Indicators for measuring health promotion practice among healthcare workers in the Nelson Mandela Bay Municipality, South Africa: A cross sectional study

Abstract Background: Measuring indicators for health promotion (HP) practice among healthcare workers is essential if health goals and objectives must be achieved. Such indicators provide connections between health policies and health outcomes; and ultimately add value to healthcare. This study identified indicators of health promotion among healthcare workers and compared them across levels of healthcare facilities in Nelson Mandela Bay Municipality, South Africa. Method: A cross sectional study involving 495 healthcare workers randomly sampled from 23 hospitals including primary, secondary, and tertiary level hospitals was conducted. Questionnaires were distributed to medical doctors, nurses, and allied health workers (AHW) such as social workers, physiotherapists, occupational therapists, and speech therapist. Questions (hereto referred to as dimensions) in the questionnaires were categorized to address Facility Related Indicators (FRI), Health worker related indicators (HRI) and Outcome related indicators (ORI). Descriptive and bivariate analysis were used to identify the indicators of HP among the three HCW groups from the three levels of health care. Indicators observed to be significant in the bivariate analysis were subjected to a multivariate analysis using the multinomial regression model. (p–value < 0.05).Results: Emerging Indicators were grouped into three categories: facility related indicators (FRI), healthcare workers’ related indicators (HRI), and outcome related indicators (ORI). Four FRI dimensions were observed to be predictors of HP among doctors. Two dimensions were positively associated with HP practices while two others were negatively associated with HP practices among medical doctors and AHWs. On the other hand, seven HRI dimensions were significantly associated with HP among medical doctors and AHW. Furthermore, 5 outcome related indicator (ORI) dimensions were significant predictors of HP among medical doctors while only two dimensions were predictors of HP among AHW. The generalized Hosmer–Lemeshow Chi-square test showed that the models for the different HP indicators fit the data.Conclusions:We identified indicators for measuring HP that can be applied at primary, secondary and tertiary hospitals in Nelson Mandela Bay Municipality, South Africa. These indicators which healthcare workers and health systems’ managers in the study area should be aware of may be adapted for use in other areas.