Generation Gaps in Healthcare: Exploring Job Satisfaction Patterns Across Four Generational Cohorts in Ogun State, Nigeria

Generation Gaps in Healthcare: Exploring Job Satisfaction Patterns Across Four Generational Cohorts in Ogun State, Nigeria

Akinbo T.M., Al’Hassan-Ewuoso H.O.

Crescent University, Abeokuta, Nigeria

DOI: https://dx.doi.org/10.47772/IJRISS.2025.908000130

Received: 24 July 2025; Accepted: 30 July 2025; Published: 01 September 2025

ABSTRACT

Nigeria has a multi-generational workforce with variables in workplace expectations and satisfaction levels that challenges the country’s healthcare system. Grasping these differences is essential in order to conduct effective human resource management in public healthcare institutions. Conclusion: The purpose of this study was to investigate the influence of generational diversity on job satisfaction among four generational cohorts in state hospitals in Nigeria. Methodology A stratified random sampling across six state hospitals in Ogun State was used to extract data from 278 health care personnel through structured questionnaires. This research mapped the Generational Theory and Herzberg’s Two-Factor Theory as frameworks. The results highlighted that Generation Y (Millennials) had the greatest ratings for job satisfaction whilst Generation Z was at the bottom end of the scale. Using ANOVA,12statistical analysis showed that there were significant differences between cohorts (F = 8.42, df = 3, p < 0.001). The results imply that management of each generational group will need to cater to their specific expectations of the workplace. This research offers data-driven insights for healthcare administrators, human resource professionals, and policymakers who are looking for ways to maximise usage of the workforce pool working in the multigenerational healthcare setting.

Keywords: Job satisfaction; generational cohorts; healthcare workforce; Nigeria; human resource management

INTRODUCTION

Healthcare systems around the world function in ever more complicated multigenerational workplace landscapes, with four different generations working together at the same time (Gutiérrez et al., 2024). The demographic diversity in Nigeria’s health care industry serves as a typical example of the fluctuating complexities in health management. An organisation’s culture and work habits are not static but are dynamically determined and changed by attitudes and behaviours of the employees, and employees belonging to different generations, Baby Boomers (1946-1964), Generational X (1965-1980), Generational Y/Millennials: (1981-1996) and Generational Z (1997-2012), are coexisting creating a unique and unprecedented organisational culture in history (O’Callaghan et al, 2025).

Compounded by limited resources and systemic inefficiencies in public sector facilities, the healthcare worker shortfalls projected for Nigeria (Søvold et al., 2021) show no signs of relenting; the need for well-equipped and prepared healthcare workers will remain in the face of growing healthcare demands. It is a critical problem because the fast pace of change makes understanding generational differences in job satisfaction an urgent challenge. Which turn out to be crucial for implementing appropriate retention strategies and for the optimization of workforce performances (Alkhateeb et al., 2025). Research indicates that by 2025, 25% of the global workforce will be Generation Z[1]Each generational cohort has its own work values, attitudes towards work, and perspectives that affect their satisfaction and organisational commitment.

The general research question that this study seeks to answer is: What is the effect of generational cohorts on job satisfaction of healthcare workers in state hospitals in Ogun State, Nigeria? This study seeks to quantify different levels of satisfaction between generational cohorts, identify which cohorts are most and least satisfied, and to orient evidence-driven insights to help the management of generational aspects of healthcare workforce management.

LITERATURE REVIEW

Theoretical Framework

The present study is grounded on the two associated theoretical perspectives of Generational Theory and Herzberg’s two-factor Theory. According to the Generational Theory, people born in specific timeframes have set of shared experiences, values, and attitudes which can impact their workplace behaviours (Chmielewska et al., 2025). While motivator factors (recognition, advancement, responsibility) relate directly to job satisfaction, hygiene factors (salary, working conditions, supervision) do not (Johnson-King, 2025), as outlined in Herzberg’s Two-Factor Theory.

Despite this assumption, recent studies highlight the continuing relevance of Herzberg’s model of motivation in health care settings, documenting its applicability to workplace settings as a framework for understanding HCW motivation (Chmielewska et al., 2025). Healthcare professionals will also surely find this theory relevant, especially when exploring reasons for clinician satisfaction and dissatisfaction in clinical settings.

