Date survey conducted Facility Name ___________________________

_______DD __________MM________YYYY Profession:

How long have you worked in the facility?
____________ years ______________Months
Introduction: This tool is designed to measure staff satisfaction in the health system, to design and
implement improvement strategies for staff satisfaction.
Professional category all Health Workforce(all health professionals including specialties and all
administrative staff)

Strongly Disagree Agree Strongly

No. Characteristics Disagree (1) (2) (3) Agree (4)
1 I feel the management of the institution is always
available to provide the required level of support
2 I receive enough support and guidance from my
immediate supervisor or team leader
3 I feel encouraged by my supervisor to offer
suggestions and feedbacks for improvements
4 I am appropriately recognized for my dedication
and commitment toward my areas of work
5 I feel I receive timely job-related mentoring and
training when I needed
6 I have clear understanding of my areas of
responsibilities
7 My work climate and work condition are well
comfort and suited for my work
8 I feel happy to work collaboratively with my
colleagues
9 I feel I can easily communicate with colleagues
from all levels of my organization
10 The organization rules and regulations are made
easy for me to do my job
11 I feel I am happy with the institution’s incentive
mechanisms in place.
12 I am happy with the opportunities available for
growth and carrier development
13 The amount of work I am expected to finish each
week is reasonable
14 My department/unit provides all the equipment,
supplies and resources necessary for me to perform
my duties
15 My work is evaluated based on fair system of
performance appraisal standards
16 I feel I am motivated enough to provide the
required level of services
17 I feel competent to deliver the services as per the
standards.
18 I feel I provide services respectfully and
empathetically
19 I would you recommend this health facility to other
workers as a good place to work