Perceived organisational support and work engagement among health sector workers during the COVID-19 pandemic: a multicentre, time-lagged, cross-sectional study among clinical hospital staff in Pakistan.

OBJECTIVE: Workplace engagement is associated with several significant positive organisational outcomes. The COVID-19 pandemic has emphasised the importance of workplace engagement, particularly for front-line healthcare workers. Drawing on the conservation of resources theory, this study examines the impact of personal and job resources in a workplace that help in resource conservation for work engagement. In view of the high burnout rates reported among health professionals during the COVID-19 pandemic, this study aims to investigate the impact of perceived organisational support (POS) on work engagement through the mediating effect of well-being and the moderating role of employees' resilience. DESIGN: Time-lagged, cross-sectional, split questionnaire-based survey study. SETTING: Data were gathered from 68 hospitals in Pakistan, of which 45 were public and 23 were private hospitals. PARTICIPANTS AND ANALYSIS: Simple random sampling techniques were used and data were collected from 345 healthcare professionals (ie, doctors, nurses and allied health professionals) using split questionnaires, in two waves with a 3-week interval, with a response rate of 80%. For analysis of data, the study used the PROCESS macro by Hayes. RESULTS: Engagement at work was positively correlated with POS, well-being and resilience. POS significantly predicted work engagement through well-being (ß=0.06, SE=0.02, 95% bias-corrected CI 0.021, 0.10). Further analysis of the strong effect of resilience on subjective well-being shows the significant value of the mediated moderation index (ß=0.06, SE=0.02, 95% bias-corrected CI 0.03, 0.11). CONCLUSION: The findings suggest that well-being may be an important pathway through which healthcare workers' POS may influence work engagement, particularly when their resilience capability is high. To maintain engagement at the workplace, hospital administrators should consider strengthening organisational and individual resources that build a supportive environment to meet the demands of challenging times.

The Interaction Effect of Birth Spacing and Maternal Healthcare Services on Child Mortality in Pakistan.

There is widespread agreement that improved health should be regarded as a means and an end in the context of the development process. The health of the populace and the equitable provision of healthcare are two indicators of a society's level of development. A variety of factors influences child mortality. This study investigated the causes of child death and the interaction effect of birth spacing (B.S.) and maternal health care services (MHCS) on child mortality. Using SPSS version 20, we used the Pakistan Demographic and Health Survey (PDHS) 2017-2018 data set to investigate the associated factors of child mortality and the moderating influence of birth spacing using binary logistic regression. The outcome variable is categorical with two categories. The findings indicated that the risk of infant death decreased with adequate B.S. between two pregnancies and access to maternal health care services. Birth spacing was found to moderate the link between access to maternal health care services (MHCS) and child mortality. Our research leads us to conclude that the amount of time between children's births significantly reduces infant mortality. When the birth spacing is at least 33 months, the relationship between maternal health care services and child mortality becomes more evident and negative.

Providing Solution in an Emergency: COVID-19 and Voice Behavior of Healthcare Professionals.

This study investigates the mechanism between idiosyncratic deals (I-deals) and voice behavior, considering display aggression and deontic justice as mediating variables. We collected data from 702 nurses and their immediate supervisors who work with COVID-19 patients through survey questionnaires at two different times, and we analyzed the data using structural equation modeling (SEM). We found that I-deals are significantly associated with deontic justice and voice behavior. Moreover, I-deals are significant but negatively associated with displayed aggression, which is significant and negatively associated with voice behavior. In addition, deontic justice and display aggression mediate the association between I-deals and voice behavior. These findings suggest that the hospitals' top management should provide I-deals to nurses to improve their voice behavior.

The Moderating Role of Maternal Education and Employment on Child Health in Pakistan.

