RESEARCH ARTICLEOpen Access Factors associated with job satisfaction among Chinese community health workers a cross sectional study Cuixia Ge Jialiang Fu Ying Chang and Lie Wang Abstract Background With the medical reform the function of community health centres emerged to be more important recently in China However the health service capabilities were tremendously different between metropolitan cities and small cities This study aims to clarify the level of job satisfaction of Chinese community health workers between a metropolitan Shenyang and a small city Benxi in Liaoning province and explore its associated factors Methods A cross sectional survey was conducted from December 2009 to February 2010 A multi stage sample was used and a total of 2 100 Chinese community health workers from the two cities completed self administered questionnaire pertaining to job satisfaction indicated by Minnesota Satisfaction Questionnaire MSQ demographic characteristic and working situations stress and job burnout The effective response rate was 80 7 Hierarchical regression analysis was performed to explore the related factors All data analyses for the two cities were performed separately Results The averages of overall job satisfaction score of Chinese community health workers were 67 17 in Shenyang and 69 95 in Benxi Intrinsic job satisfaction and extrinsic job satisfaction among Chinese community health workers were significantly different between Shenyang and Benxi p 0 05 In Shenyang hierarchical regression analysis showed that the fourth model explained 36 32 of the variance of intrinsic and extrinsic job satisfactions respectively In Benxi the fourth model explained 48 52 of the variance of intrinsic and extrinsic job satisfactions respectively Three significant predictors of intrinsic and extrinsic job satisfactions for the two cities were the two dimensions social support and decision latitude of stress and cynicism of burnout Conclusion From this study the job satisfaction among Chinese community health workers in the two cities enjoyed a moderate level of job satisfactions which represented they are not fully satisfied with their jobs Community health workers in Shenyang had lower job satisfaction as compared to those in Benxi This study strengthened the evidence that stress and burnout were important predictors of intrinsic and extrinsic job satisfactions Background China s health care system is a three tiered system which consists of municipal and provincial hospital dis trict hospitals community health centres CHCs in urban areas In this system CHCs play an important role in providing primary care to local residents in order to link the lower and upper levels 1 Community health workers including physicians nurses and others are employed by CHCs to provide primary medical ser vices The community health centre is a system which promotes the implementation of primary public health From October 1949 to October 1992 China was in the era of planned economy Under the planned economy the physicians with a college or higher education were assigned to each big hospital Thus there were so few physicians with a college or higher education in the community health centres In China barefoot doctors were the main parts of the community health workers Generally barefoot doctors are farmers who graduated from secondary school and received minimal basic Correspondence liewang Department of Social Medicine School of Public Health China Medical University Shenyang Liaoning People s Republic of China Ge et al BMC Public Health 2011 11 884 2011 Ge et al licensee BioMed Central Ltd This is an Open Access article distributed under the terms of the Creative Commons Attribution License http creativecommons org licenses by 2 0 which permits unrestricted use distribution and reproduction in any medium provided the original work is properly cited medical and paramedical training In Chinese culture this means that some physicians don t have a college education in the community health centres However most physicians have a college education in big hospi tals Thus the government had many methods for developing the community health centre such as direct investment strategic investment government purchasing and so on Since 1997 the Chinese urban community health care system has been rebuilt To date the num ber of CHCs has increased rapidly in China According to the Liaoning Health statistics yearbook there are 796 urban CHCs with nearly 10 500 community health workers in Liaoning province alone in 2008 At the end of 2007 the local government first implemented a pol icy unlinked lines of revenue and expenditure 2 in funding community health services in Shenyang Liaon ing Province Unlinked lines of revenue and expendi ture means that the government provides the funds to run the hospital but the level of funding is not linked to the actual expenditure including the salaries of doc tors It has brought greater convenience to local resi dents and rea