The Moderating Role of Health Centre Characteristics in the Relationship between Psychosocial Work Environment and Quality of Health Care in Health Centre IVs in South Western Uganda

Abstract

Abstract: This study examined the moderating role of health centre characteristics in the relationship between psychosocial work environment and quality of health care in Health Centre IVs in South Western Uganda. The study adopted a mixed-methods cross-sectional design grounded in a critical realist philosophical orientation. Data were collected from 35 Health Centre IVs in Southwestern Uganda, involving 238 healthcare workers, 172 health service recipients, and six District Health Officers. Quantitative data were analyzed using descriptive statistics, Pearson correlation analysis, hierarchical regression, and Structural Equation Modelling (SEM), while qualitative data were analyzed using thematic content analysis. Pearson correlation analysis revealed a positive and statistically significant relationship between psychosocial work environment and quality of health care (r = .496**, p < .01). SEM results indicated that psychosocial work environment was positively and significantly associated with quality of health care (β = .507, p < .001), while health centre characteristics were also positively and significantly associated with quality of health care (β = .161, p < .001). More importantly, the interaction between psychosocial work environment and health centre characteristics was positive and statistically significant (β = .235, p < .001), indicating that favorable health centre characteristics strengthened the positive relationship between psychosocial work environment and quality of health care. These findings suggest that improving workplace conditions alone may not achieve optimal service quality unless supported by favorable organizational and structural conditions within Health Centre IVs. This study extends the literature by demonstrating that health centre characteristics significantly moderate the relationship between psychosocial work environment and quality of health care