BACKGROUND: Pakistan has challenges in fulfilling its universal responsibilities of providing better health facilities to everyone. The Sustainable Development Goals (SDGs) aim to reduce maternal and infant mortality rates. Despite declines in mother and child death, the total mortality ratio has marginally increased. However, neonatal death has not decreased significantly. Family planning is important for controlling population growth and improving child as well as maternal health. Pakistan's government has unceasingly tried to enhance the provision of contraceptive facilities, but still, an unmet need for family planning (UMNFP) exists in our country. Women are said to have UMNFP if they want to limit or space childbearing, but they are not using contraception methods for any reason. The study aimed to explore the effect of the UMNFP and to investigate the moderating role of a mother's education and employment status on a child's health. METHODS: We analyzed the data of 2,244 women in this study. To investigate the study objectives, we utilized the secondary dataset of the Pakistan Demographic and Health Survey (PDHS) 2017-18 (publicly available on the website of the National Institute of Population Studies) and applied binary logistic regression using SPSS 24. RESULTS: Results suggest a positive effect of a woman's age (25 to 39 years), maternal education (higher), father's education (higher), family's wealth status (richest), mass media exposure, and adequate birth spacing (at least for 33 months) on a child's health. On the other hand, there is an indirect association between maternal employment, unmet need for family planning, and a child's health. The moderating role of maternal education and employment on the relationship between household wealth status and a child's health is positive. CONCLUSIONS: We conclude that the strong predictors of child health are UMNFP, maternal education, and employment. The link between the met need for family planning and the child's health is positive. The moderating effect of maternal education and household wealth status on a child's health is progressive. Similarly, the interaction effect of a mother's employment and household wealth status on a child's health is positive. Finally, we concluded that the link between the health of the child and household wealth status is much more diverse and positive when the mother is highly educated and currently employed.

Work-family and family-work conflict and stress in times of COVID-19.

This study aims to investigate the spillover impact of work-family/family-work conflict and stress on five major industrial sectors (education, textile, hospitals, banks, and retail stores), during the first wave of Covid-19. The purpose of this cross-sectional study is twofold; firstly, to test a hypothesized model where work-family/family-work conflicts are related to stress and where stress could exert a mediating role in such relationships. Secondly, we seek to explore the presence of these conflicts and stress in each of the five major industrial sectors and evaluate if there are significant differences between them, identifying the sociodemographic characteristics associated. Two questionnaires were applied to 748 employees from the selected industries. According to our results, stress predicts both types of conflict and also exerts a mediator role. It was primarily found that the five sectors are significantly different regarding the work-family/family-work conflicts and stress. Findings and implications are discussed.

Predictors of Child's Health in Pakistan and the Moderating Role of Birth Spacing.

There is a consensus that better health should be viewed both as a means and an end to achieve development. The level of development should be judged by the health status of the population and the fair distribution of health services across the people. Many determinants affect a child's health. This study aimed to explore a child's health predictors and the moderating role of birth spacing on the association between mother's health care services utilization (MHCSU) and a child's health. In this study, we used the dataset of Pakistan Demographic and Health Survey 2017-18 to explore the predictors of child health and the moderating role of birth spacing through binary logistic regression, using SPSS version 20. The results showed an association of mother's age (35 to 49 years), her education (at least secondary), health care services (more accessible), father's education (at least secondary), their wealth status (high), and exposure to mass media to improved child health. However, the effect of a mother's employment status (employed) on her child's health is significant and negative. The coefficient of moderation term indicated that the moderating role of birth spacing on the association between MHCSU and a child's health is positive. We conclude that birth spacing is a strong predictor for improving a child's health. The association between MHCSU and child's health is more distinct and positive when the birth spacing is at least 33 months.

Socio-economic determinants of child mortality in Pakistan and the moderating role of household's wealth index.

