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Organizational Culture as a Predictor of Job Satisfaction: The Case of Public Hospitals Governed Under Addis Ababa City Administration Health Bureau

Published in Advances (Volume 6, Issue 2)
Received: 12 May 2025     Accepted: 29 May 2025     Published: 23 June 2025
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Abstract

Back ground: This study investigates the influence of organizational culture on employee job satisfaction within public hospitals administered by the Addis Ababa City Administration Health Bureau (AACAHB) in Ethiopia. The research is conducted by Employing a cross-sectional, quantitative research design, data were collected through structured questionnaires distributed to a sample of 420 employees, yielding a response rate of 98.81%. The study draws on Cameron and Quinn's Competing Values Framework (CVF), which identifies four culture types—Clan, Adhocracy, Market, and Hierarchy—each with distinct attributes impacting organizational dynamics and job satisfaction. Descriptive and inferential statistical analyses, including Pearson correlation and regression, were conducted using SPSS 26. Findings reveal that Market culture is the dominant culture within AACAHB hospitals, characterized by competitiveness, results orientation, and a strong focus on innovation. This culture, along with other types, is positively correlated with job satisfaction, with the strongest associations observed for Market and Clan cultures. The overall job satisfaction mean score of 3.71 indicates a generally positive satisfaction level among employees. These results suggest that fostering a balanced cultural environment that incorporates elements of both performance-driven and collaborative cultures could enhance employee satisfaction. The study’s insights offer valuable implications for organizational development strategies aimed at cultivating a supportive and effective workplace culture within AACAHB hospitals.

Published in Advances (Volume 6, Issue 2)
DOI 10.11648/j.advances.20250602.13
Page(s) 49-56
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2025. Published by Science Publishing Group

Keywords

Organizational Culture, Job Satisfaction, Public Hospitals, Competing Values Framework, Market Culture

