Background

Pharmacy, a profession that links the health sciences with the chemical and basic sciences, has attained the status of being viewed from the general organization point of view. This study aimed to identify the factors that affect organizational commitment and determine the nature of organizational commitment across the community and academic pharmacy practice in southwest Nigeria.

Methods

The three-component model of organizational commitment proposed by Meyer and Allen (1991) was used in this study to measure organizational commitment. This study was a cross-sectional survey of pharmacists in community pharmacy and academic pharmacy practice in Oyo State, Nigeria. The sample size was estimated to be 191 respondents, 60 academic pharmacists and 131 community pharmacists. A pretested semi-structured questionnaire was used as the main instrument for this study. The pre-test of the research instrument gave a Cronbach alpha’s value of 0.89.

Results

Organization commitment was affected by age of respondents (χ2 (4) = 9.981, p = .041). The factors that affected community pharmacists were job design (p = .001), autonomy (p = .001), collaboration with colleagues (p = .005), leadership style (p = .005), working condition (p = .003), job recognition (p = .021) and equity (p = .022). The nature of organization commitment was mostly affective and normative in academic pharmacy practice, while it was mostly affective and continuance in community pharmacy practice.

Conclusion

The study showed a difference in organizational commitment between community and academic pharmacists. The factors that affected organization commitment of the pharmacists were job design, autonomy, collaboration with colleagues, leadership style, working conditions, job recognition and equity. Effective commitment was prevalent for academic pharmacy practice, while effective and continual commitment were prevalent in the community pharmacy practice category.

Pharmacists have been in high demand in the past few decades, and this has given rise to debate about the job description of pharmacists.1  The WHO2  announced pharmacists as an integral member of the health care team with specific duties that include provision of medicines for patient care and other pharmaceutical care services. According to Ihlen and Verhoeven3  “an organization can be defined simply as a group of people working together in a structured way to achieve a goal.” Because every organization is comprised of humans and human interactions, it is necessary to understand the dynamics of these relationships and how they concern said organization. These behaviors and relationships within any organization have been categorized as affecting the individual, individual characteristics, individual motivation, rewards and appraisal, groups and interpersonal influence, group behaviors, intergroup behavior and conflict, leadership, organizational culture, power and politics.4 

Khalid et al.5  define organizational commitment in relation to the degree of identification of employees with their organizations and how much an employee is attached and believes in the values of the organization and their willingness to remain with the organization. It is also defined by Cohen6  as “a force that binds an individual to a course of action of relevance to one or more targets.” According to Meyer and Allen,7  organization commitment is “a psychological state that (a) characterizes the employee’s relationship with the organization, and (b) has implications for the decision to continue or discontinue membership in the organization.” There are some factors that have already been established to influence organizational commitment. These include personal characteristics, personal variables such as skill, knowledge, age, tenure, job level, financial opportunities available, enhanced job characteristics, leadership behaviors, motivation, stress, job involvement, occupational commitment, job satisfaction and group relationship.8 

Meyer and Allen explained that organizational commitment can be expressed as affective, normative and continuance commitments. They defined affective commitment as “positive feelings of identification with attachment to, and involvement in the work of the organization” and normative commitment as “the employee’s feelings of obligation to remain with the organization.”7  Continuance commitment as “the extent which employees feel committed to their organization by virtue of the costs that they feel are associated with leaving.”9  All three forms of commitments are what, in differing measures, keep an individual committed to any organization and reduces the possibility of them leaving. Taking a more cursory look at things, affective commitment is expected to have the most visible positive effects on the performance of the individual, with the normative commitment coming after. Continuance commitment is assumed to have a negative effect on performances within any organization.10  While this is somewhat true, they also argued that individuals can experience all three forms of commitment, and it is necessary to understand the interaction among all three as it pertains to behavior and performance within the organization.7 

The practice of pharmacy as a profession has been evolving over time. This evolution into several practice groups brings the complication of choice of practice, job turnover from some practice groups, seeking comfort in another, etc.11  The rate of job turnover is at a high in colleges of pharmacy and there is a reported possibility of an impending shortage in the workforce, with a changing culture in the academia raising level of turnover among pharmacy academicians.12,13  Furthermore, a study conducted by Alhuwitat,14  revealed that community pharmacists generally have a low level of job satisfaction, with their job description having a significant impact on their job satisfaction. In essence, the number of pharmacists interested in continuing in the profession is reducing and this depends on a sense of commitment towards the organization.1 

According to Al-Muallem and AlSurimi,15  “work commitment is highly related to the duration of employment and age. Younger pharmacists have a lower level of satisfaction and organizational attachment. Other predictors of organizational commitment include supervisor support, perceptions of the effects of pharmaceutical care movement and practice setting.16  High job satisfaction will positively affect work commitment, consequently decreasing turnover intention among pharmacists.17  These and many more are very important reasons why there is a need for an inquiry into the root cause of the problem to salvage the possible pending crisis.

