article review on business ethics in ethiopia

A Review of Corporate Social Responsibility Practices in Ethiopia

• First Online: 02 December 2020

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• Ahmed Kellow 4 &
• Nebil Kellow 4  

Part of the book series: Palgrave Studies of Internationalization in Emerging Markets ((PSIEM))

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The purpose of this chapter is to examine the status of corporate social responsibility (CSR) in Ethiopia in terms of the legal and policy framework and practices. Corporate social responsibility is well defined and integrated in the mindsets of companies in developed countries. In Africa, there is a growing understanding of the role of CSR and the need to integrate them into national policies. This chapter reviews global and African practices in CSR; in the case of Ethiopia, determinants of CSR practices are identified and discussed. The methodology employed to conduct this brief study is a review of reports and research written on corporate social responsibility. Accordingly, 30 reports were assessed. The findings established that the predominant culture in Ethiopia is one of philanthropy rather than CSR. It is very common for companies to contribute to community development activities, grand projects of the government and relief support in times of natural disasters. Systemic integration of CSR into company strategies and business planning is not visible even in the largest corporations. There is also a policy gap on the government’s part as there are no clearly defined policies and strategies towards encouraging CSR.

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Kellow, A., Kellow, N. (2021). A Review of Corporate Social Responsibility Practices in Ethiopia. In: Apitsa, S.M., Milliot, E. (eds) Doing Business in Africa. Palgrave Studies of Internationalization in Emerging Markets. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-50739-8_9

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Legal Aspects of Corporate Social Responsibility in Ethiopia: A Sustainable Development Perspective

2022, The Journal of Sustainable Development Law and Policy

For many years, corporate social responsibility (CSR) has been shaping policies and actions on the role of businesses in society. This article explains the legal aspects of CSR from the perspective of sustainable development under Ethiopian law, based on the recognition of the crucial role of businesses in achieving sustainable development in the UN 2030 Agenda. By exploring and examining the major Ethiopian laws that govern businesses, it shows that the laws have incorporated diverse rules on CSR and have sustainable development as their objective. It also expounds how CSR, as incorporated in the laws, can be a key instrument to achieve sustainable development in Ethiopia, including through conducting proper governmental supervision of the conduct of businesses and encouraging the adoption and use of voluntary CSR codes of conduct by businesses to complement the CSR laws.

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This article aims to identify the existence of local and international legal and policy frameworks that can be used to commence structured CSR practice and establish comprehensive legal and policy frameworks in Ethiopia and the rest of the developing countries. The penultimate purpose of this study is also to ascribe the legal and policy frameworks that support Internal and/or External CSR. These all are the major foci of the contribution of this research article. Design/methodology/approach: National and international legal and policy documents related to CSR were reviewed. The study adopts a qualitative approach through a systematic review and meta-analysis was used to meet its research objectives. Findings: The findings depict that various legal and policy documents can contribute as a foundation for the laws, policies, and guidelines of CSR that will be established in Ethiopia, thus it helps to ensure the effective implementation of CSR. However, most of the legal and policy resources are emphasised on ICSR than ECSR. Moreover, the finding supports the existence of a significant gap in CSR orientations between developed and developing nations. Practical Implications: This study provides insight into the legal and policymakers that endeavor to bridge the gaps through establishing comprehensive law and policy frameworks. This wills results in corporate businesses to consider CSR compulsory and that promotes societal well-being.

International Journal of Social Work

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Journal of Advanced Research in Economics and Administrative Sciences

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Purpose: study aimed to assess the Corporate Social Responsibility practices, business-community relations, and the missing links in Corporate Social Responsibility-community development in Ethiopia. Approach/Methodology/Design: Case study and thematic analysis of data on 45 structured interviews of key informants from federal and regional government, companies, and local community was collected, transcribed, and analyzed to identify the current CSR practices and consequences, and the missing links in CSR-community development interface. Findings: The CSR is ad-hoc philanthropy activity based on neo-liberal and voluntary approach motivated by market performance, reputation and image building objectives. There is no community development orientation, no social and environmental impacts. There are tax dodging, deforestation, water and chemical pollutions, britches of labor and community rights, CSiRs; National indigenous culture based community development oriented mandatory CSR policy, coordinating agency, engaging community, measuring the implementation, rewarding good CSR performance and punishing CSiRs. Practical Implications: The study has implications for academics, managers, policy makers, public administrators, community activists and leaders. It contributes to CSR approach in developing countries, CSR theories, thinking, and practice in African context, the business community relations, the business management approaches, scope of stakeholders, in improving CSR to contribute to community development. Originality/value: This study's originality lies in bringing Ethnic diversity, federal-regional government, political history, collective rights, power of community and nationalism in CSR to the front.

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CSR is an important agent of change to address the challenges of social dimension of human development However, Ethiopia lagged behind the concept of Corporate Social Responsibility (CSR) guideline and framework. The central theme of this paper is to analyze how Corporate Social Responsibility (CSR) is important for human development. Based on analysis of 50 scholarly papers and research journals, books and organizational website products/ leaflets, the importance of CSR for human development is discussed in relation to the experiences of Japan and South Africa and their relevance to Ethiopia. CSR is an essential concept for the accumulation of social capital (in the form of social networks development and activities of voluntary associations) thereby facilitating greater participation in civic and political associations, trust, honesty, reliability, and developing collaboration in the society. Ethiopians and CSR are compatible because Ethiopians are “open minded” and receptive towa...

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International Journal of Business Ecosystem & Strategy (2687-2293)

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This paper examines CSR approaches and practices of local firms in Ethiopia, where the state is still a key player in business life. Moreover, it assesses at which stage Ethiopian CSR is. This mixed-method study includes quantitative analysis through SPSS and qualitative content analysis. A revised CSR practices scale has been conducted on owners/managers and employees of 100 local companies in Ethiopia. Besides, the companies' official websites have been thoroughly reviewed using five variables to understand their CSR approaches and practices better. The findings reveal that Ethiopian companies practice CSR though it is at the stage of fragmented CSR and the priorities differ from the global trend. Most respondent companies generally have excellent legal practices and CSR practices toward employees and customers. However, philanthropy, social sustainability, and management of CSR are remarkably at a mediocre level. Content analysis shows similarity with the results of quantitat...

