Document Type : Original Article


1 Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran

2 Student Research Committee, Zahedan University of Medical Sciences, Zahedan, Iran


Background: In 2014, Health Transformation Plan (HTP) started in Iranian health system to improve productivity of health organizations. The aim of the present study was to assess the employees’ productivity in health centers after HTP.
Methods: This cross-sectional study with analytical approach was carried out in Zahedan University of Medical Sciences in 2018. 150 health workers were selected using census method. Data were collected by Hersey & Goldsmith Workforce Productivity Questionnaire. For the data analysis, descriptive and statistical methods such as Pearson correlation 2-tailed, one-way ANOVA, T-tests and regression model were used.
Results: Our findings showed that 96% of health workers were female. Mean score of productivity was 63.8±12.7, which is in the moderate level. Besides, we found a significant negative relationship between productivity and job experience of the employees (P = 0.021, F = 2.975).
Conclusion: In this study, productivity was at a moderate level. It seems with better motivation of the staff, there might be an improvement in productivity.
Human resources are considered as fundamental resources and the most important factor for developing any organization. Today, due to the effect of the employees’ efficiency on overall function, many organizations preliminarily focus on increasing the employees’ productivity. European Productivity Agency defines productivity as “the level of using each producing factor properly, which first seems an overview that constantly tries to improve the existing condition” (1-3).
Today, the most important factor in community development is increased attention to human productivity, and organizations can only reach their achievement via using human resources because human being defines waste or productivity of physical resources or materials (4). To motivate the employees, who provide high quality cares and help the development of a society, we need to invest on human resources management. Despite this global importance, today, health systems ignore the mentioned fact;  as a result, decreased human productivity has become a challenge (5).
According to the existing reports, health centers and organizations in Iran, in contrast to industry and business ones, have rarely investigated effective ways of improving the employees’ productivity; also, Iranian human productivity index is weaker than the mean East Asian countries (4). Studies have shown that without long-term, thorough, and evidence-based plan, this goal seems unachievable (6). We should also consider that decreased productivity in health area can lead to decreased quality of life and social security in communities (3). According to a study, the costs that are the result of decreased productivity in health care organizations can be many times more than direct costs of medical conditions (7). This is also important that the human resources productivity in health organizations is more significant than other organizations because these organizations, besides doing their routines, have the ability to face the crisis, too. This area of health is considered as one of the most basic parts of  economic development in different countries. In health care organizations, in order to get productivity, we need to take a systemic, local, and practical overview. That is, organizational factors like employees’ motivation, working culture, mental health, right choice of workers, effective leadership, occupational function, and other factors cannot improve productivity individually and they must work as a system. We should also pay attention to reciprocal relationship between these factors. Sufficient organizational structure, effective function, proper work equipment, balanced area, and  most importantly professional and effective human resource are necessary to reach  adequate productivity (3, 6, 8).
On May 5, 2014, a series of reforms has been done in Iranian health system under the title of Health Transformation Plan (HTP), with three main approaches of financial protection of patients,  fairness in access to health services, and improvement of the quality of services (9). Because there is a special look at health area in this plan, and absence of proper research on this topic, this study seemed necessary to be conducted. Therefore, this study aimed to evaluate the employees’ productivity in health centers after HTP. The results of this study can provide required information for health policymakers and managers to improve the human resources productivity and in turn can result in increased quality of service delivery.


1. Heydari A, Kabir M J, Babazadeh Gashti A, Jafari N, Lotfi M, Aryaei M, et al. Job satisfaction of health workers in Golestan Province based on Herzberg s model in the year 2012. Jorjani Biomed J. 2014; 2 (2):49-42.
2. Forouzanfar MM, Alitaleshi H, Hashemi B, Baratloo A, Motamedi M,Majidi A, et al. Emergency nurses job satisfaction and its determinants. Journal of Shahid Beheshti School of Nursing &Midwifery. 2013; 23(80).
3. Sadeghi G, Adham D, Panahi M, Khalili Z, Naseri M, Abbasgholizadeh N, et al. Survey of "Improving Productivity of Clinical Staffs’ Law" Enforcement in Hospitals Affiliated to Ardabil University of Medical Sciences. 2017; 8 (2):151-159.
4. Hajinabi K, Nasiripoor A A, Zahedkar P, Mehrabian F. Relationship between nurses’ working shifts with human resources productivity. J Holist Nurs Midwifery. 2013; 23 (1):7-12.
5. Danesh kohan A, Alipour M, Ahmadi N, Sajjadi F, Sari M. Job Satisfaction Among Employees of Azna District Health Network, 2009. JRUMS. 2013; 12 (7):505-518.
6. M. Bahadori, E. Teimourzadeh, and H. Masteri Farahani, “Factors affecting human resources’ productivity in a military health organization,” Journal of Military Medicine, vol. 15, no. 1, pp. 77–86, 2013.
7. Mattke S, Balakrishnan A, Bergamo G, Newberry SJ. A review of methods to measure health-related productivity loss. Am J Manag Care. 2007; 13:211–217.
8. Rezghi Shirsavar H, Moosavi, M. Relationship between job satisfaction and productivity of employees in Tehran Medical Sciences Islamic Azad University. Journal of healthcare management. 2014. 3 (3-4). 19-27.
10. Shaemi Barzoki A, Mohammdi M. A survey of the impact of transformational leadership on manpower productivity with the mediating role of organizational entrepreneurship. Management. 2016. 6 (12). 1-28.
11. Hoboubi N, Choobineh A, Kamari Ghanavati F, Keshavarzi S, Hosseini AA, The Impact of Job Stress and Job Satisfaction on Workforce Productivity in an Iranian Petrochemical Industry. Safety and Health at Work.  2017; 8 (1): 67-71
 12. Karimi S, Mohammadinia L, Mofid M. The Survey of Relation between Compasses of Socialization and Productivity of Employees in Selected Hospitals. Health Inf Manage 2015; 11(7):1046.
13. Khammarnia M, Kassani A, Peyvand M. Relationship between partnership working and employees’ productivity in a University of Medical Sciences in the South of Iran. J Health Man & Info. 2016;3(3):89-93.
14. Masoumi Ganjgah P, Geranmayeh M, Haghani S. The Influential Factors in the Job Motivation among Midwives as the Healthcare Providers in the Iranian Health Sector Evolution Plan. IJN. 2020; 33 (125) :13-27
15. Mirkamali K, Ahmadizad A, Kazemzadeh S, Varmaghani M. Determining the Relationship Between Job Burnout and Employee Productivity. Iran J Ergon. 2019; 7 (1):37-44