Nature and root causes of workplace violence against healthcare professionals in Tanzania: a case study of public hospitals in Dar es Salaam Region.

Background: workplace violence is an increasing global episode that is currently becoming a social and public health problem. The purpose of this study was to investigate the status and prevalence of workplace violence against health care professionals in Dar es Salaam, Tanzania. Methodology: A cross sectional survey study was conducted using a mixed quantitative and qualitative approach in which 355 healthcare personnel in Dar es Salaam region were involved in quantitative study where the questionnaire jointly developed by ILO/ICN/WHO/PSI on work place violence was used in data collection, the response rate being (100%). Qualitative data was collected through observation by a researcher, in-depth interview (15interviewees), 6 Focus group discussions with 10 participants per each (i.e.60participsnts). These were purposively selected from the same study sample of 355. Quantitative data were analyzed by using binary logistic regression model and descriptive cross-tabulation in the SPSS program version-20. In -depth interview data were analyzed by thematic analysis while data from observation were subjected under content analysis. Findings; Descriptive cross-tabulation indicated that, the prevalence of workplace violence was 252 (71%) with 37(10.7%) exposed to physical and 228(63.9%) exposed to psychological violence. Binary logistic regression model indicated a significant association between physical violence and: - routine direct physical contact with patients (p<0.020, OR:0.178,95% Cl:0.04-0.759),nurses (p<0.001, OR:0.304,95%Cl:0.047-0.62),and midwives(p<0.0001, OR:11.949,95%Cl:5.569-25.63), working with terminally ill patients(p<0.017, OR:0.207,95%Cl:0.057-0.754). The same analysis indicated a significant association between psychological violence and administrators (p<0.007) young employees aged 20-29years (p<0.015), working between (18h: 00–07h: 00) (p< 0.050) and female workers (p<0.002). Qualitative data indicated a range of socio-cultural, political and economic root causes for health workers’ exposure to workplace violence. Conclusion: More than half the healthcare professionals in Dar esSalaam region were exposed to different forms of workplace violence in the last 12 months. Immediate appropriate and coherent interventions are needed to protect health workers so as to create a safer workplace environment.