This desk review aims to examine the impact of workplace conflict on the quality of healthcare delivery in

Ghana, with a particular focus on the clinical care profession. It examined existing literature, documents, and

reports to gather information, identify patterns, the causes, consequences, and potential solutions to workplace

conflict in Ghana's healthcare sector, and conclude.

solving, effective communication, addressing systemic issues, and leadership support can reduce workplace

conflicts in Ghana's health sector.

Studies have shown that across the world, about two-thirds of all healthcare workers experience some form of

workplace violence, such as verbal abuse, threats, physical abuse, and sexual harassment, which are fertile

ground for workplace conflicts (Liu J, Gan Y, Jiang H, Li L, Dwyer R, Lu K, et al, 2019). In Africa, South Africa

and Egypt topped the list of workplace violence and conflicts between patients, patient relatives, coworkers, or

supervisors (Njaka S, Edeogu OC, Oko CC, Goni MD, Nkadi N., 2020). Although Abdellah RF, Salama KM.

(2017) and Gates DM. (2004) admitted that workplace violence and conflicts in the healthcare sector pose

significant challenges globally; they noted that developing countries experience higher rates.

and well-being (Magnavita N, Heponiemi T., 2012; Blanchar Y., 2011). Healthcare facilities also suffer

consequences, such as absenteeism, loss of skilled professionals, compensation claims, psychological effects,

and increased employee turnover (Abdellah RF, Salama KM, 2017). Workplace violence affects all healthcare

professionals, but nurses are particularly vulnerable (Nelson R., 2014; Gillespie GL, Gates D, Berry P., 2013).

Tawiah, P. A. et al (2024) in their study found that more than 50% of healthcare workers suffered verbal abuses

on account of old age, work experience, feuds over on-call duties from managers and colleagues, which made

them apprehensive about the system, and most often resulted in workplace conflicts.

Workplace conflict is a pervasive issue in the healthcare sector, affecting the quality of care delivered to patients.

Conflicts among healthcare professionals can arise from various factors, including poor communication,

differing opinions, and inadequate leadership. Healthcare systems face numerous challenges, and workplace

and management in resolving conflicts and promoting a positive work environment (Weberg, D., 2010).

According to Piryani, Rano Mal & Piryani, Suneel. (2019), conflict arises from internal discord or interpersonal

differences that can potentially cause harm. As an inherent aspect of human interaction, conflict can emerge in

any profession, including healthcare. It may manifest within healthcare teams, between different professional

groups, or between patients and healthcare providers. Piryani, Rano Mal & Piryani, Suneel. (2019) alluded that

effective management of these conflicts is crucial to maintaining a positive and productive work environment.

Conflict arises when individuals or groups with differing interests, beliefs, or experiences clash due to

incompatible agendas or perspectives. This discord can manifest as disagreements or disputes, highlighting the

need for effective management and resolution strategies (Hanifa et al., 2020).

negatively, conflict can be beneficial if managed effectively. Properly handled, conflict can foster critical

thinking, creativity, and innovative solutions. Effective conflict management enables leaders to harness diverse

perspectives, build stronger teams, and drive success. With the implementation of a constructive approach to

conflict resolution, organizations can transform potential drawbacks into opportunities for growth and

improvement. Leaders who master conflict management can unlock the full potential of their teams and achieve

better outcomes (Bernburg et al., 2019; Low et al., 2019; Malla et al., 2019; Veenema et al., 2019).

Workplace conflicts are double-edged swords that can both harm and benefit the workplace environment,

especially within the healthcare sector. Larasati and Raharja (2020) and Abunemeh, S. (2024) maintained that

the presence of conflict can compromise the quality and efficiency of patient care. When healthcare professionals

experience conflict, communication and teamwork suffer, increasing the risk of medical errors and

During the Pre-Colonial Era in Ghana, conventional healthcare practices were prevalent, particularly in rural

areas. Traditional priests, clerics, and herbalists played a significant role in providing primary healthcare to the

population. These traditional healthcare providers used herbal remedies, spiritual practices, and other forms of

conventional medicine to treat various ailments (Addo, J., 2019; Twumasi, P. A., 2005). The key aspects of the

colonial (traditional) healthcare system focused mainly on herbal medicine, where traditional healers used local

plants and herbs to create remedies for various health conditions. These remedies were often passed down

through generations and were tailored to the specific needs of the community (Twumasi, P. A., 2005). It also

incorporated spiritual practices, with the traditional healthcare providers often combining spiritual practices,

such as prayer and ritual ceremonies, into their healing practices. These practices were believed to have a

often unregulated, and the quality of care varied depending on the individual practitioner (Antwi-Baffour et al.,

2014). Patrons also have limited access to modern medical facilities and equipment, including medicines,