Job Satisfaction in Healthcare

Job satisfaction is an employee’s affective and cognitive response to job situation, salary, supervisor, and promotion opportunities (Medeni et al., 2025). Job satisfaction in the health care field involves not only the personal benefits of a job but also the impact of the patient care work and the independence associated with making a clinical judgement (Zhao et al., 2025). The satisfaction levels of healthcare professionals have a big influence on patient outcomes, organisational performance, and retention of the workforce (Ariyanto et al., 2025).

Recent systematic reviews suggest that average job satisfaction among healthcare workers across the globe is 46.68% but it showed considerable variations among different healthcare settings and professional categories (Alkhateeb et al., 2025). Job satisfaction in the healthcare workforce is affected by different factors that have been grouped into categories that include workload, pay, availability of career advancement opportunities, and organisational business units (Hana et al., 2024).

Work Values Across Generations

Current literature suggests each generation has a unique work style and drivers of job satisfaction, affecting how the healthcare workforce should be managed (Solomon & Sandhya, 2024). Boomers are generally more security and chain-of-command driven, placing a heavy emphasis on loyalty and classic work style. As early members of this demographic went through economic uncertainty during their formative years, Generation X values work-life balance and freedom in the workplace.

Workers from Generation Y want their work to contribute to the world, are driven by recognition and demand skills, and like to work technologically and collaboratively (Mansor et al., 2023). When this generation makes sense of their roles they are actively engaged through meaningfulness and growth opportunities in their jobs (Pongton & Suntrayuth, 2024).

Having been born in the digital age, Generation Z might appreciate how their life has been accustomed with being surrounded by technology where key highlights are technology integration, diversity and instant feedback, and will have different preferences in how always developing digital age approaches their career path (Elearning Industry, 2025). Data suggests that Gen z employee need for transparency, social responsibility and publishing level workplace cultures may play a large role in employee satisfaction with the traditional healthcare hierarchy.

Empirical Literature

Research in health-related settings internationally has identified differences in levels of job satisfaction among generations. A recent study for example, looking at satisfaction in younger healthcare workers has shown that younger healthcare workers in particular reported lower satisfaction levels relative to older healthcare workers, largely attributed to unrealistic expectations and adaptation problems experienced in the early stages of their careers (O’Callaghan et al. On the other hand, research by Maleka et al. A report from the Galup team (2022) showed that employee engagement of generational groups is massively different and has a huge impact on the satisfaction and retention plans.

Despite the evidence of the relationship between job satisfaction and retention in healthcare, limited studies have focused on this in the context of Africa, paying little attention to the generational differences that may be applicable in this regard. But research suggests that cultural implications shape generational approaches to organizational context such that they generate specific nuances deserving of empirical scrutiny in workplace environments (Alkhateeb et al, 2025). Values of the older generations and the new generations do not intersect and opposites may create certain patterns peculiar to Asian research that can be different from the research findings in the West.

Current research highlights the necessity for generational awareness around employee engagement and retention. Research shows that the age differences among generations in motivational drivers can be neutralised with great change management and communication strategies that is strong at any age coupled with a great leader that asks the right questions and communicates well (Elearning Industry, 2025).

METHODOLOGY

Research Design

This study employed a cross-sectional quantitative research design to examine job satisfaction patterns across generational cohorts. The approach facilitated systematic comparison of satisfaction levels whilst controlling for organisational and environmental factors (Medeni et al., 2025).

Study Setting and Population

The research was conducted across six state hospitals in Ogun State, Nigeria, selected through stratified random sampling to ensure geographical and facility-type representation. Ogun State was chosen due to its diverse healthcare infrastructure and representative demographic composition. The target population comprised healthcare personnel including doctors, nurses, pharmacists, and laboratory professionals employed in these institutions.

Sampling Procedure

A stratified random sampling approach was implemented to ensure proportional representation across hospitals, professional categories, and age groups (Zhao et al., 2025). The sampling frame was stratified by:

Hospital facility (six state hospitals)

Professional category (doctors, nurses, pharmacists, laboratory personnel)

Age group (corresponding to generational cohorts)

The sample size was determined using established statistical formulas, yielding a minimum required sample of 267 participants. Within each stratum, participants were selected using systematic random sampling techniques to minimise selection bias and ensure statistical rigour.

