Optimizing health workforce distribution and satisfaction in Ghana's Upper East Region: a quantitative analysis of intrinsic and extrinsic predictors.

INTRODUCTION: inadequate health workforce distribution and retention challenges hinder Universal Health Coverage in low-income settings. This study assessed health worker distribution and satisfaction determinants in public primary healthcare facilities in Ghana's Upper East Region. METHODS: a quantitative cross-sectional design was employed. Data were collected from human resource departments and health workers via semi-structured questionnaires. Univariate and multivariate regression analyses identified associations between workforce satisfaction and intrinsic/extrinsic factors. RESULTS: significant staffing gaps were observed: Bawku West (27.99%), Builsa North (36.94%), and Bongo (51.67%). Multivariate analysis revealed that clear responsibility (aOR=4.58, p=0.001) and effective communication (aOR=10.14, p<0.001) were strong intrinsic predictors of satisfaction. Enhanced supervision (aOR=8.39, p<0.001) was a key extrinsic factor. Female workers had lower satisfaction odds (aOR=0.70), while widowed/separated individuals reported higher satisfaction (aOR=2.15). CONCLUSION: targeted interventions to clarify roles, improve communication, and strengthen supervision are critical to optimize workforce distribution and enhance satisfaction in rural Ghana.