BACKGROUND: Child mortality is an important social indicator that describes the health conditions of a country as well as determines the country's overall socio-economic development. The Government of Pakistan has been struggling to reduce child mortality (67.2 per thousand live births in 2019). Pakistan could not achieve the target set for Millennium Development Goals to reduce child mortality and still working to meet the target set by the Sustainable Development Goals. This study has investigated the socio-economic determinants of child mortality in Pakistan by using household-level data. Socio-economic characteristics related to women (mothers) and households have been considered as possible determinants of child mortality. The moderating role of a household's wealth index on the association between woman's education and child mortality has also been investigated. METHODS: The comprehensive dataset of the Pakistan Demographic and Health Survey 2017-18 has been used to explore the determinants of child mortality by using multivariable logistic regression. The interaction term of women's education and household wealth index has been used to investigate the moderating role of the household's wealth index. RESULTS: The results indicate that the likelihood of child mortality decreases with an increase in women's education, their empowerment, their husband's education, the wealth status of their households, access to clean drinking water, access to toilet facilities, and exposure to mass media. Whereas, an increase in unmet need for family planning increases the likelihood of child mortality. The study also identified the moderating role of a household's wealth index on the association between woman's education and child mortality. CONCLUSIONS: Household wealth status moderates the association between women's education and child mortality. The absolute slope of the curve showing the association of women's education and child mortality is higher (more negative) for richer households than poorer households. It implies that a household's wealth status strengthens the relationship between women's education and child mortality. With the increase in the household's wealth status, the effect of a mother's education on child mortality becomes more pronounced.

Sustainable leadership and wellbeing of healthcare personnel: A sequential mediation model of procedural knowledge and compassion.

Introduction: In healthcare organizations, saving patients' lives while maintaining the staff's wellbeing, performance and competencies were challenging during the COVID-19 pandemic. Although the complexity of healthcare settings is widely recognized, the pandemic evidenced the necessity of attending to the employees' wellbeing in such a sector. This research aims to examine the effect of sustainable leadership on wellbeing of healthcare personnel. Furthermore, we also evaluate whether procedural knowledge and compassion act as mediators in such a relationship. Methods: The hypothesized model was tested in healthcare organizations in a South Asian country, and the data were collected during the pandemic crisis. A total of 366 health personnel (physicians and nurses) participated in this research. With Hayes' PROCESS macro, we examined all the direct and indirect paths, including sequential mediation. Results: The findings confirm the impact of sustainable leadership on wellbeing and this relationship is also mediated by procedural knowledge and compassion. Discussion/conclusion: Sustainable leadership fosters wellbeing among healthcare workers via the sequential mediation of procedural knowledge and compassion. Study findings suggest that sustainable leaders can trigger procedural knowledge among employees which in turn crafts the state of compassion in them that leads to their wellbeing. Theoretical and practical implications are discussed in light of study findings.

Workplace Incivility and Job Satisfaction: Mediation of Subjective Well-Being and Moderation of Forgiveness Climate in Health Care Sector.

Our study investigates the role of subjective well-being and forgiveness climate between workplace incivility and job satisfaction. Drawing on conservation of resource theory, we proposed a model in which workplace incivility is associated with job satisfaction through subjective wellbeing, and forgiveness climate moderates this association. Data was collected through a survey method from 672 nurses and doctors in the health care sector at two different times. Respondents completed workplace incivility and subjective well-being scale at Time 1, and a forgiveness climate and job satisfaction scale at time 2. Findings through PROCESS Macros (Model 5) show that workplace incivility has a negative influence on job satisfaction and subjective well-being. Subjective well-being plays a mediating role in the negative effect of workplace incivility on job satisfaction. Moreover, forgiveness climate moderates the relationship between workplace incivility and job satisfaction. The implications for practice and research are discussed.

Impact of Prosocial Motivation on Organizational Citizenship Behavior and Organizational Commitment: The Mediating Role of Managerial Support.