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International Social Work

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Getinet Fentahun , yohannis G

Ethiopia is one of the developing countries where the philosophy of corporate social responsibility is not well developed and also the governance system takes the form of mere control and decision making rather than encouraging development and implementation of a well-developed ethical code of conduct in the four spectrums. The main purpose of the study is focuses on to assessing forms and norms of manufacturing firm CSR practice in East Gojjam Zone. The study has realized in 13 higher manufacturing firms and 253 respondent stakeholders from the surrounding have been taken through descriptive study design. Primarily Questionnaire, interview, observation have used. Data have been analyzed by descriptive statistical tools by apply SPSS package. The results had shown us that there are no accepted forms and norms in external environment, Social and economy /context on the way organizations CSR operations in east Gojjam zone. Hence, the sympathy to the forms and norms of social responsibility in our case is still in its infant stage. The dilemma between the global standards and the local practices towards implementing CSR haven't been balanced. Generally, the study recommends that Prospectors & Developers Association of Canada (2009) management system structure and requirements e-toolkit must be applied.

IJLHSS Journal

Corporate Social Responsibility has gone through many changes structurally and context wise. The essence of this concept, which is more often than not philanthropically motivated, has however not seen much change as modern companies due to benevolence and obligation under the law have been faithful to the cause of supporting development in their localities and countries. The influence of time and globalization on concepts and theories of humanity has been no different from corporate social responsibility. Over the years we have witnessed how this concept has metamorphosed to suit the changing demands of states especially those categorised as developing countries. This academic piece highlights the developments of corporate social responsibility within legal statutes and also takes a look at current practices of the concept in developing countries within the main regions of Latin America, Asia and Africa. This legal perspective presents a whole new front to enable efficient championing of the corporate social responsibility course.

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Please note you do not have access to teaching notes, corporate social responsibility: an attitude of ethiopian corporates.

Social Responsibility Journal

ISSN : 1747-1117

Article publication date: 3 October 2008

The purpose of this research is to find an attitude of Ethiopian corporate sector towards corporate social responsibility (CSR). In addition this research analyzed the opinion of employees, customers' as well the general public about the Ethiopian corporate sector's socially responsible actions.

Design/methodology/approach

This paper reviewed the relevant literature of CSR. Through structured questionnaires and in‐depth interviews with 50 Ethiopian companies, this study analyzed CSR towards different interest groups, e.g. owners or shareholders, employees, customers, creditors and suppliers, general public or community at large and government. To cross validate, the researcher also conducted a survey with another three questionnaires to obtain the views of 100 employees, 200 customers and another 200 general public. Collected data was analyzed using SPSS and Microsoft Excel software packages.

Ethiopian companies expressed 100 percent positive attitude in implementing CSR towards customers, creditors and suppliers, general public and government. However, only 40 percent of companies' were positive on periodical disclosure of information to its shareholders, 80 percent believed in fair wages and security of employment, and 10 percent of companies were negative on meaningful freedom, job satisfaction and humane treatment. Related to the cross validate section, overall 69 percent employees were not happy with companies' policies, 71 percent customers thought they were manipulated and another 75 percent general public were not pleased with CSR from the Ethiopian corporate sector.

Originality/value

This research paper serves as a basis for Ethiopian managers to understand the key interest groups and their expectations from the corporate sector and also to be acquainted with the opinions of employees, customers, and general public to assess the social performance of their organizations.

• Corporate social responsibility

Mouly Potluri, R. and Temesgen, Z. (2008), "Corporate social responsibility: an attitude of Ethiopian corporates", Social Responsibility Journal , Vol. 4 No. 4, pp. 456-463. https://doi.org/10.1108/17471110810909867

Emerald Group Publishing Limited

Copyright © 2008, Emerald Group Publishing Limited

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American Journal of Economics

p-ISSN: 2166-4951    e-ISSN: 2166-496X

2020;  10(6): 441-448

doi:10.5923/j.economics.20201006.14

Received: Sep. 30, 2020; Accepted: Nov. 9, 2020; Published: Nov. 28, 2020

Business Challenges and Opportunities for Youth, Micro, Small and Medium Scale Entrepreneurs in Ethiopia: An Article Review

Habtamu Alamineh

Department of Management, College of Business and Economics, Wolkite University, Wolkite, Ethiopia

Copyright © 2020 The Author(s). Published by Scientific & Academic Publishing.

These days, academic institutions, students and the whole population outnumbered compared with the last 30 years in Ethiopia. As a result, the probability of getting jobs in the government organisation has been cumbersome. Due to these reasons, youths and students are forced to start businesses in the form of unions and small enterprises. There are two bog standard factors that can challenge entrepreneurs’ in Ethiopia. These are, factors related to the entrepreneurs' personal qualities and external factors. To overcome those entrepreneurial challenges, the government should design entrepreneurship education and behavioral sciences as a compulsory subject for all students at all levels in addition to balancing the political, economical, social, and cultural factors. Also, it is expected from private and governmental organizations to attract business incubators, social entrepreneurs, and foreign investors’ to promote entrepreneurship in the nation. Moreover, designing free interest loans and tax system for young entrepreneurs until they will be strong and competent in the market may help them to sustain in the competition.

Keywords: Youth, Micro, and Small business, Unemployment, Ethiopia

Cite this paper: Habtamu Alamineh, Business Challenges and Opportunities for Youth, Micro, Small and Medium Scale Entrepreneurs in Ethiopia: An Article Review, American Journal of Economics , Vol. 10 No. 6, 2020, pp. 441-448. doi: 10.5923/j.economics.20201006.14.

Article Outline

1. introduction, 2. literature review, 2.1. the roles of msmes in ethiopia, 2.2. opportunities for entrepreneurship development in ethiopia, 3. methodology, 4. analysis and results, 5. conclusions and recommendations.

