Heavy workload and chronic staff shortage are leading causes of workplace conflicts among healthcare workers at upazila health complexes, according to a new study.
Communication gaps, unclear job responsibilities and limited participation of junior staff in decision-making further aggravate tension, potentially affecting teamwork and service delivery, added the National Institute of Preventive and Social Medicine (NIPSOM) research.
The findings were presented today at a dissemination programme at the NIPSOM auditorium. The mixed-method study was conducted in selected upazila health complexes across Bangladesh.
Speaking at the event, Health Minister Sardar Md Shakhawat Hussain said the government was shifting the country's healthcare system from a curative to a preventive approach, as the existing system could no longer cope with the growing number of patients.
He urged researchers to conduct more studies to support the transition.
NIPSOM Assistant Professor Amena Khatun Mita served as the principal investigator of the study, while lecturers Kamrun Nahar and Tanzila Naureen, who served as co-researchers, presented the findings.
Conducted between January and May last year, the study interviewed 456 physicians, nursing supervisors, senior staff nurses, resident medical officers (RMOs), and upazila health and family planning officers. It also included 15 key informant interviews with officials involved in conflict management.
The researchers found interpersonal conflicts to be the most common form of workplace dispute, mainly arising from miscommunication, disagreements between doctors and nurses, blaming colleagues, and conflicts with patients and their attendants.
Internal rifts frequently stemmed from duty roster issues, excessive workload and unclear roles within teams, while intergroup conflicts often involved professional disputes among doctors, nurses and other staff.
Despite these challenges, most healthcare workers preferred collaborative approaches when dealing with supervisors and peers, while compromising was the most common strategy for handling conflicts with subordinates.
Participants also reported that supportive colleagues helped them overcome workplace difficulties, and many described their overall work experience as positive and rewarding.
To reduce workplace conflicts, the researchers recommended strengthening communication, holding regular staff meetings, clearly defining roles and responsibilities, ensuring equitable workload distribution through adequate staffing, promoting teamwork and capacity building, and providing supportive leadership and supervision.
The programme also featured the dissemination of findings from another NIPSOM study titled Feasibility of Combined C-reactive Protein and WHO Four Symptoms for Screening of Tuberculosis in Bangladesh.
Researchers said a rapid C-reactive protein (CRP) test could serve as a complementary tool for tuberculosis (TB) screening in Bangladesh but should not be used as a standalone test because it does not meet the World Health Organization's minimum performance standards for a TB triage test.
The cross-sectional study was conducted between January and March this year among presumptive and confirmed TB patients attending DOTS clinics and antiretroviral therapy centres at three specialised hospitals.
The study was led by Prof Fahmida Khanam. The co-investigators were Rafaat Choudhury, Mohammad Jamal Uddin, Nadia Alam and Mahmuda Haque Jui.
Researchers found that the CRP test had an overall sensitivity of 65.8 percent and specificity of 64.3 percent for TB screening. In comparison, the WHO recommends that a TB triage test should have a minimum sensitivity of more than 90 percent and specificity above 70 percent.
SM Ziauddin Hyder, special assistant to the prime minister on health affairs; Prof Dr Sayeba Akhter, chairman of the Bangladesh Medical Research Council; Prof Pravath Chandra Biswas, director general of the Directorate General of Health Services; and Zahirul Islam Shakil, secretary general of the Doctors Association of Bangladesh (DAB), also addressed the programme.
The event was chaired by NIPSOM Director Prof Nasrin Sultana.
