females, sexual harassment predicted turnover intention, whereas among males, years of experience and safety culture were significant predictors. CONCLUSION: Immediate action is needed to enhance the organizational safety culture of these healthcare facilities, addressing workplace sexual harassment, reducing sex stereotypes, and preventing further depletion of this critical healthcare workforce. Without immediate action, this could severely affect patient outcomes and healthcare quality in Ghana, thereby compromising progress toward Sustainable Development Goal 3. CLINICAL TRIAL NUMBER: Not applicable.