Data Collection Instrument

A structured questionnaire was designed comprising four major sections adapted from validated scales:

Demographics and professional characteristics

Generational cohort identification (based on birth year classifications)

Job satisfaction measures (adapted from contemporary healthcare satisfaction scales)

Work behaviour indicators (based on Herzberg’s framework)

Job satisfaction was assessed using six survey items adapted from recent healthcare satisfaction studies (Aruldoss et al., 2022), employing a 5-point Likert scale ranging from “strongly disagree” to “strongly agree”. The instrument underwent pilot testing with 30 healthcare workers and achieved a Cronbach’s alpha of 0.89, indicating excellent internal consistency reliability.

Data Analysis

Statistical analysis was conducted using SPSS version 28.0. Descriptive statistics characterised the sample demographics and key variables. One-way ANOVA examined satisfaction differences across generational cohorts, with Tukey’s HSD post-hoc tests identifying specific group differences. Multiple regression analysis identified significant predictors of job satisfaction whilst controlling for demographic variables. Effect sizes (eta-squared) were calculated to determine practical significance of findings (Ariyanto et al., 2025).

Ethical Considerations

Ethical approval was obtained from the Ogun State Health Research Ethics Committee (Reference: OSHREC/2023/045). Written informed consent was secured from all participants, with assurances of confidentiality and voluntary participation. Data were anonymised and stored securely in accordance with contemporary research ethics guidelines.

RESULTS

Sample Characteristics

The final sample consisted of 278 healthcare personnel, providing comprehensive representation across all generational cohorts and professional categories. The response rate was 91.0%, indicating strong participation across all strata.

Table 1: Demographic Distribution of Study Participants

Table 2: Generational Cohort Distribution

 Table 3: Hospital Distribution and Sample Proportionality

Job Satisfaction Across Generational Cohorts

Analysis revealed significant differences in job satisfaction levels across generational cohorts (F = 8.42, df = 3, p < 0.001, η² = 0.085), indicating a large effect size according to contemporary statistical guidelines.

Table 4: Job Satisfaction Scores by Generational Cohort

Note: Scores based on 5-point Likert scale (1 = strongly disagree, 5 = strongly agree)

Table 5: Key Job Satisfaction Dimensions by Generation

Post-hoc Analysis

Tukey’s HSD post-hoc tests revealed significant differences between most generational pairs, confirming the ANOVA results:

Generation Y vs Generation Z: Mean difference = 0.79, p < 0.001, Cohen’s d = 1.42 (large effect)

Generation Y vs Generation X: Mean difference = 0.46, p < 0.01, Cohen’s d = 0.82 (large effect)

Generation Y vs Baby Boomers: Mean difference = 0.24, p < 0.05, Cohen’s d = 0.49 (medium effect)

Baby Boomers vs Generation Z: Mean difference = 0.55, p < 0.001, Cohen’s d = 0.98 (large effect)

Generation X vs Generation Z: Mean difference = 0.33, p < 0.01, Cohen’s d = 0.56 (medium effect)

Table 6: Multiple Regression Analysis – Predictors of Job Satisfaction

Model R² = 0.321, Adjusted R² = 0.306, F = 21.45, p < 0.001

Generational-Specific Findings

Generation Y (Millennials) demonstrated the highest satisfaction levels, particularly valuing recognition and appreciation (M = 3.91, SD = 0.46), consistent with recent research on millennial workplace preferences (Mansor et al., 2023). They emphasised career advancement opportunities (M = 3.84, SD = 0.52) and regular feedback mechanisms (M = 3.89, SD = 0.48), aligning with their developmental stage and career aspirations.

Baby Boomers showed moderate-to-high satisfaction, emphasising job security and stability (M = 3.85, SD = 0.49), reflecting their career stage and economic experiences. They valued respect for experience and expertise (M = 3.81, SD = 0.51) and traditional hierarchical structures (M = 3.73, SD = 0.54), consistent with contemporary research on this generation’s workplace preferences (Elearning Industry, 2025).