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Business and human rights in ethiopia: the status of the law and the practice, bantayehu demlie gezahegn.

Business activities in Ethiopia by both multinational and national companies are under growing scrutiny. Ongoing court cases in Kenya against Meta (formerly Facebook) for allegedly helping fuel the two-year deadly conflict in northern Ethiopia, increased reports of alleged poor labour conditions in apparel factories in industrial parks, and allegations of land grabbing by commercial agribusiness are some examples. The existing research and practice approaches the issue of private sector accountability predominantly from corporate social responsibility (CSR) perspective. The CSR landscape itself is regulated in a fragmented manner. In contexts lacking well-developed CSR frameworks, a growing body of research examines the promise of a newly evolving Business and Human Rights (BHR) paradigm. To date, there is a dearth of scholarly and policy discussion employing the term ‘business and human rights’ in Ethiopia, attesting the status of the field in academic and public discourse. This article presents a modest attempt at exploring the status of business and human rights law and practice in Ethiopia. By analysing relevant laws and reviewing selected practical cases, the article identifies salient issues, opportunities, and challenges toward developing and enforcing business and human rights standards.

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Review paper on research ethics in Ethiopia: experiences and lessons learnt from Addis Ababa University College of Health Sciences 2007-2012

• PMID: 25816496

Health research in Ethiopia is increasing both in volume and type, accompanied with expansion of higher education and research since the past few years. This calls for a proportional competence in the governance of medical research ethics in Ethiopia in the respective research and higher learning institutes. The paper highlights the evolution and progress ofthe ethics review at Addis Ababa University - College of Health Sciences (AAU-CHS) in the given context of health research review system in Ethiopia. Reflections are made on the key lessons to be drawnfrom the formative experiences of the Institutional Review Board (IRB) and their implications to the Ethiopian health research review system. This article is a review paper based on review of published and un published documents on research ethics in Ethiopia and the AAU-CHS (2007-2012). Thematic summaries of review findings are presented in thematic areas - formation of ethics review and key factors in the evolution of ethics review and implications. The IRB at AAU-CHS has been pivotal in providing review and follow-up for important clinical studies in Ethiopia. It has been one of the first IRBs to get WHO/SIDCER recognition from Africa and Ethiopia. Important factors in the successes of the IRB among others included leadership commitment, its placement in institutional structure, and continued capacity building. Financial challenges and sustainability issues need to be addressed for the sustained gains registered so far. Similar factors are considered important for the new and younger IRBs within the emergent Universities and research centers in the country.

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• Published: 24 May 2024

Turnover intention and its associated factors among nurses in Ethiopia: a systematic review and meta-analysis

• Eshetu Elfios 1 ,
• Israel Asale 1 ,
• Merid Merkine 1 ,
• Temesgen Geta 1 ,
• Kidist Ashager 1 ,
• Getachew Nigussie 1 ,
• Ayele Agena 1 ,
• Bizuayehu Atinafu 1 ,
• Eskindir Israel 2 &
• Teketel Tesfaye 3  

BMC Health Services Research volume  24 , Article number:  662 ( 2024 ) Cite this article

325 Accesses

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Nurses turnover intention, representing the extent to which nurses express a desire to leave their current positions, is a critical global public health challenge. This issue significantly affects the healthcare workforce, contributing to disruptions in healthcare delivery and organizational stability. In Ethiopia, a country facing its own unique set of healthcare challenges, understanding and mitigating nursing turnover are of paramount importance. Hence, the objectives of this systematic review and meta-analysis were to determine the pooled proportion ofturnover intention among nurses and to identify factors associated to it in Ethiopia.

A comprehensive search carried out for studies with full document and written in English language through an electronic web-based search strategy from databases including PubMed, CINAHL, Cochrane Library, Embase, Google Scholar and Ethiopian University Repository online. Checklist from the Joanna Briggs Institute (JBI) was used to assess the studies’ quality. STATA version 17 software was used for statistical analyses. Meta-analysis was done using a random-effects method. Heterogeneity between the primary studies was assessed by Cochran Q and I-square tests. Subgroup and sensitivity analyses were carried out to clarify the source of heterogeneity.

This systematic review and meta-analysis incorporated 8 articles, involving 3033 nurses in the analysis. The pooled proportion of turnover intention among nurses in Ethiopia was 53.35% (95% CI (41.64, 65.05%)), with significant heterogeneity between studies (I 2  = 97.9, P  = 0.001). Significant association of turnover intention among nurses was found with autonomous decision-making (OR: 0.28, CI: 0.14, 0.70) and promotion/development (OR: 0.67, C.I: 0.46, 0.89).

Conclusion and recommendation

Our meta-analysis on turnover intention among Ethiopian nurses highlights a significant challenge, with a pooled proportion of 53.35%. Regional variations, such as the highest turnover in Addis Ababa and the lowest in Sidama, underscore the need for tailored interventions. The findings reveal a strong link between turnover intention and factors like autonomous decision-making and promotion/development. Recommendations for stakeholders and concerned bodies involve formulating targeted retention strategies, addressing regional variations, collaborating for nurse welfare advocacy, prioritizing career advancement, reviewing policies for nurse retention improvement.

Peer Review reports

Turnover intention pertaining to employment, often referred to as the intention to leave, is characterized by an employee’s contemplation of voluntarily transitioning to a different job or company [ 1 ]. Nurse turnover intention, representing the extent to which nurses express a desire to leave their current positions, is a critical global public health challenge. This issue significantly affects the healthcare workforce, contributing to disruptions in healthcare delivery and organizational stability [ 2 ].

The global shortage of healthcare professionals, including nurses, is an ongoing challenge that significantly impacts the capacity of healthcare systems to provide quality services [ 3 ]. Nurses, as frontline healthcare providers, play a central role in patient care, making their retention crucial for maintaining the functionality and effectiveness of healthcare delivery. However, the phenomenon of turnover intention, reflecting a nurse’s contemplation of leaving their profession, poses a serious threat to workforce stability [ 4 ].