During the Colonial Era (1874-1957), the British established a formal medical system in Ghana, focusing on

hospital-based clinical care. This system primarily served expatriates and merchants in urban areas, with limited

access to healthcare for the indigenous population (Twumasi, P. A., 2005). The main elements of the Colonial

Medical System include Hospital-Based Care (HBC), where the British built hospitals in urban areas that were

often well-equipped and staffed by European doctors and nurses, which provided westernized medical care and

medical system was largely inaccessible to the indigenous population, particularly in rural areas, because the

provision of healthcare services was concentrated in urban centers, leaving rural communities without adequate

medical care (Patterson, K. D., 1981). The colonial healthcare system impacted Ghana in two main ways: The

introduction of Western-style medicine disrupted traditional healthcare practices in Ghana. Many Ghanaians

were encouraged to abandon their traditional healing practices in favor of modern medicine (Feierman, S., &

Janzen, J. M., 1992). It also exacerbated healthcare disparities in Ghana. The system allowed only expatriates

and merchants to have access to high-quality medical care, while the indigenous population was often left with

limited or no access to healthcare services (Addo, J., 2019).

After gaining independence in 1957, the Ghanaian government made efforts to expand healthcare services to

improve access and quality of care for its citizens. However, the country faced significant challenges, including

economic decline and political instability, which impacted the healthcare system. To expand healthcare services

aimed to improve healthcare access, particularly in rural areas aimed to improve healthcare access, particularly

D.K., 2003).

Consequently, in the 1980s, the government introduced the "cash and carry" system, which required patients to

After gaining independence in 1957, the Ghanaian government made efforts to expand healthcare services to

improve access and quality of care for its citizens. However, the country faced significant challenges, including

economic decline and political instability, which impacted the healthcare system. To expand healthcare services

aimed to improve healthcare access, particularly in rural areas aimed to improve healthcare access, particularly

in rural areas, the government invested in healthcare infrastructure, increasing the number of hospitals, clinics,

Consequently, in the 1980s, the government introduced the "cash and carry" system, which required patients to

pay out-of-pocket fees for healthcare services. This system limited access to healthcare for many Ghanaians,

particularly those from low-income backgrounds (Nyonator, F., & Kutzin, J., 1999). The "cash and carry" system

had a devastating impact on healthcare access in Ghana, as many people were unable to afford healthcare

services, leading to reduced healthcare utilization, increased morbidity and mortality, and widening health

disparities (Blanchet, N. J., Fink, G., & Osei-Akoto, I., 2012).

Management Teams (RHMTs and DHMTs) to oversee healthcare delivery, manage resources, and implement

national health policies at the district level (Nyonator, F., & Kutzin, J., 1999). To ensure the effective and efficient

execution of national health policies, the Ghana Health Service (GHS) was established in 1996 through an Act

of Parliament (Act 525), as an autonomous body to implement national health policies. The GHS has been

mandated inter alia to improve healthcare delivery by enhancing the quality and accessibility of healthcare

services, promoting health research, supporting research and innovation in healthcare, and developing health

human resources by strengthening the capacity of healthcare professionals (Blanchet, N. J., Fink, G., & Osei-

Akoto, I., 2012).

To ensure the financial accessibility of healthcare and the achievement of Universal Health Coverage (UHC),

Ghana in 2003 launched the National Health Insurance Scheme (NHIS) to provide universal healthcare coverage

Despite these sources of funding to ensure uninterrupted healthcare, the NHIS in Ghana faces challenges. The

centers having a higher concentration of health professionals. Ghana’s healthcare delivery also faces a shortage

of healthcare workers, particularly in rural areas. The doctor-to-patient ratio is lower than the global average,

government should also improve healthcare infrastructure, where the state should work with Public Private

Partnerships (PPPs) to expand health infrastructure, especially in rural areas, and implement community-based

healthcare programs. There must be a strong political and administrative commitment to strengthen the NHIS,

increasing its coverage and benefits, and improving the quality of care. Healthcare must be improved through

rigorous training and retraining with a focus on bridging the equity gap of healthcare workers, especially in rural

areas. Preventive care must be taken seriously, with a huge investment in disease surveillance, prevention, and

control, and promotion of public health campaigns and education.

Muhammad & Junaid, Fatima (2011) identified cultural differences, lack of employees' social intelligence, and

pre-existing mindsets as the primary causes of workplace conflicts. Scholars provided two dimensions of

workplace conflicts: Affective Conflict and Substantive Conflict.

Substantive workplace conflict arises when organizational members have differing opinions on task-related

issues, such as goals, procedures, or decision-making processes (Guetzkow & Gyr, 1954). It is often referred to

as task conflict (Jehn, 1997a; Pelled et al., 1999) or cognitive conflict (Amason, 1996). Task conflict involves

disagreements about task-specific issues, including the appropriate course of action (Jehn, 1997a; Pelled et al.,

1999).