1. Introduction
Organizations are dynamic places with a complex social system of employees where organizations and employees both influence each other in terms of social and work norms. Healthcare organizations are service organizations where the interactions with people within the organization and the engagement with the beneficiaries of the service of the organizations are valuable and essential to the organization's very existence where turnover and absenteeism negatively affect the productivity, patient experience and serving capability .
Organizational culture represents the collective values, beliefs, and behavioral norms shared by members within an enterprise, shaping how work is conducted and how objectives are pursued. This culture, manifested through both management practices and individual actions, is instrumental in achieving or hindering an organization’s formal objectives . As a fundamental component of society, culture profoundly influences individual and organizational behavior; it establishes a framework of shared values and beliefs that impact employees’ attitudes, job satisfaction, and overall performance within a workplace .
Though organizational culture is a multifaceted concept, it is frequently defined as a set of unwritten norms, values, and beliefs that guide behavior within an organization. Armstrong and Michael describe it as “the pattern of values, norms, beliefs, attitudes, and assumptions that may not have been articulated but shape the ways in which people behave and things get done” . Given its complexity, evaluating organizational culture necessitates examining multiple dimensions rather than a singular, unified cultural perspective .
Cameron and Quinn’s Competing Values Framework (CVF) identifies four primary culture typologies that influence organizational effectiveness: Clan, Adhocracy, Market, and Hierarchy. Each typology has distinct characteristics, contributing to varied organizational dynamics and implications for employee job satisfaction .
The influence of organizational culture extends to employee job satisfaction, an indicator of how content individuals are within their roles. Job satisfaction is integral to employee morale, productivity, and retention, thereby impacting an organization’s success and performance outcomes . Often studied in organizational research, job satisfaction is associated with commitment, productivity, and a sense of belonging within the workplace .
Within the health sector, where workforce stability and morale are critical to service quality and organizational success, understanding the relationship between organizational culture and job satisfaction becomes essential. Health workers play a central role in service delivery, making their satisfaction paramount to achieving institutional goals and maintaining effective health systems .
Statement of Problem
Organizational culture, as a construct, serves as the foundational framework through which shared values and behavioral norms are communicated within an organization. It promotes cohesion and aligns individual actions with organizational objectives. For optimal organizational performance, managers and employees alike must develop an understanding of the cultural context within which they operate . Research indicates that job satisfaction can drive innovation, reduce employee turnover, enhance service quality, and improve employee well-being, both psychologically and physically .
OC affects factors beyond patient care, such as turnover . Observations from AACAHB reveal issues related to low motivation, high absenteeism, and turnover rates, indicating potential dissatisfaction rooted in the current organizational culture. These issues may lead to a frequent influx of inexperienced staff, which can hinder the organization’s efficiency and effectiveness in achieving its objectives. Despite AACAHB’s efforts to attract well-qualified staff, the challenge of retaining them suggests a gap between intended organizational culture and actual practice.
While existing studies have explored job satisfaction in the health sector, particularly regarding job performance and workload, the specific influence of organizational culture on job satisfaction has not been extensively examined. This study aims to address this gap by analyzing recent data to understand how distinct cultural traits within AACAHB influence job satisfaction. By identifying the cultural characteristics that most significantly impact satisfaction, this research seeks to contribute to the literature on organizational culture and inform strategies for fostering a supportive and satisfying work environment at AACAHB in Addis Ababa.
2. Objective of the Study
The primary objective of this study is to examine the role of organizational culture as a predictor of employee job satisfaction within AACAHB in the year 2024.
3. Research Methodology
3.1. Description of the Study Area
The study was conducted in select public hospitals under the Addis Ababa City Administration Health Bureau (AACAHB) in Ethiopia from January to June 2024. As Ethiopia’s largest city and primary commercial and cultural hub, Addis Ababa occupies an area of 527 square kilometers and hosts an estimated population density of 5,165 individuals per square kilometer.
3.2. Research Design
The study utilized an institutional-based, cross-sectional quantitative design to evaluate organizational culture and its effect on employee job satisfaction within selected public hospitals.
3.3. Study Population
The study population included employees from selected public hospitals, namely Minilik II Hospital, Zewditu Memorial Hospital, and Ras Desta Damtew memorial Hospital.
3.4. Sampling Design and Sample Size Determination
The sample size was calculated using the single population proportion formula, assuming a 95% confidence interval, a 5% margin of error, and a proportion (p) of 50% for employees satisfied with the organizational culture, given the lack of prior studies in this area.
ni=(Zα/2) ²p(1-p) / d2
where P= proportion of employees who are satisfied by organizational culture (0.5%).
d=margin of error=0.05
Zα/2=confidence level required and Zα/2 at 95% CI=1.96
So the sample size was 382. After adding 10% for non response rate the final sample size is 420. This is distributed proportionate to their population.
3.5. Source and Types of Data
Primary data were collected from randomly selected employees of AACAHB, focusing on their perspectives on organizational culture and job satisfaction.
3.6. Data Collection Methods
Data were collected using a structured, close-ended questionnaire distributed to respondents in print form. The instrument was based on the validated and widely used Organizational Culture Assessment Instrument by Cameron and Quinn, which is recognized for its reliability across multiple studies.
3.7. Method of Data Analysis
Prior to analysis, data were carefully edited, cleaned, and coded. Subsequently, data were entered into SPSS version 26, enabling detailed descriptive and inferential analysis, including correlation analysis. SPSS was selected due to its compatibility with various data formats and its capacity to generate tabulated reports and complex inferential statistics.
3.8. Ethical Considerations
Approval for this study was obtained from the Research and Publication Office of Yardstick International College and the Addis Ababa Health Bureau Ethical Review Committee. Study participants were fully briefed on the research’s purpose, and written informed consent was secured from all respondents prior to participation. Data collectors provided additional information on the study’s objectives and content and emphasized participants' rights to refuse or discontinue participation at any time. The ethical clearance is prepared in accordance with the Declaration of Helsinki.
3.9. Reliability and Validity of Data Collection Tools
To ensure content validity, the questionnaire was developed based on previous studies and a comprehensive literature review. The survey instrument was further reviewed by independent experts and a consulting statistician to assess its clarity, conceptual consistency, and potential investigative bias.
4. Result and Discussion
Socio demographic characteristic
A total of 420 questionnaires were distributed among participants, and 415 were completed and returned, resulting in a response rate of 98.81%. This high response rate is sufficient to draw representative conclusions about the broader population. From the total respondents 307 (74%) were females while the rest 26% were male. The majority (53.5%) of respondents were between 31-35 years old, followed by 25.1% aged 26-30. Only 3.1% were over 40, indicating a predominantly young workforce. (See table 1)
Table 1. Demographic characteristics of respondents for organizational culture as a predictor of employees’ job satisfaction in the case of AACAHB 2024 GC.