Studies conducted globally shows that high turnover rates among nurses in several regions, with notable figures reported in Alexandria (68%), China (63.88%), and Jordan (60.9%) [ 5 , 6 , 7 ]. In contrast, Israel has a remarkably low turnover rate of9% [ 8 ], while Brazil reports 21.1% [ 9 ], and Saudi hospitals26% [ 10 ]. These diverse turnover rates highlight the global nature of the nurse turnover phenomenon, indicating varying degrees of workforce mobility in different regions.

The magnitude and severity of turnover intention among nurses worldwide underscore the urgency of addressing this issue. High turnover rates not only disrupt healthcare services but also result in a loss of valuable skills and expertise within the nursing workforce. This, in turn, compromises the continuity and quality of patient care, with potential implications for patient outcomes and overall health service delivery [ 11 ]. Extensive research conducted worldwide has identified a range of factors contributing to turnover intention among nurses [ 11 , 12 , 13 , 14 , 15 , 16 , 17 ]. These factors encompass both individual and organizational aspects, such as high workload, inadequate support, limited career advancement opportunities, job satisfaction, conflict, payment or reward, burnout sense of belongingness to their work environment. The complex interplay of these factors makes addressing turnover intention a multifaceted challenge that requires targeted interventions.

In Ethiopia, a country facing its own unique set of healthcare challenges, understanding and mitigating nursing turnover are of paramount importance. The healthcare system in Ethiopia grapples with issues like resource constraints, infrastructural limitations, and disparities in healthcare access [ 18 ]. Consequently, the factors influencing nursing turnover in Ethiopia may differ from those in other regions. Previous studies conducted in the Ethiopian context have started to unravel some of these factors, emphasizing the need for a more comprehensive examination [ 18 , 19 ].

Although many cross-sectional studies have been conducted on turnover intention among nurses in Ethiopia, the results exhibit variations. The reported turnover intention rates range from a minimum of 30.6% to a maximum of 80.6%. In light of these disparities, this systematic review and meta-analysis was undertaken to ascertain the aggregated prevalence of turnover intention among nurses in Ethiopia. By systematically analyzing findings from various studies, we aimed to provide a nuanced understanding of the factors influencing turnover intention specific to the Ethiopian healthcare context. Therefore, this systematic review and meta-analysis aimed to answer the following research questions.

What is the pooled prevalence of turnover intention among nurses in Ethiopia?

What are the factors associated with turnover intention among nurses in Ethiopia?

The primary objective of this review was to assess the pooled proportion of turnover intention among nurses in Ethiopia. The secondary objective was identifying the factors associated to turnover intention among nurses in Ethiopia.

Study design and search strategy

A comprehensive systematic review and meta-analysis was conducted, examining observational studies on turnover intention among nurses in Ethiopia. The procedure for this systematic review and meta-analysis was developed in accordance with the Preferred Reporting Items for Systematic review and Meta-analysis Protocols (PRISMA-P) statement [ 20 ]. PRISMA-2015 statement was used to report the findings [ 21 , 22 ]. This systematic review and meta-analysis were registered on PROSPERO with the registration number of CRD42024499119.

We conducted systematic and an extensive search across multiple databases, including PubMed, CINAHL, Cochrane Library, Embase, Google Scholar and Ethiopian University Repository online to identify studies reporting turnover intention among nurses in Ethiopia. We reviewed the database available at http://www.library.ucsf.edu and the Cochrane Library to ensure that the intended task had not been previously undertaken, preventing any duplication. Furthermore, we screened the reference lists to retrieve relevant articles. The process involved utilizing EndNote (version X8) software for downloading, organizing, reviewing, and citing articles. Additionally, a manual search for cross-references was performed to discover any relevant studies not captured through the initial database search. The search employed a comprehensive set of the following search terms:“prevalence”, “turnover intention”, “intention to leave”, “attrition”, “employee attrition”, “nursing staff turnover”, “Ethiopian nurses”, “nurses”, and “Ethiopia”. These terms were combined using Boolean operators (AND, OR) to conduct a thorough and systematic search across the specified databases.

Eligibility criteria

Inclusion criteria.

The established inclusion criteria for this meta-analysis and systematic review are as follows to guide the selection of articles for inclusion in this review.

Population: Nurses working in Ethiopia.

Study period: studies conducted or published until 23November 2023.

Study design: All observational study designs, such as cross-sectional, longitudinal, and cohort studies, were considered.

Setting: Only studies conducted in Ethiopia were included.

Outcome; turnover intention.

Study: All studies, whether published or unpublished, in the form of journal articles, master’s theses, and dissertations, were included up to the final date of data analysis.

Language: This study exclusively considered studies in the English language.

Exclusion criteria

Excluded were studies lacking full text or Studies with a Newcastle–Ottawa Quality Assessment Scale (NOS) score of 6 or less. Studies failing to provide information on turnover intention among nurses or studies for which necessary details could not be obtained were excluded. Three authors (E.E., T.G., K.A) independently assessed the eligibility of retrieved studies, other two authors (E.I & M.M) input sought for consensus on potential in- or exclusion.

Quality assessment and data extraction

Two authors (E.E, A.A, G.N) independently conducted a critical appraisal of the included studies. Joanna Briggs Institute (JBI) checklists of prevalence study was used to assess the quality of the studies. Studies with a Newcastle–Ottawa Quality Assessment Scale (NOS) score of seven or more were considered acceptable [ 23 ]. The tool has nine parameters, which have yes, no, unclear, and not applicable options [ 24 ]. Two reviewers (I.A, B.A) were involved when necessary, during the critical appraisal process. Accordingly, all studies were included in our review. ( Table  1 ) Questions to evaluate the methodological quality of studies on turnover intention among nurses and its associated factors in Ethiopia are the followings:

Q1 = was the sample frame appropriate to address the target population?

Q2. Were study participants sampled appropriately.

Q3. Was the sample size adequate?

