Remuneration Inequity and Its Effects on Job Satisfaction Turnover Intention and Migration Intention Among Health Workers in Southwest Nigeria

Abstract

Remuneration inequity remains a persistent challenge in Nigeria’s health sector, with growing implications for workforce motivation, retention, and health system performance. This study empirically examines compensation disparities among health professional cadres in Southwest Nigeria, assesses their consequences for job satisfaction, turnover intention, and migration intention, and identifies relevant policy pathways for reform. A cross-sectional analytical design was employed, involving 400 health workers drawn from public health facilities across selected states in Southwest Nigeria. Data were collected using a structured, self-administered questionnaire capturing demographic characteristics, remuneration levels, perceived equity, job satisfaction, and workforce intentions. Descriptive statistics, analysis of variance (ANOVA), correlation analysis, and regression modeling were used for data analysis. The findings reveal statistically significant remuneration disparities across professional cadres, with medical doctors earning substantially higher salaries than nurses, pharmacists, laboratory scientists, and community health workers. Perceived remuneration inequity was positively associated with lower job satisfaction and significantly predicted turnover and migration intentions. Lower-paid cadres were disproportionately affected, highlighting increased risks of workforce attrition and skill shortages. The study concludes that existing remuneration structures contribute to systemic inequities that may undermine health system efficiency and sustainability. Policy reforms aimed at harmonizing salary structures, improving transparency, and introducing equity-based incentives are essential to enhance workforce morale, retention, and the delivery of quality healthcare services in Nigeria.