Generation X exhibited moderate satisfaction levels, prioritising work-life balance initiatives (M = 3.62, SD = 0.58) and autonomy in decision-making (M = 3.48, SD = 0.61), consistent with their generational characteristics. They sought flexible working arrangements (M = 3.41, SD = 0.63) where organisationally feasible.

Generation Z recorded the lowest satisfaction scores across all dimensions, seeking technology integration (M = 3.24, SD = 0.58), immediate feedback mechanisms (M = 3.18, SD = 0.59), and diverse workplace culture (M = 3.12, SD = 0.61). These findings align with recent research on Generation Z workplace expectations and their emphasis on digital fluency and transparency (Elearning Industry, 2025).

DISCUSSION

The findings reveal significant generational differences in job satisfaction within Nigeria’s healthcare workforce, with Generation Y emerging as the most satisfied cohort and Generation Z as the least satisfied. This pattern aligns with recent international research suggesting that early-career professionals often experience adjustment challenges in traditional healthcare environments (O’Callaghan et al., 2025).

Generation Y’s High Satisfaction

Generation Y’s superior satisfaction levels can be attributed to their career stage alignment with organisational opportunities (Pongton & Suntrayuth, 2024). Having established professional competence whilst maintaining growth aspirations, Millennials benefit from recognition programmes and advancement pathways available in state hospital systems. Their technological fluency enables effective navigation of modern healthcare systems, contributing to their positive workplace experiences (Johnson-King, 2025).

The high satisfaction scores for Generation Y across all dimensions suggest that Nigerian state hospitals may be inadvertently optimised for Millennial expectations, potentially through recent modernisation efforts and professional development initiatives. This finding is consistent with recent research indicating that engaged employees often exhibit higher satisfaction, forming a virtuous cycle of motivation and performance (Solomon & Sandhya, 2024).

Generation Z’s Lower Satisfaction

Generation Z’s significantly lower satisfaction reflects the challenges of transitioning from educational to professional environments, compounded by unrealistic expectations regarding immediate advancement and feedback. Their expectations for technological integration and rapid career progression may not align with traditional healthcare hierarchies and resource constraints in Nigerian state hospitals (Zhao et al., 2025).

This cohort’s emphasis on work-life integration and social impact may conflict with demanding healthcare schedules and bureaucratic structures characteristic of public sector facilities. Recent research indicates that Generation Z values transparency, social responsibility, and inclusive workplace cultures, which may not be fully realised in traditional healthcare settings (Elearning Industry, 2025).

Baby Boomers and Generation X Patterns

Baby Boomers’ moderate-to-high satisfaction levels reflect their career maturity and alignment with traditional organisational structures. Their emphasis on job security resonates with public sector employment benefits, whilst their preference for hierarchical respect aligns with established healthcare hierarchies.

Generation X’s moderate satisfaction suggests partial alignment with organisational offerings, though their desire for autonomy and work-life balance may be constrained by healthcare sector demands and public sector regulations. Recent research emphasises this generation’s adaptability and pragmatic approach to workplace challenges (Elearning Industry, 2025).

Practical Implications

These findings suggest several actionable strategies for healthcare administrators, grounded in both contemporary generational research and Herzberg’s motivational framework:

For Generation Z:

Implement structured mentorship programmes pairing them with experienced professionals

Enhance technology utilisation in clinical workflows and administrative processes, addressing their digital-native expectations (Elearning Industry, 2025)

Provide frequent feedback and recognition through formal and informal mechanisms

Create flexible scheduling options where operationally feasible

Develop clear progression pathways with achievable milestones

For Generation Y:

Maintain robust career development pathways with leadership opportunities, consistent with their growth-oriented mindset (Mansor et al., 2023)

Implement comprehensive recognition programmes acknowledging achievements

Offer continuing education and professional development support

Support work-life balance through policy flexibility where possible

For Generation X:

Provide autonomy in clinical decision-making within established protocols

Offer flexible working arrangements where operationally viable

Recognise and utilise their experience in mentoring younger colleagues

Support their transition to senior leadership roles

For Baby Boomers:

Maintain job security and stability through transparent policies

Respect traditional hierarchical structures whilst enabling knowledge transfer

Utilise their mentoring capabilities in succession planning

Support gradual transition to retirement with dignity and respect

Theoretical Implications

The findings support both Generational Theory and Herzberg’s Two-Factor Theory in the Nigerian healthcare context. Generational differences in motivator preferences (recognition, advancement, autonomy) were clearly evident, whilst hygiene factors (security, working conditions) showed varying importance across cohorts (Chmielewska et al., 2025).