Q4. Were the study subjects and the setting described in detail?

Q5. Was the data analysis conducted with sufficient coverage of the identified sample?

Q6. Were the valid methods used for the identification of the condition?

Q7. Was the condition measured in a standard, reliable way for all participants?

Q8. Was there appropriate statistical analysis?

Q9. Was the response rate adequate, and if not, was the low response rate.

managed appropriately?

Data was extracted and recorded in a Microsoft Excel as guided by the Joanna Briggs Institute (JBI) data extraction form for observational studies. Three authors (E.E, M.G, T.T) independently conducted data extraction. Recorded data included the first author’s last name, publication year, study setting or country, region, study design, study period, sample size, response rate, population, type of management, proportion of turnover intention, and associated factors. Discrepancies in data extraction were resolved through discussion between extractors.

Data processing and analysis

Data analysis procedures involved importing the extracted data into STATA 14 statistical software for conducting a pooled proportion of turnover intention among nurses. To evaluate potential publication bias and small study effects, both funnel plots and Egger’s test were employed [ 25 , 26 ]. We used statistical tests such as the I statistic to quantify heterogeneity and explore potential sources of variability. Additionally, subgroup analyses were conducted to investigate the impact of specific study characteristics on the overall results. I 2 values of 0%, 25%, 50%, and 75% were interpreted as indicating no, low, medium, and high heterogeneity, respectively [ 27 ].

To assess publication bias, we employed several methods, including funnel plots and Egger’s test. These techniques allowed us to visually inspect asymmetry in the distribution of study results and statistically evaluate the presence of publication bias. Furthermore, we conducted sensitivity analyses to assess the robustness of our findings to potential publication bias and other sources of bias.

Utilizing a random-effects method, a meta-analysis was performed to assess turnover intention among nurses, employing this method to account for observed variability [ 28 ]. Subgroup analyses were conducted to compare the pooled magnitude of turnover intention among nurses and associated factors across different regions. The results of the pooled prevalence were visually presented in a forest plot format with a 95% confidence interval.

Study selection

After conducting the initial comprehensive search concerning turnover intention among nurses through Medline, Cochran Library, Web of Science, Embase, Ajol, Google Scholar, and other sources, a total of 1343 articles were retrieved. Of which 575 were removed due to duplication. Five hundred ninety-three articles were removed from the remaining 768 articles by title and abstract. Following theses, 44 articles which cannot be retrieved were removed. Finally, from the remaining 131 articles, 8 articles with a total 3033 nurses were included in the systematic review and meta-analysis (Fig.  1 ).

PRISMA flow diagram of the selection process of studies on turnover intention among nurses in Ethiopia, 2024

Study characteristics

All included 8 studies had a cross-sectional design and of which, 2 were from Tigray region, 2 were from Addis Ababa(Capital), 1 from south region, 1 from Amhara region, 1 from Sidama region, and 1 was multiregional and Nationwide. The prevalence of turnover intention among nurses ‘ranges from 30.6 to 80.6%. Table  2 .

Pooled prevalence of turnover intention among nurses in Ethiopia

Our comprehensive meta-analysis revealed a notable turnover intention rate of 53.35% (95% CI: 41.64, 65.05%) among Ethiopian nurses, accompanied by substantial heterogeneity between studies (I 2  = 97.9, P  = 0.000) as depicted in Fig.  2 . Given the observed variability, we employed a random-effects model to analyze the data, ensuring a robust adjustment for the significant heterogeneity across the included studies.

Forest plot showing the pooled proportion of turnover intention among nurses in Ethiopia, 2024

Subgroup analysis of turnover intention among nurses in Ethiopia

To address the observed heterogeneity, we conducted a subgroup analysis based on regions. The results of the subgroup analysis highlighted considerable variations, with the highest level of turnover intention identified in Addis Ababa at 69.10% (95% CI: 46.47, 91.74%) and substantial heterogeneity (I 2  = 98.1%). Conversely, the Sidama region exhibited the lowest level of turnover intention among nurses at 30.6% (95% CI: 25.18, 36.02%), accompanied by considerable heterogeneity (I 2  = 100.0%) ( Fig.  3 ).

Subgroup analysis of systematic review and meta-analysis by region of turnover intention among nurses in Ethiopia, 2024

Publication bias of turnover intention among nurses in Ethiopia

The Egger’s test result ( p  = 0.64) is not statistically significant, indicating no evidence of publication bias in the meta-analysis (Table  3 ). Additionally, the symmetrical distribution of included studies in the funnel plot (Fig.  4 ) confirms the absence of publication bias across studies.

Funnel plot of systematic review and meta-analysis on turnover intention among nurses in Ethiopia, 2024

Sensitivity analysis

The leave-out-one sensitivity analysis served as a meticulous evaluation of the influence of individual studies on the comprehensive pooled prevalence of turnover intention within the context of Ethiopian nurses. In this systematic process, each study was methodically excluded from the analysis one at a time. The outcomes of this meticulous examination indicated that the exclusion of any particular study did not lead to a noteworthy or statistically significant alteration in the overall pooled estimate of turnover intention among nurses in Ethiopia. The findings are visually represented in Fig.  5 , illustrating the stability and robustness of the overall pooled estimate even with the removal of specific studies from the analysis.

Sensitivity analysis of pooled prevalence for each study being removed at a time for systematic review and meta-analysis of turnover intention among nurses in Ethiopia

Factors associated with turnover intention among nurses in Ethiopia

In our meta-analysis, we comprehensively reviewed and conducted a meta-analysis on the determinants of turnover intention among nurses in Ethiopia by examining eight relevant studies [ 6 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ]. We identified a significant association between turnover intention with autonomous decision-making (OR: 0.28, CI: 0.14, 0.70) (Fig.  6 ) and promotion/development (OR: 0.67, CI: 0.46, 0.89) (Fig.  7 ). In both instances, the odds ratios suggest a negative association, signifying that increased levels of autonomous decision-making and promotion/development were linked to reduced odds of turnover intention.