Items

Category

Frequency

Percentile

Sex of respondents

Male

108

26.0

Female

307

74.0

Total

415

100.0

Age of respondents

Below 21

-

-

21-25

18

4.3

26-30

104

25.1

31-35

222

53.5

36-40

58

14.0

41-45

13

3.1

>46

-

-

Total

415

100

Educational Background of Respondents

Diploma

26

6.3

BSC / MD

196

47.1

masters

177

42.7

Specialist and above

16

3.9

Total

415

100

Job experience

0-3 years

49

11.7

3-6 years

77

18.6

7-10

187

45.1

11-15

93

22.4

15-20

9

2.2

Total

415

100

Position of respondents

Department head/ director

44

10.6

Case team leader

105

25.3

professional

266

64.1

Total

415

100

Organizational culture
Based on the grand mean of each type of the organizational culture, Market culture is the dominant culture in the study sites with the highest grand mean of 3.78 and standard deviation of .601. next to Hierarchy culture, Clan culture was the second dominant culture in the organization with the second highest grand mean of 3.70 and standard deviation of .683. thirdly, Adhocracy culture was ranked on the 3rd dominant organizational culture with mean of 3.58 and standard deviation of 0.639. Finally, Hierarchy culture was rated as the fourth with the grand mean of 3.02 and standard deviation of 0. 801.
Table 2. Descriptive Statistics of the Market Culture for organizational culture as a predictor of employees’ job satisfaction in the case of AACAHB 2024 GC.

No

Market culture

N/%

SD

D

Ne

A

SA

1

The organization is a very controlled and structured place. Formal procedures generally govern what people do.

415

0

32

95

243

45

100

0

7.7

22.9

58.6

10.8

2

The leadership in the organization is generally considered to exemplify coordinating, organizing, or smooth-running efficiency.

415

0

69

67

223

53

100

0

16.6

16.1

53.8

13.5

3

The management style in the organization is characterized by security of employment, conformity, predictability, and stability in relationships.

415

23

74

67

235

16

100

5.5

17.8

16.1

56.6

3.9

4

The glue that holds the organization together is formal rules and policies. Maintaining a smooth-running organization is important

415

12

42

65

244

52

100

2.9

10.1

15.7

58.8

12.5

5

The organization emphasizes permanence and stability. Efficiency, control and smooth operations are important.

415

16

28

52

268

51

100

3.9

6.7

12.5

64.6

12.3

6

The organization defines success on the basis of efficiency. Dependable delivery, smooth scheduling and low-cost production are critical.

415

13

52

115

186

49

100

3.1

12.5

27.7

44.9

11.8

Job satisfaction
From analysis of levels of job satisfaction one can infer that there was good level of job satisfaction in public hospitals. This finding should be in caution because in this research the researcher assessed the levels of overall job satisfaction with five items only. If someone measures job satisfaction with nine dimensions (facets of job satisfaction) the result might be opposite to this finding (low level of job satisfaction). (see Table 3)
Table 3. Respondents’ Rating on Level of Job Satisfaction Table for organizational culture as a predictor of employees’ job satisfaction in the case of AACAHB 2024 GC.