This study, based on the conservation of resources (COR) theory, explores the impact of contextual variables, such as prosocial motivation, on employee discretionary behavior and organizational commitment. The mediating mechanism of managerial support at work defines the nature of the proposed relationships. Data from 303 administrative, instructional, and supervisory staff-predominantly male (95%) and with an average age of 30 years-working on Technical and Vocational Education and Training (TVET) for Pakistan's public sector were collected and analyzed by employing SPSS version 24. Confirmatory factor analyses suggested a good fit model, while a correlation matrix provided a significant and positive effect of prosocial motivation on employee citizenship behaviour and organizational commitment. Managerial support mediated the relationship between prosocial motivation and the employees' organizational commitment and citizenship behaviour. The theoretical and practical implications discussed in this study seek to guide the management area to promote managerial support for better outcomes. These outcomes have considerable tactical, statistical, and real-world inferences for the stakeholders of the TVET sector.

My Family Stands Behind Me: Moderated Mediation Model of Family Support and Work Engagement.

Family motivation as a mediating mechanism is a novel and under-researched area in the field of positive organizational scholarship. Drawing on Social Exchange Theory (SET), this study empirically validates family motivation as a mediator between family support and work engagement. The process by Hayes (2013) was used to analyze time-lagged data collected from 356 employees of the education sector. Results confirm the mediating role of family motivation in the relationship between family support and work engagement and the moderating role of calling in the relationship between family support and family motivation. This study adds to the literature of family-work enrichment accounts by validating family support as a novel antecedent for family motivation and positive attitudes. The implications of the study are discussed.

Impact of Authoritative and Laissez-Faire Leadership on Thriving at Work: The Moderating Role of Conscientiousness.

This study empirically investigates the less discussed catalytic effect of personality in the relationship of leadership style and employee thriving at work. The growth and sustainability of the organization is linked with the association of leadership style and employee thriving at the worplace. The objectives of this study are to explore the impact of authoritative and laissez-faire leadership styles and the moderating role of the personality trait of conscientiousness on thriving in the workplace. A sample of 312 participants was taken from a leading school system with its branches in Lahore and Islamabad, Pakistan. The participants either worked as managers, teachers in headquarters, or school campuses, respectively. The regression results of the study show that authoritative leadership and conscientiousness have a significantly positive impact on thriving at work. Furthermore, conscientiousness moderates the relationship between laissez-faire style of leadership and thriving at work relationship.. The findings of this study have theoretical implications for authoritative and laissez-faire leadership, employee conscientiousness, and managerial applications for the practitioners.

Impact of Ethical Leadership on Employee Engagement: Role of Self-Efficacy and Organizational Commitment.

The aim of this study was to examine the roles of self-efficacy and organizational commitment in the sequential mediation of the relationship between ethical leadership and employee engagement. Data were collected through self-reported questionnaires of employees from private and public sector organizations of Pakistan. We opted for a three-wave time-lagged design, and we used the PROCESS macro by Hayes on a sample of 211 employees (35% male, 65% female) via the 2000 re-sample bias-corrected bootstrap method. The results show a significant relationship between ethical leadership and employee engagement with mediating effects of self-efficacy and organizational commitment. Self-efficacy and organizational commitment fully mediated the relationship. The results provide insight into the understanding of employee behavior, particularly in the presence of moral leadership. Drawing on the conservation of resource theory, we examined how ethical leader support enables employees to invest their resources into positive outcomes. Theoretical and practical implications are discussed.

Role of husband's attitude towards the usage of contraceptives for unmet need of family planning among married women of reproductive age in Pakistan.