The objectives of this study were to identify the factors that promote organizational commitment and determine the nature of organizational commitment across the community pharmacy and academic pharmacy practice settings in southwest Nigeria. The three-component model of organizational commitment proposed by Meyer and Allen7  was used to measure organizational commitment.

This study was a cross-sectional survey of pharmacists in community pharmacy and academic pharmacy practice in Oyo State Nigeria. The academic pharmacists (AP) were lecturers at the University of Ibadan (Oyo State). The community pharmacists (CP) were superintendent pharmacists working in community pharmacies in the state as obtained from the register of Pharmacists Council of Nigeria (PCN, 2016). The total population of respondents was 270, 71 academic and 199 community pharmacists.

Sampling was done by simple random sampling. Using a 95% confidence interval and a 0.5 margin of error, the sample size was estimated to be 191 respondents, 60 academic pharmacists and 131 community pharmacists. A pretested semi-structured questionnaire was used as the main instrument for this study. The pre-test of the research instrument gave a Cronbach alpha’s value of 0.89. The questionnaire used for this study was adapted from the Meyer and Allen7 (1991) design. The questionnaire consists of three components, the affective, and normative and continuance commitments. The questionnaire was modified such that each dimension of organizational commitment, measured by six items; had the possible responses arrayed on a five-point Likert scale (rather than on Allen and Meyer’s seven-point scale) comprising “strongly disagree” (1), “disagree” (2), “neutral” (3), “agree” (4) and “strongly agree” (5).

Data were collected using hard copy questionnaires administered to the lecturers and community pharmacists. The data collection lasted about seven weeks and the collected data were analyzed with Statistical Package for the Social Sciences (SPSS) software (version 21) to obtain descriptive statics like frequencies, percentages, median and inferential statistics like correlations, Kruskal-Wallis test and Mann-Whitney test. Ethical approval was obtained from the Institute of Public Health, Obafemi Awolowo University, Ile-Ife Osun state with certificate number IPH/OAU/12/994.

A total of 240 questionnaires were administered: 177 among community pharmacists and 63 among the academic pharmacists. One hundred and ninety-one questionnaires were retrieved (131 and 60 for community pharmacists and academic pharmacists respectively), yielding a response rate of 80.83%.

Table 1 presents the demographic data of primary respondents by gender, age, practice setting, marital status, work duration with present organization and job status. There were more males than females and most of the respondents had worked 10 years or less at their current organization, despite being mostly under 50 years of age.

Table 1.

Demographic Characteristics of Respondents

Demographic Characteristics of Respondents
Demographic Characteristics of Respondents

The factors influencing organizational commitment (Table 2) were assessed and the results measured on a Likert scale of agreement (1-5) showed that both categories of pharmacists, AP and CP, strongly agreed or agreed to the following factors affecting their commitment to their organizations: job design, working hours, autonomy, collaboration with colleagues, leadership style, working conditions and job recognition. They were however neutral or disagreed about their remuneration reflecting in their working hour and on their qualification and status. The community pharmacists agreed to satisfactory remuneration that academic pharmacists were indifferent about.

Table 2.

Factors Influencing Organizational Commitment

Factors Influencing Organizational Commitment
Factors Influencing Organizational Commitment

The factors promoting organizational commitment were correlated with the commitment of the respondents to their organization and it was observed that for academic pharmacists, organization commitment strongly correlated positively with job design, and leadership style and correlated negatively with collaboration with colleagues as can be seen in Table 3. For the community pharmacists, organizational commitment correlated with job design, autonomy, collaboration with colleagues, leadership style, working conditions, job recognition and equity.

Table 3.

