Employee engagement and improvement of care quality in public health facilities in Togo: Qualitative research

Abstract

The Togolese health system faces numerous structural challenges, including a shortage of staff, insufficient material and financial resources, as well as persistent inequalities in access to care. In this context, employee engagement appears as a strategic lever to improve the quality of services in public hospitals. This qualitative research, conducted in six health facilities (CHR and CHP) with sixty participants including doctors, nurses, midwives, and administrative staff, analyzes the influence of engagement on professional practices and patient satisfaction. The results show that factors such as recognition, a collaborative climate, continuous training, and participative leadership strengthen engagement, while the lack of resources, workload, Perceived injustice and the lack of financial recognition constitute major obstacles. The study confirms that employees' emotional commitment directly contributes to adherence to protocols, attendance, and the quality of the caregiver-patient relationship, thereby improving user satisfaction. However, these effects remain limited by persistent structural constraints. The research recommends strengthening human resources governance, increasing investment in continuous training, implementing recognition systems, and adopting participatory management. It also opens up prospects for quantitative and comparative studies in West Africa, in order to better understand the impact of engagement on the quality of care in different contexts.

Classification JEL : I18, I15, J28, O15

Paper Type: Empirical Research