Forest plot of the association between autonomous decision making with turnover intention among nurses in Ethiopia2024

Forest plot of the association between promotion/developpment with turnover intention among nurses in Ethiopia, 2024

In our comprehensive meta-analysis exploring turnover intention among nurses in Ethiopia, our findings revealed a pooled proportion of turnover intention at 53.35%. This significant proportion warrants a comparative analysis with turnover rates reported in other global regions. Distinct variations emerge when compared with turnover rates in Alexandria (68%), China (63.88%), and Jordan (60.9%) [ 5 , 6 , 7 ]. This comparison highlights that the multifaceted nature of turnover intention, influenced by diverse contextual, cultural, and organizational factors. Conversely, Ethiopia’s turnover rate among nurses contrasts with substantially lower figures reported in Israel (9%) [ 8 ], Brazil (21.1%) [ 9 ], and Saudi hospitals (26%) [ 10 ]. Challenges such as work overload, economic constraints, limited promotional opportunities, lack of recognition, and low job rewards are more prevalent among nurses in Ethiopia, contributing to higher turnover intention compared to their counterparts [ 7 , 29 , 36 ].

The highest turnover intention was observed in Addis Ababa, while Sidama region displayed the lowest turnover intention among nurses, These differences highlight the complexity of turnover intention among Ethiopian nurses, showing the importance of specific interventions in each region to address unique factors and improve nurses’ retention.

Our systematic review and meta-analysis in the Ethiopian nursing context revealed a significant inverse association between turnover intention and autonomous decision-making. The odd of turnover intention is approximately reduced by 72% in employees with autonomous decision-making compared to those without autonomous decision-making. This finding was supported by other similar studies conducted in South Africa, Tanzania, Kenya, and Turkey [ 37 , 38 , 39 , 40 ].

The significant association of turnover intention with promotion/development in our study underscores the crucial role of career advancement opportunities in alleviating turnover intention among nurses. Specifically, our analysis revealed that individuals with promotion/development had approximately 33% lower odds of turnover intention compared to those without such opportunities. These results emphasize the pivotal influence of organizational support in shaping the professional environment for nurses, providing substantive insights for the formulation of evidence-based strategies targeted at enhancing workforce retention. This finding is in line with former researches conducted in Taiwan, Philippines and Italy [ 41 , 42 , 43 ].

Our meta-analysis on turnover intention among Ethiopian nurses reveals a considerable challenge, with a pooled proportion of 53.35%. Regional variations highlight the necessity for region-specific strategies, with Addis Ababa displaying the highest turnover intention and Sidama region the lowest. A significant inverse association was found between turnover intention with autonomous decision-making and promotion/development. These insights support the formulation of evidence-based strategies and policies to enhance nurse retention, contributing to the overall stability of the Ethiopian healthcare system.

Recommendations

Federal ministry of health (fmoh).

The FMoH should consider the regional variations in turnover intention and formulate targeted retention strategies. Investment in professional development opportunities and initiatives to enhance autonomy can be integral components of these strategies.

Ethiopian nurses association (ENA)

ENA plays a pivotal role in advocating for the welfare of nurses. The association is encouraged to collaborate with healthcare institutions to promote autonomy, create mentorship programs, and advocate for improved working conditions to mitigate turnover intention.

Healthcare institutions

Hospitals and healthcare facilities should prioritize the provision of career advancement opportunities and recognize the value of professional autonomy in retaining nursing staff. Tailored interventions based on regional variations should be considered.

Policy makers

Policymakers should review existing healthcare policies to identify areas for improvement in nurse retention. Policy changes that address challenges such as work overload, limited promotional opportunities, and economic constraints can positively impact turnover rates.

Future research initiatives

Further research exploring the specific factors contributing to turnover intention in different regions of Ethiopia is recommended. Understanding the nuanced challenges faced by nurses in various settings will inform the development of more targeted interventions.

Strength and limitations

Our systematic review and meta-analysis on nurse turnover intention in Ethiopia present several strengths. The comprehensive inclusion of diverse studies provides a holistic view of the issue, enhancing the generalizability of our findings. The use of a random-effects model accounts for potential heterogeneity, ensuring a more robust and reliable synthesis of data.

However, limitations should be acknowledged. The heterogeneity observed across studies, despite the use of a random-effects model, may impact the precision of the pooled estimate. These considerations should be taken into account when interpreting and applying the results of our analysis.

Data availability

Data set used on this analysis will available from corresponding author upon reasonable request.

Abbreviations

Ethiopian Nurses Association

Federal Ministry of Health

Joanna Briggs Institute

Preferred Reporting Items for Systematic review and Meta-analysis Protocols

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Eshetu Elfios, Israel Asale, Merid Merkine, Temesgen Geta, Kidist Ashager, Getachew Nigussie, Ayele Agena & Bizuayehu Atinafu

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E.E. conceptualized the study, designed the research, performed statistical analysis, and led the manuscript writing. I.A, T.G, M.M contributed to the study design and provided critical revisions. K.A., G.N, B.A., E.I., and T.T. participated in data extraction and quality assessment. M.M. and T.G. K.A. and G.N. contributed to the literature review. I.A, A.A. and B.A. assisted in data interpretation. E.I. and T.T. provided critical revisions to the manuscript. All authors read and approved the final version.

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Elfios, E., Asale, I., Merkine, M. et al. Turnover intention and its associated factors among nurses in Ethiopia: a systematic review and meta-analysis. BMC Health Serv Res 24 , 662 (2024). https://doi.org/10.1186/s12913-024-11122-9

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Southwest Religious Training Clash Tests Judge’s Sanctions Power

By Patrick Dorrian

A fight over court-ordered training for three Southwest Airlines Co. attorneys by a Christian legal group is set to go before the Fifth Circuit Monday, giving the appeals court a chance to weigh in on whether attorneys can be required to submit to such instruction.