No

Item

Mean

Standard Deviation

1

I definitely like my job

3.83

.072

2

I like my job better than the average workers do

3.76

.953

3

Most days, I am enthusiastic about my job

3.72

.867

4

I find real enjoyment in my job

3.66

1.007

5

I feel fairly well satisfied with my job

3.69

1.009

Relation ship between organizational culture and job satisfaction
on the other hand, with regard of the overall level of job satisfaction, it has grand mean of 3.71 with standard deviation of 0.656. This implies significant number of respondents were satisfied on their job. the result of this may be since the hospital environment needs personalized decision, customer/ patient oriented, and shared responsibility which aligns with market culture. (see table below)
Table 4. Descriptive Statistics on Grand Mean Comparison Among Organizational Cultures Table for organizational culture as a predictor of employees’ job satisfaction in the case of AACAHB 2024 GC.

Type of culture

n

Mean

Standard dev.

Clan culture

415

3.70

.683

adhocracy Cuture

415

3.58

.639

Hierarchy Culture

415

3.02

.552

Market culture

415

3.78

.601

Level of job satisfaction

415

3.71

.656

A correlation analysis was conducted to evaluate the relationship between organizational culture dimensions and job satisfaction. To that end, job satisfaction has positive relationship with clan culture, adhocracy culture, market culture and hierarchy culture and their correlation is also statistically significant.
Specifically, the dominant (market) culture in study site and job satisfaction have large strength relationship with (r=.499). another study also shows the same result for example according to a study conducted in slovakia and Mali there is a strong relation among organizational culture and job satisfaction (r=.726). . Another study on Health Personnel's of Zahedan University of Medical Sciences (Iran) and addis Ababa city technical and vocational education and training college showed that adhocracy and market cultures have positive and significant relation with satisfaction of co workers. .
Table 5. Relationship between Organizational Culture and Overall job satisfaction for organizational culture as a predictor of employees’ job satisfaction in the case of AACAHB 2024 GC.

clan culture

adhocracy culture

hierarchy culture

market culture

job satisfaction

clan culture

Pearson Correlation

1

.536**

.679**

.569**

.423**

Sig. (2-tailed)

<.001

<.001

<.001

<.001

N

415

415

415

415

415

adhocracy culture

Pearson Correlation

.536**

1

.411**

.476**

.372**

Sig. (2-tailed)

<.001

<.001

<.001

<.001

N

415

415

415

415

415

hierarchy culture

Pearson Correlation

.679**

.411**

1

.482**

.516**

Sig. (2-tailed)

<.001

<.001

<.001

<.001

N

415

415

415

415

415

market culture

Pearson Correlation

.569**

.476**

.482**

1

.499**

Sig. (2-tailed)

<.001

<.001

<.001

<.001

N

415

415

415

415

415

job satisfaction

Pearson Correlation

.423**

.372**

.516**

.499**

1

Sig. (2-tailed)