Factors That Have a Significant Influence Organizational Commitment in the Practice Groups of the Study Population

Factors That Have a Significant Influence Organizational Commitment in the Practice Groups of the Study Population
Factors That Have a Significant Influence Organizational Commitment in the Practice Groups of the Study Population

The organizational commitment was measured for both practice settings based on the three components proposed by Meyer and Allen (1991), which divided organizational commitment into normative, affective and continuance commitments. The responses and medians obtained for organizational commitment are shown in Table 4, where questions 1-6, 7-12 and 13-18, measured affective, continuance and normative commitment respectively. Thus, the pharmacy practice group (PPG) median shows the average responses obtained within the specific PPG of interest (community or academic pharmacy).

Table 4.

Data Representing the Affective, Continuance and Normative Organizational Commitment among the Pharmacy Practice Groups

Data Representing the Affective, Continuance and Normative Organizational Commitment among the Pharmacy Practice Groups
Data Representing the Affective, Continuance and Normative Organizational Commitment among the Pharmacy Practice Groups

To quantitatively measure organizational commitment, the responses were evaluated based on a scoring function derived for the sole purpose of this study. The median score for each inquiry was derived and used to ascertain the average response per inquiry. The preferred measure of central tendency utilized for this study was the median because the median takes account of the fact that respondents are ranked on ordinal variables in their responses (1-strongly disagree, 2-disagree, 3-neutral, 4-agree and 5-strongly agree).

The scoring for ranking was derived as: Affective commitment was calculated by summing respondents’ scores on Q1, Q2 and Q3 of affective commitment, thus making the highest score obtainable to be 15 (all 5s–strongly agree) and the lowest to be three (all ones 1s–strongly disagree). Respondents with aggregate scores of three to eight were defined to be less committed while those aggregate scores of nine to 15 are defined to be committed. For continuance commitment, Q8, Q9, Q11 and Q12 were used, making the highest score obtainable to be 20 (all 5s–strongly agree) and the lowest attainable to be four (all 1s – strongly disagree). Respondents with four to 11 aggregate scores are defined to be less committed while those with scores 12 to 20 are committed. For normative commitment, Q13, Q16, Q17 and Q18 were used — highest obtainable score is 20 and lowest in four. Respondents with four to 11 aggregate scores are less committed while those with 12 to 20 are committed.

Scores assigned to the three components of organizational commitment were summed up and used to classify combined organizational commitment. The higher scores, 34-55, were defined as committed and the lower scores, between 11-33, were defined as less committed.

In the pharmacy practice groups, continuance commitment was significantly higher in the CP group (mean rank = 104.30) compared to AP (mean rank = 77.88), (p = 0.000). Though affective commitment was higher in AP compared to CP descriptively, this did not translate to significance in further inferential tests. These results are summarized in Table 4.

A Kruskal-Wallis test was carried out to determine if the affective, normative and continuance commitment differed with age while a Mann-Whitney’s test was conducted to assess whether they differed with the gender of respondents. The details of the results are shown in Table 5 and 6 below respectively. The tests showed that there was a significant difference only for normative commitment for age (χ2 (4) = 13.904, p = .008).while a significant difference in gender was observed in affective commitment with males being higher than females ((m) = 103.42, (f) = 84.53, p = .003).

Table 5.

Kruskal-Wallis Test: Exploring the Impact of Age on Organizational Commitment

Kruskal-Wallis Test: Exploring the Impact of Age on Organizational Commitment
Kruskal-Wallis Test: Exploring the Impact of Age on Organizational Commitment
Table 6.

Mann-Whitney U Test Showing the Impact of Gender on Organizational Commitment

Mann-Whitney U Test Showing the Impact of Gender on Organizational Commitment
Mann-Whitney U Test Showing the Impact of Gender on Organizational Commitment

In a bid to estimate the levels of combined organizational commitment across pharmacy practice groups, another Mann-Whitney test showed that there was a higher level of combined commitment (p = 0.031) in the CP group (mean rank = 100.97) compared to the AP group (mean rank = 85.16). The final results, exploring the relationship between age and combined commitment, showed the tendency for commitment to be higher in the age ranges above 50 (χ2 (4) = 9.981, p = .041), with a mean rank of over 108 above 50 years of age.

Most of the respondents in this study were males, which is consistent with the study of Ekpenyong et al.18  that showed there were more males in the pharmacy workforce in Nigeria in 2018.