The airline is challenging Texas federal judge Brantley Starr ‘s order requiring three of its in-house lawyers to undergo “religious liberty” training by the nonprofit Alliance Defending Freedom. The group has been involved in several high-profile US Supreme Court cases involving LGBTQ+ rights and abortion services in recent years.

Starr, a Trump appointee who took the bench in 2019, ordered the training in an employment bias case after finding Southwest willfully disregarded a prior order requiring it to inform flight attendants that the company “may not” discriminate against them based on religion.

At issue is when district court judges can require attorneys to undergo training for contempt of court, and whether and when advocacy organizations can be designated to provide it. If Starr’s order survives, case watchers say, it could embolden other courts to make similar moves.

“Everyone can picture a future in which courts or administrative agencies send in groups to try to change people’s point of view,” Walter Olson , a senior fellow at the Cato Institute said.

Starr’s order came after a jury found the airline discriminated against anti-abortion flight attendant Charlene Carter when it fired her for messages she sent to her union president, protesting the union’s attendance at the 2017 Women’s March.

Southwest says the training is “unprecedented” and would amount to “reeducation.” Starr was off-base in ordering it, because the airline substantially complied with his may-not-discriminate-notice directive when it informed flight attendants that the company “does not” discriminate based on religion, and emailed them the jury’s verdict in favor of Carter and the court’s subsequent judgment, Southwest says.

Scope of Review

The airline, Carter, and the union, which the jury also found violated Carter’s rights, each appealed portions of the lower court proceedings.

Whether US Court of Appeals for the Fifth Circuit judges Edith Brown Clement , Kurt D. Engelhardt , and Cory T. Wilson will reach the training issue, and the scope of review if they do, is unclear.

The myriad issues on appeal include whether the verdict against Southwest was supported by the evidence, so the training sanction may not be considered if that verdict is overturned or a new trial is granted.

It’s also possible that the Fifth Circuit will say the contempt finding is unsupported and that Starr had no basis for the sanction. That might mean the court won’t address whether religious-liberty training was appropriate.

The appeals court won’t wade into whether the ADF was properly designated as the trainer even if it does reach the sanctions issue and upholds the underlying contempt finding, University of North Texas at Dallas College of Law associate professor Michael Maslanka predicted. It will instead find a way to say the parties should agree on who will conduct the training, he said.

It’s also more likely that the Fifth Circuit will rule the Southwest attorneys should be sent for ethics training rather than religious liberty training, Maslanka said.

Politics or Intolerance?

Civil contempt sanctions are supposed to be limited to what it takes to get a party to comply, University of Miami law professor Jan L. Jacobowitz said. “What does religious liberty training have to do with that?” she said.

It’s not unheard of for courts to impose training sanctions on attorneys, Jacobowitz said. “It’s this particular type of training to be conducted by a court designated organization that’s troubling,” she said.

“The overarching concern is the politicization of the courts,” Jacobowitz said.

Retired University of Virginia law professor Douglas Laycock expressed similar concerns.

“The real problem is to order training by the ADF, which at best is a highly ideological and one-sided organization,” Laycock said. “No one trusts the ADF to give neutral training,” he said.

The ADF, which filed an amicus brief supporting neither party, disagrees with its critics.

It’s “baseless and intolerant to suggest that people of faith cannot provide legal instruction simply because their religious beliefs might differ from their audience’s,” ADF’s chief legal counsel Jim Campbell said in a statement.

ADF lawyers “are some of the most effective religious liberty litigators in America, having won 15 cases” in the US Supreme Court in the last 13 years, Campbell said. “The judge’s order calls for ADF to provide training in religious liberty law—not religious doctrine.”

‘Reeducation’ Concerns

Cato Institute’s Olson questioned whether Starr’s order is really that unprecedented. It’s not unusual for an organization viewed as “intrinsically controversial” or ideological to be designated to provide involuntary training, whether by a court or an administrative agency, though it might be the first time in the area of religion that a party has been sent to a group like the ADF, he said.

He pointed to Masterpiece Cakeshop Ltd. v. Colorado Civil Rights Commission , where a Christian baker was ordered by a Colorado agency to undergo training after being found in violation of a state law for declining to design a wedding cake for a gay couple—training that Justice Neil Gorsuch later referred to as “reeducation,” Olson said.

That’s the same word Southwest uses on appeal. The whole basis of the baker’s lawsuit in Masterpiece Cakeshop was that he was standing on his religious principles, Olson said. So the training Colorado ordered seemed to be directly aimed at that and the state lecturing the baker on something that isn’t necessarily complicated, he said.

It’s easier to categorize what happened in Masterpiece Cakeshop as ideological or reeducation than what happened in Carter’s case, “but the concern is the same,” Olson said.

The ADF represented the Christian baker in Masterpiece Cakeshop .

Starr’s sanctions order is “extraordinary and unusual,” University of Virginia law professor Xiao Wang said. If it stands, other parties may find it problematic if advocacy organizations start getting tapped to do this type of training, he said.

“If Carter had lost her case and faced the prospect of sanctions, she would likely have objected if she’d been ordered to take training from Americans United for the Separation of Church and State,” Wang said.

National Right to Work Legal Defense Foundation Inc.; Pryor & Bruce; and Jenkins & Watkins PC represent Carter. Reed Smith LLP; Skadden, Arps, Slate, Meagher & Flom LLP; and Ryan Law Partners LLP represent Southwest. Law Offices of Cloutman & Greenfield PLLC represents the union.

The cases are Carter v. Local 556, Transport Workers Union of Am., 5th Cir., No. 23-10008, oral argument 6/3/24, Carter v. Sw. Airlines Co., 5th Cir., No. 23-10536, oral argument 6/3/24, and Carter v. Sw. Airlines Co., 5th Cir., No. 23-10836, oral argument 6/3/24.

To contact the reporter on this story: Patrick Dorrian in Washington at [email protected]

To contact the editors responsible for this story: Carmen Castro-Pagán at [email protected] ; Keith Perine at [email protected]

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Boeing Gives F.A.A. Plan to Address Systemic Quality-Control Issues

The action plan is the latest in a series of moves by the F.A.A. to push for safety improvements throughout Boeing during a tumultuous year for the company.