BACKGROUND: Family planning services deliver a wide range of benefits to the well-being of females and the community. It can curtail the risk of maternal and neonatal mortality through the reduction in abortions and pregnancies. The government of Pakistan has been struggling to convince people about the usefulness of family planning programs. However, different factors related to social norms, values, and culture are important to determine the success of these programs. One such factor is the patriarchal structure of Pakistani society where most of the household decisions are made by men. The objective of this research is to examine the role of the husband's attitude towards the usage of contraceptives for the unmet need of family planning (UMNFP) among married women of reproductive age (MWRA) in Pakistan. METHOD: The dataset of Pakistan Demographic and Health Survey 2017-18 is utilized to examine the role of the husband's attitude towards the usage of contraceptives in UMNFP among MWRA in Pakistan. RESULTS: The UMNFP was considerably lower among MWRA between 40 years and above compared to women 15-19 years. The odds of UMNFP were higher among women and men who were educated up to the primary level compared to those with no education. Odds of UMNFP were higher among women from the poor wealth quintile compared to the poorest wealth quintile; similarly, it was significantly lower among women who were from the richer and the richest wealth quintile compared to the poorest wealth quintile. The odds of UMNFP were lower among women who were employed compared to those who were not employed. Lastly, the odds of UMNFP were higher among women whose husbands opposed to using contraceptives, who perceived that there was a religious prohibition for such use and when a decision on the contraception use was solely made by the husband. CONCLUSIONS: Husband's attitude towards the usage of contraceptives is an important predictor of UMNFP. Liaising with the community and religious leaders to persuade people particularly men about the usefulness of family planning programs and encouraging men to understand their women's say in using contraceptives should be encouraged.

E-Leadership and Teleworking in Times of COVID-19 and Beyond: What We Know and Where Do We Go.

Suddenly, COVID-19 has changed the world and the way people work. Companies had to accelerate something they knew was imminent in the future, but not immediate and extremely humongous. This situation poses a huge challenge for companies to survive and thrive in this complex business environment and for employees, who must adapt to this new way of working. An effective e-leadership, which promotes companies' adaptability, is needed. This study investigates the existing knowledge on teleworking and e-leadership; and analyzes the supposed challenges. The literature review shows that companies with effective e-leadership can view teleworking as an opportunity. It is advantageous for not only companies' productivity but also the environment and people who work remotely. However, a traditional or no leadership can result in some risks. Thriving in remote work environments implies that managers must adjust the companies' structure, making them less hierarchical, and developing new abilities to establish a strong and trustworthy relationship with their employees to maintain their competitiveness, while retaining a genuine concern for their employees' well-being. Similarly, successful e-leadership must be able to consolidate and lead effective virtual teams to accomplish organizational goals. This study contributes to the literature and leaders during the pandemic.

Role of Family Motivation, Workplace Civility and Self-Efficacy in Developing Affective Commitment and Organizational Citizenship Behavior.

The mechanism connecting the antecedents to positive attitudes like affective commitment (AC) and positive behaviors like organizational citizenship behavior (OCB) is an under-researched area in the field of positive organizational scholarship. Drawing on Social Exchange Theory (SET), this study empirically validates family motivation and civility as antecedents of affective commitment and organizational citizenship behavior through the mediating mechanism of self-efficacy. The process by Hayes (2013) was used to analyze time-lagged and multi-source data collected from 335 employees of educational and telecom sector. Results indicate that the relationship of affective commitment with family motivation and civility is partially mediated whereas the relationship of organizational citizenship behavior with family motivation and civility is fully mediated by self-efficacy. This study adds to the literature of family-work enrichment accounts by validating family motivation as a novel antecedent for positive behavioral outcomes. The implications of the study are discussed.

Authentic Leadership and Creativity: Moderated Meditation Model of Resilience and Hope in the Health Sector.

Authentic leaders are recognized as self-aware individuals who act according to their values and beliefs in the organization. Most of the studies have acknowledged the positive impact of authentic leaders on followers. However, the characteristics of an authentic leader, such as making decisions according to his/her own belief system, might negatively affect the followers. The current study aims to investigate the relationship of authenthic leadership/leaders (AL) and creativity through the mediating role of resilience. In this study, data were collected from 172 nurses working at public hospitals using a three-wave, time-lagged study design. The findings show that authentic leadership significantly predicts hope among employees. A hopeful individual positively reflects creativity in the workplace and also mediates the relationship between authentic leadership and creativity at workplace. These results report that authentic leadership impacts hope in a positive manner; thereby, increasing the level of creativity of nurses at the workplace. The study also highlights that if a resilient nurse is supervised by an authentic leader, it decreases hope and eventually creativity at work. The paper elaborates theoretical and practical implications for the health care sector along with limitations and direction for future research.