The study identified job design, autonomy, collaboration with colleagues, leadership style, working conditions, job recognition, and equity as having significant effect on overall organizational commitment across pharmacy practice groups. Some of these relationships are explored in multiple studies with similar outcomes. For instance, Kong16  identified leadership or supervisor’s support and practice setting as factors that affect the commitment of hospital and community pharmacists in Illinois. Almutari19  found a positive correlation between commitment and leadership efficacy. The same research highlighted support, encouraging innovation, innovative ideas, showing a positive attitude to work and not complaining about task as attributes that a leader can possess to improve workers commitment to the organization. All these are seen to significant extents in the pharmacy practice groups. In community pharmacies where pharmacists less than five years on the job are likely to be under a superintendent pharmacist or pharmacy manager, high leadership prowess and encouraging innovation can be a factor to improve commitment among community pharmacists.

For academic pharmacists, job design and leadership style have a positive correlation with organizational commitment. This seems appropriate because a clear chain of command and layout of the organizational structure in academia exists, and this gives room for proper leadership and mentorship from leaders in the field to affect pharmacists’ commitment.20 This will also influence the drive to succeed among academic pharmacists. Understandably, continuance commitment decreases steadily with the collaboration with colleagues, thus explaining some of the reasons for high continuance commitment in the CP group.

The results revealed that a significant proportion of the respondents across practice groups have affective and normative commitments to their organization. This study agrees with the observation by Rashid22  who showed in his study that independent/small chain pharmacies show significantly higher levels of affective and normative commitment. For both community and academic pharmacists, the results obtained correlate with the many factors that impact commitment such as job design, work hours, freedom to make decisions, leadership style, working conditions, job recognition, work environment and remuneration that reflect the working hours and qualification and skillset.23 

To further examine the reason for high continuance commitment in community pharmacy practice groups, Faloye24  noted that the individual’s commitment to the organization is based on the assessment of economic benefts gained by remaining or lost by leaving. As such CPs may not necessarily identify with the organization but develop commitment because of potential benefits, such as monetary benefts, age, service period and a lack of alternative employment.25  This observation holds especially in developing countries where community pharmacists may be faced with limited opportunities for securing employment.

To balance the variation in organizational commitment observed in the practice groups, some other factors to be considered include the possibility that CPs are taught to make the health care of their community a priority, as they feel obligated to stay and “do their job.” Also, APs may have a perceived obligation to stay due to the organization’s investment in them (training and development) and a desire to further advance their careers and achieve their professional goals.26  The effect of gender was only bearing on affective commitment, where men were reported to have higher affective commitment toward their organizations. These results seem to replicate the affirmations of Ramamoorthy and Stringer27  where women reported lower affective commitment than men when equality perceptions are lower. While this study did not focus on equality perceptions and its impact on organizational commitment, it may be good to explore equality perceptions across gender lines in pharmacy practice.

Combined organizational commitment was seen to be higher in the ages above 50 years. Thus affirming Luu et al.28  and Onuoha and Idemudia’s29  assertion that age had an influence on commitment. This could be because they had achieved a certain level of stability on their current jobs as it relates to pay and promotions and have fewer opportunities in securing another job or lack the drive to pursue such opportunities. However, results from some studies seemed to take a different view.30 

The study showed that the overall commitment of community pharmacists was higher than academic pharmacists which does not agree with the study by Al-Muallem and Al-Surimi15  that revealed no significant difference in commitment in both groups.

The study showed a difference in the organizational commitment between community and academic pharmacists and this commitment also differed with the age of respondents. The factors that affected organization commitment of community pharmacists are job design, autonomy, collaboration with colleagues, leadership style, working conditions, job recognition and equity. The factors affecting the organization commitment of academic pharmacists are job design, collaboration with colleagues and leadership style. Pharmacists in the two practice settings considered have a high level of affective commitment. In addition, continuance commitment was specifically more prevalent in community pharmacy group. Affective commitment differed with both genders while normative commitment differed with age of respondents.

Academic pharmacists in this paper refers to duly licensed pharmacists who work as faculty in pharmacy practice education/pharmaceutical sciences education. Many pharmacy faculty educators in Nigeria are trained and licensed pharmacists with further expertise in their different departments/disciplines. This feature is unique among Nigerian schools of pharmacy. The superintendent-pharmacists are those pharmacists who oversee the daily operations of the community pharmacies where they work. Superintendent-pharmacists are also legally responsible for all drug stock, pharmacy practice and pharmaceutical care activities which take place within pharmacy premises. Superintendent-pharmacists (as referred to in Nigeria) are equivalent to pharmacy managers or pharmacists-in-charge referred to in other countries.

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