By Mark Walker and Niraj Chokshi

Boeing’s top executives delivered a plan to improve quality and safety to the Federal Aviation Administration on Thursday, vowing to address systemic issues that have damaged the company’s reputation and put the aircraft manufacturer at the center of several federal investigations.

Boeing detailed these and other steps during a three-hour meeting with the F.A.A.’s administrator, Mike Whitaker, where the company submitted a “comprehensive action plan” that the regulator ordered in February.

Mr. Whitaker had given Boeing 90 days to develop a plan to make sweeping safety improvements after a midcabin panel known as a door plug blew out of a 737 Max 9 jet flying at about 16,000 feet on Jan. 5. No one was seriously injured during the flight.

The F.A.A. said in a statement on Thursday that “senior” leaders from the agency would “meet with Boeing weekly to review their performance metrics, progress and any challenges they’re facing in implementing the changes.”

Boeing was also required to address findings, from an expert panel convened by the F.A.A. last year, that revealed persistent issues with the company’s safety culture. Mr. Whitaker said Boeing had accepted all of the recommendations the panel made in the report.

“We need to see a strong and unwavering commitment to safety and quality that endures over time,” Mr. Whitaker said during a news conference on Thursday. “This is about systemic change, and there’s a lot of work to be done.”

In a statement, Boeing said the action plan it delivered to the F.A.A. was based on feedback it received from employees and through conversations with the regulator. Boeing provided some additional detail on the actions it was taking to improve quality but did not make the safety plan public.

In an email to employees, Stephanie Pope, the head of Boeing’s commercial plane unit and the company’s chief operating officer, said the company is investing in training, simplifying plans and processes, eliminating defects and improving quality and safety.

The company has made some changes, including expanding training for new hires to 14 weeks from 10 weeks; helping managers spend more time on the factory floor and less time in meetings; increasing inspections at Boeing and at a top supplier, and ordering more tools and equipment.

“Many of these actions are underway and our team is committed to executing on each element of the plan,” David Calhoun, Boeing’s chief executive, said in a statement. “It is through this continuous learning and improvement process that our industry has made commercial aviation the safest mode of transportation. The actions we are taking today will further strengthen that foundation.”

The company has also conducted more than 20 meetings at sites around the world, pausing work to gather employee feedback on improving quality. More than 70,000 Boeing workers have participated, providing tens of thousands of comments, the company has said.

Mr. Whitaker, who met on Thursday with Mr. Calhoun, said he planned to continue to meet weekly with Boeing to make sure the actions were executed correctly and in a timely manner. Mr. Whitaker will meet with Boeing’s chief executive in September. Mr. Calhoun has said he plans to step down at the end of the year.

There is no timeline for Boeing to carry out the changes, Mr. Whitaker said.

He also said Boeing had developed six measures by which it and the agency would be able to track the company’s progress. The F.A.A. will also maintain heightened inspections of both Boeing and Spirit AeroSystems, a supplier that makes the bodies of the 737 Max jet. Boeing has said it plans to buy Spirit to gain more control over the quality of the parts it produces for the company.

The action plan is the latest in a series of moves by the F.A.A. to push for safety improvements throughout Boeing. The regulator limited Boeing’s monthly production of 737 Max jets and audited its production lines, and is investigating the company’s compliance with federal safety standards.

Mr. Whitaker said the F.A.A. would continue to put limits on Boeing until the agency was satisfied with the company’s progress. The regulator and Boeing have not yet discussed raising the number of Max jets that Boeing can produce in a month beyond 38, he said. Boeing is making the planes at well below that rate, but has said it hopes to accelerate production in the second half of the year.

“We will not approve production increases beyond the current cap until we’re satisfied,” Mr. Whitaker said during the news conference. “Bottom line, we will continue to make sure every airplane that comes off the line is safe and reliable.”

The Justice Department has also opened a criminal investigation into the Jan. 5 episode. A preliminary investigation by the National Transportation Safety Board suggested that the Max 9 plane might have left Boeing’s factory in Renton, Wash., without the panel bolted down.

Boeing also faces potential legal repercussions from crashes involving its planes. The Justice Department said this month that Boeing had violated a 2021 settlement reached after two 737 Max plane crashes killed hundreds in 2018 and 2019, and could be prosecuted on a criminal charge of conspiracy to defraud the F.A.A.

The Justice Department found that Boeing had failed to “design, implement and enforce” a compliance and ethics program that was a condition of the settlement. The company plans to contest the department’s determination.

That 2021 settlement had been criticized for being too lenient on Boeing and for being struck without consulting the families of the 346 people killed in the Max crashes, which were in Indonesia and Ethiopia and led to the grounding of the 737 Max fleet for 20 months. An investigation determined that both crashes involved the mistaken triggering of a maneuvering system designed to help avert stalls in flight.

Mark Walker is an investigative reporter focused on transportation. He is based in Washington. More about Mark Walker

Niraj Chokshi writes about aviation, rail and other transportation industries. More about Niraj Chokshi

Boeing: A Company in Turmoil

Plan To Fix Safety Issues: Boeing’s top executives delivered  a plan to improve quality and safety to the F.A.A ., vowing to address systemic issues that have damaged the company’s reputation and put the manufacturer at the center of several federal investigations.

Settlement Violation: The Department of Justice said that Boeing was in violation of a 2021 settlement  related to problems with the company’s 737 Max model that led to two deadly plane crashes in 2018 and 2019.

A New Investigation: The F.A.A. has opened an investigation  into Boeing after the plane maker told the regulator that it might have skipped required inspections involving the wings of some 787 Dreamliners.

A Huge Loss: Boeing reported a $355 million loss  for the first three months of the year, as it deals with a quality crisis stemming from a Jan. 5 flight during which a panel blew off one of its planes.

A CEO to Fix Boeing: The plane maker, which is searching for a new chief executive, is likely to consider a small number of people , including several former Boeing executives.

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