<.001

<.001

<.001

<.001

N

415

415

415

415

415

** Correlation is significant at the 0.01 level (2-tailed).
5. Summary, Conclusions and Recommendations
5.1. Summary of Major Finding
After the analysis, major findings of the study include:
The gender of the respondents in demography was 26% male, while female respondents were 74%. The study therefore indicates that the majority of respondents were female and the proportion indicates most of the population in health sector are female.
The results with regard to age of respondent, 53.5% lies within 31-35 age group and 25.1% are 26-30 year old. With regard to their level of education, 47.1% were degree holders whereas, 42.7% of the respondents have masters holders & 3.9% are specialists and above.
The finding with respect to respondents’ experience, 45.1% are of 7-10 years of experience followed by 22.4% served more than 10 years. regard to job position, 64.1% of the respondents are found to be professionals (either health care workers or admin staff); 25.3% of the respondents are case team leaders and the rest 10.6% are department heads/ directors.
Current study found out that Market culture that is characterized by Employees are encouraged to be competitive, goal-oriented, and results-driven, value innovation, entrepreneurship, and customer focus, decentralized decision making, allowing for quick responses to demands and changing conditions is dominant culture. Employees are empowered to take risks, make decisions, and drive results. is the dominant existing culture in public hospitals governed under AACAHB.
In addition, the study reveals that the level of overall job satisfaction in the public hospitals governed under AACAHB. was good. The average mean value for the job satisfaction surveys was 3.71.
The correlation result indicated job satisfaction has positive relationship with clan culture, adhocracy culture, market culture and hierarchy culture and their correlation is also statistically significant.
5.2. Conclusions
The purpose of this study was to assess the effect of job satisfaction on employee satisfaction at public hospitals governed under AACAHB. A total sample of 415 employees with different sex, experience and job position were surveyed. based on the finding, the researcher makes the following conclusions:
In public hospitals governed under AACAHB. market culture was dominant culture type. In this type of culture. The organization is a very controlled and structured place, Formal procedures generally govern what people do, The leadership in the organization is generally considered to exemplify coordinating, organizing, or smooth-running efficiency, The glue that holds the organization together is formal rules and policies. Maintaining a smooth-running organization is important and The organization emphasizes permanence and stability. Efficiency, control and smooth operations are important. Based on this result, one can conclude that public hospitals which are governed under AACAHB are characterized by maintaining sooth running organizations, coordination and team work, decentralized decisiveness making which are very mandatory for customers or patients in general.
With regard to the levels of overall job satisfaction, the employees’ of public hospitals which are governed under AACAHB was highly satisfied with their jobs. This might be due to the the dominance of the market culture. The correlation depicts that there was positive relationship between organizational culture and employees’ job satisfaction. Furthermore, all organizational culture types have positive relationship with job satisfaction.
5.3. Recommendations
Based on the study findings and conclusions the following recommendations are follows:
1. Public hospitals should focus more on Order, Rules, Regulation and Stability very largely. Although the data shows that there were good employees’ overall job satisfactions when estimated by overall job satisfaction survey, other activities should be done to boost job satisfaction on continuous basis to improve employees’ commitment and high performance.
2. The result showed that market culture positively affects job satisfaction so officials shall give higher emphasis to this cultures in order to bring better level of job satisfaction.
3. For future researchers, further research is needed to be undertaken to examine the effect of organizational culture on job satisfaction in different organization is very necessary in order to verify the current findings. Furthermore, studies across federal hospitals and other regions are also very important to generalize the finding to the overall nation level.
4. Finally, additional variables such as the nine job satisfaction facets should be included for the future study to analyze the adverse effect of organizational culture on job satisfaction clearly.
Abbreviations

AACAHB

Addis Ababa City Administration Health Bureau

CVF

Competing Values Framework

Conflicts of Interest
The authors declare no conflicts of interest.
References
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  • APA Style

    Endalew, D., Bhagwat, D. (2025). Organizational Culture as a Predictor of Job Satisfaction: The Case of Public Hospitals Governed Under Addis Ababa City Administration Health Bureau. Advances, 6(2), 49-56. https://doi.org/10.11648/j.advances.20250602.13

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    Endalew, D.; Bhagwat, D. Organizational Culture as a Predictor of Job Satisfaction: The Case of Public Hospitals Governed Under Addis Ababa City Administration Health Bureau. Advances. 2025, 6(2), 49-56. doi: 10.11648/j.advances.20250602.13

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    AMA Style

    Endalew D, Bhagwat D. Organizational Culture as a Predictor of Job Satisfaction: The Case of Public Hospitals Governed Under Addis Ababa City Administration Health Bureau. Advances. 2025;6(2):49-56. doi: 10.11648/j.advances.20250602.13