Aside from affective and substantive conflicts, there are other workplace conflicts that have been identified.

environment. Effective conflict resolution strategies, such as active listening and empathy, can help manage

interpersonal conflicts and improve relationships.

conflicts arise from disagreement or antagonism between two or more social groups, resulting from perceived

incompatibility in goals, values, or resources, such as power and economic wealth. Intergroup conflicts are

fueled by factors such as negative emotions, stereotypes, prejudice, and a competitive desire for scarce resources,

leading to behaviors ranging from social exclusion to physical violence (Robert Böhm, Hannes Rusch, &

Jonathan Baron, 2020). Several scholars have made specific analyses of the causes of intergroup conflicts. Sherif

misunderstandings between groups, and power imbalances resulting from unequal power distribution between

Hall (2005) noted that interprofessional workplace conflicts pose a significant concern in many organizations

and arise from actual or perceived contradictions of needs, values, or interests between two or more individuals

from different professions. Hall (2005) maintained that interprofessional conflicts can lead to stress, tension, and

negative emotions among team members, ultimately affecting patient care and team effectiveness. Scholars

agreed that the causes of interprofessional conflicts are multifaceted. According to Suter et al. (2009), individual

factors, such as differences in personalities, values, and communication styles, can contribute to such conflicts.

Reeves et al. (2010) listed interpersonal factors, including poor communication, lack of trust, and inadequate

workplace conflicts are diverse. Structural factors, such as role ambiguity, overlapping responsibilities, and

inadequate communication channels, can contribute to conflicts (Rahim, 2002). Additionally, interpersonal

factors, including differences in personality, values, and communication styles, can also lead to conflicts

(Thomas, 1992). Furthermore, organizational changes, such as restructuring or downsizing, can create an

environment conducive to conflict (Jehn & Mannix, 2001).

of the primary areas impacted is productivity and performance. Research has shown that conflicts can lead to

decreased productivity, efficiency, and overall performance (Rahim, 2002). When conflicts arise, employees may

become distracted, demotivated, or disengaged, ultimately affecting the organization's ability to achieve its goals.

Employee morale and job satisfaction are also significantly affected by organizational conflicts. Unresolved

breakdown in collaboration among team members, departments, or levels of management, and ultimately impede

Workplace conflict in the Ghanaian context arises from various sources, including cultural, organizational, and

individual factors. One of the primary causes of workplace conflict in Ghana is the cultural dynamics that shape

employee behavior and interactions. According to a study by Boachie-Mensah and Seidu (2012), Ghanaian

employees place a high value on respect and hierarchy, which can lead to conflicts when these values are not

adhered to. Additionally, organizational factors, such as poor communication, inadequate resources, and unclear

the Ghanaian context. Organizational leadership needs to acknowledge the cultural, organizational, and

individual factors that contribute to conflict, and take pragmatic steps to prevent and resolve them to improve

With respect to the African Continent, experts revealed that Ghana's unique cultural drivers of workplace

conflicts are deeply rooted in its collectivist culture, which emphasizes communal responsibility and harmony

within the community. This cultural context influences how conflicts are perceived and addressed in the

workplace. They talked of Communal Values vs. Individualism and maintained that Ghanaians tend to prioritize

communal, societal, or shared values over individual interests, and this sometimes leads to conflicts when

personal goals clash with collective expectations, Respect for Authority and Elders, where traditional Ghanaian

provide fertile grounds for misunderstandings or miscommunications in the workplace, especially in

multicultural settings, and Cultural Diversity and Ethnicity, where Ghana a home to many ethnic groups, each

with its own distinct culture and language, often sloganeered ‘diversity can be a strength’ often leads to conflicts

stemming from historical grievances, cultural differences, or competition for resources (Justice Reuben Aduse,

2024; Abbey Francis, 2004; Martha Anyimiah Ackah, 2014). Compared to other African contexts, Ghana's

cultural drivers of workplace conflicts differ in terms of the level of cultural homogeneity. They maintained that

while some African countries have more homogeneous cultures, Ghana has a more diverse cultural heritage,

which makes cultural integration difficult (Justice Reuben Aduse, 2024; Abbey Francis, 2004; Martha Anyimiah

high-context communication style requires different approaches to conflict resolution compared to other global

Workplace conflicts in Ghana that could be mediated through cultural and traditional domains include land

disputes between companies and local communities. Unlike other global contexts, in Ghana, land disputes often

arise between companies and local communities, particularly in rural areas where traditional leaders hold

significant authority. Traditional leaders could mediate these disputes, leveraging their knowledge of local