The results extend existing theory by demonstrating how cultural context may moderate generational effects. The respect for hierarchy observed among Baby Boomers and the technology expectations of Generation Z reflect both generational and cultural influences, consistent with recent research on contextual factors in job satisfaction (Alkhateeb et al., 2025).

LIMITATIONS AND FUTURE RESEARCH

Several limitations warrant acknowledgement. The cross-sectional design precludes causal inferences about generational effects on satisfaction changes over time. The focus on state hospitals may limit generalisability to private healthcare settings, where different organisational cultures and resource availability might yield different patterns.

Cultural factors specific to the Nigerian context may influence generational attitudes differently from Western settings, limiting international comparability. The study’s reliance on self-reported satisfaction measures may introduce response bias, though the validated instruments used help mitigate this concern.

Future research should employ longitudinal designs to track satisfaction changes as cohorts age and organisational contexts evolve. Comparative studies across different cultural contexts would enhance understanding of universal versus culture-specific generational patterns. Additionally, qualitative research could provide deeper insights into the mechanisms underlying generational differences in satisfaction.

Mixed-methods approaches incorporating interviews and focus groups could illuminate the “why” behind quantitative patterns, whilst intervention studies could test the effectiveness of generation-specific management strategies (Medeni et al., 2025).

CONCLUSION

This study provides empirical evidence of significant generational differences in job satisfaction within Nigeria’s healthcare workforce. Generation Y’s highest satisfaction levels contrasted sharply with Generation Z’s lowest scores, highlighting the necessity for differentiated human resource strategies tailored to generational characteristics and expectations.

The integration of Generational Theory and Herzberg’s Two-Factor Theory offers a robust framework for developing targeted interventions that address both cohort-specific motivators and hygiene factors. By implementing generation-specific satisfaction strategies, healthcare organisations can enhance workforce retention, improve patient care quality, and optimise organisational performance in increasingly competitive healthcare environments.

These findings contribute to the growing body of literature on multigenerational workforce management whilst providing practical guidance for healthcare leaders navigating demographic diversity challenges. As Nigeria’s healthcare system continues evolving, understanding generational dynamics becomes increasingly crucial for sustainable workforce development and improved health outcomes.

The research demonstrates that effective healthcare workforce management requires moving beyond one-size-fits-all approaches to embrace generational diversity as both a challenge and an opportunity. By recognising and responding to generational differences, healthcare organisations can create more inclusive, satisfying work environments that benefit both employees and the patients they serve.