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  • @article{10.11648/j.advances.20250602.13,
      author = {Duresa Endalew and Dayal Bhagwat},
      title = {Organizational Culture as a Predictor of Job Satisfaction: The Case of Public Hospitals Governed Under Addis Ababa City Administration Health Bureau
    },
      journal = {Advances},
      volume = {6},
      number = {2},
      pages = {49-56},
      doi = {10.11648/j.advances.20250602.13},
      url = {https://doi.org/10.11648/j.advances.20250602.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.advances.20250602.13},
      abstract = {Back ground: This study investigates the influence of organizational culture on employee job satisfaction within public hospitals administered by the Addis Ababa City Administration Health Bureau (AACAHB) in Ethiopia. The research is conducted by Employing a cross-sectional, quantitative research design, data were collected through structured questionnaires distributed to a sample of 420 employees, yielding a response rate of 98.81%. The study draws on Cameron and Quinn's Competing Values Framework (CVF), which identifies four culture types—Clan, Adhocracy, Market, and Hierarchy—each with distinct attributes impacting organizational dynamics and job satisfaction. Descriptive and inferential statistical analyses, including Pearson correlation and regression, were conducted using SPSS 26. Findings reveal that Market culture is the dominant culture within AACAHB hospitals, characterized by competitiveness, results orientation, and a strong focus on innovation. This culture, along with other types, is positively correlated with job satisfaction, with the strongest associations observed for Market and Clan cultures. The overall job satisfaction mean score of 3.71 indicates a generally positive satisfaction level among employees. These results suggest that fostering a balanced cultural environment that incorporates elements of both performance-driven and collaborative cultures could enhance employee satisfaction. The study’s insights offer valuable implications for organizational development strategies aimed at cultivating a supportive and effective workplace culture within AACAHB hospitals.
    },
     year = {2025}
    }
    

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    T1  - Organizational Culture as a Predictor of Job Satisfaction: The Case of Public Hospitals Governed Under Addis Ababa City Administration Health Bureau
    
    AU  - Duresa Endalew
    AU  - Dayal Bhagwat
    Y1  - 2025/06/23
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    N1  - https://doi.org/10.11648/j.advances.20250602.13
    DO  - 10.11648/j.advances.20250602.13
    T2  - Advances
    JF  - Advances
    JO  - Advances
    SP  - 49
    EP  - 56
    PB  - Science Publishing Group
    SN  - 2994-7200
    UR  - https://doi.org/10.11648/j.advances.20250602.13
    AB  - Back ground: This study investigates the influence of organizational culture on employee job satisfaction within public hospitals administered by the Addis Ababa City Administration Health Bureau (AACAHB) in Ethiopia. The research is conducted by Employing a cross-sectional, quantitative research design, data were collected through structured questionnaires distributed to a sample of 420 employees, yielding a response rate of 98.81%. The study draws on Cameron and Quinn's Competing Values Framework (CVF), which identifies four culture types—Clan, Adhocracy, Market, and Hierarchy—each with distinct attributes impacting organizational dynamics and job satisfaction. Descriptive and inferential statistical analyses, including Pearson correlation and regression, were conducted using SPSS 26. Findings reveal that Market culture is the dominant culture within AACAHB hospitals, characterized by competitiveness, results orientation, and a strong focus on innovation. This culture, along with other types, is positively correlated with job satisfaction, with the strongest associations observed for Market and Clan cultures. The overall job satisfaction mean score of 3.71 indicates a generally positive satisfaction level among employees. These results suggest that fostering a balanced cultural environment that incorporates elements of both performance-driven and collaborative cultures could enhance employee satisfaction. The study’s insights offer valuable implications for organizational development strategies aimed at cultivating a supportive and effective workplace culture within AACAHB hospitals.
    
    VL  - 6
    IS  - 2
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Author Information
  • Department of Research and Training, Ras Desta Damtew Memorial Hospital, Addis Ababa, Ethiopia

  • Department of Business Management, Debre Birhan University, Debre Birhan, Ethiopia

  • Abstract
  • Keywords
  • Document Sections

    1. 1. Introduction
    2. 2. Objective of the Study
    3. 3. Research Methodology
    4. 4. Result and Discussion
    5. 5. Summary, Conclusions and Recommendations
    Show Full Outline
  • Abbreviations
  • Conflicts of Interest
  • References
  • Cite This Article
  • Author Information