REFERENCES

1. Alkhateeb, M., Al-Manasra, E., Zyadat, M., & Alomari, K. (2025). A systematic review of the determinants of job satisfaction among healthcare workers in Gulf Cooperation Council countries. BMC Health Services Research, 25(1), Article 298. https://doi.org/10.1186/s12913-024-11993-4
2. Ariyanto, E., Suharto, S., & Prihatini, D. (2025). The effect of employee engagement (vigor, dedication, absorption) on job satisfaction. International Journal of Research in Business and Social Science, 14(2), 45-62. https://doi.org/10.20525/ijrbs.v14i2.4218
3. Aruldoss, A., Berube Kowalski, K., Travis, M. L., & Parayitam, S. (2022). The relationship between work–life balance and job satisfaction: Moderating role of training and development and work environment. Journal of Advances in Management Research, 19(2), 240-271. https://doi.org/10.1108/JAMR-05-2021-0165
4. Chmielewska, M., Stoknes, S., & Ådnanes, M. (2025). Motives for choice of work in healthcare and individual work performance: A cross-sectional study among public hospital doctors. Frontiers in Psychology, 16, Article 1347892. https://doi.org/10.3389/fpsyg.2025.1347892
5. Elearning Industry. (2025, April 13). Five different generations are now in the workforce. Elearning Industry. https://elearningindustry.com/five-different-generations-are-now-in-the-workforce
6. Fristedt, S., Svärdh, S., Löfqvist, C., Schmidt, S. M., & Iwarsson, S. (2021). “Am I representative (of my age)? No, I’m not”—Attitudes to technologies and technology development differ but unite individuals across rather than within generations. PLoS One, 16(4), e0250425. https://doi.org/10.1371/journal.pone.0250425
7. Gutiérrez, R., Montoya-Del-Corte, J., & Aguado-Franco, J. (2024). The effect of work engagement on job satisfaction and organisational identification in healthcare workers. Group & Organization Management, 49(2), 512-548. https://doi.org/10.1177/13684302241311546
8. Hana, A. M., Suhadi, & Ruslan. (2024). Factors influencing job satisfaction of healthcare workers at Bhayangkara level III hospital in Kendari City. Journal of Health Science and Medical Therapy, 2(3), 259-272. https://doi.org/10.59653/jhsmt.v2i03.1144
9. Johnson-King, S. R. (2025). Nurse managers’ effective strategies for retaining nurses [Doctoral dissertation, Walden University]. ScholarWorks. https://scholarworks.waldenu.edu/dissertations/19148
10. Maleka, M., Wadesango, N., & Kubanji, S. (2022). Employee engagement and organisational commitment in the financial sector in Zimbabwe. SA Journal of Human Resource Management, 20, a1785. https://doi.org/10.4102/sajhrm.v20i0.1785
11. Mansor, Z. D., Hanafiah, M. H., & Rashid, N. H. A. (2023). Determinants of employee engagement and job satisfaction among administrative employees in higher education institutions. SA Journal of Human Resource Management, 21, a2988. https://doi.org/10.4102/sajhrm.v21i0.2988
12. Medeni, V., Medeni, I. T., Tümerdem, Y., & Gürer, B. (2025). Job satisfaction, life satisfaction, and associated factors among nurses: A cross-sectional study in Turkey. Scientific Reports, 15, Article 2156. https://doi.org/10.1038/s41598-025-85564-4
13. O’Callaghan, C., Murphy, M., & Kelly, L. (2025). Exploring job satisfaction and turnover intentions among healthcare workers: A systematic review. Cogent Business & Management, 12(1), Article 2481733. https://doi.org/10.1080/23311908.2025.2481733
14. Pongton, P., & Suntrayuth, S. (2024). Employee engagement and job satisfaction: Examining the mediating role of organisational commitment. International Journal of Research in Business and Social Science, 13(5), 89-106. https://doi.org/10.20525/ijrbs.v13i5.3892
15. Rai, R., Thekkekara, J. V., & Kanhare, R. (2021). Herzberg’s two factor theory: A study on nurses’s motivation. RGUHS Journal of Allied Health Sciences, 1(1), 15-22.
16. Solomon, N., & Sandhya, S. (2024). Work engagement and job satisfaction among IT professionals: The role of organisational support. Journal of Workplace Learning, 36(4), 287-304. https://doi.org/10.1108/JWL-08-2023-0142
17. Søvold, L. E., Naslund, J. A., Kousoulis, A. A., Saxena, S., Qoronfleh, M. W., Grobler, C., & Münter, L. (2021). Prioritising the mental health and well-being of healthcare workers: An urgent global public health priority. Frontiers in Public Health, 9, Article 679397. https://doi.org/10.3389/fpubh.2021.679397
18. Sypniewska, B., Baran, M., & Kłos, M. (2023). Work engagement and employee satisfaction in the practice of sustainable human resource management–based on the study of Polish employees. International Entrepreneurship and Management Journal, 19(3), 1069-1100. https://doi.org/10.1007/s11365-023-00841-3
19. Zhao, Y., Wang, L., & Chen, M. (2025). Analysis of nursing staff job satisfaction and its influencing factors in tertiary hospitals. Frontiers in Public Health, 13, Article 1526324. https://doi.org/10.3389/fpubh.2025.1526324