Abstract:Background Healthcare workforce retention is a global priority, with an estimated shortfall of 10 million workers by 2030. In Malaysia, public sector healthcare workers face increasing job dissatisfaction and burnout, contributing to rising turnover intention. While perceived organizational support (POS) is known to influence turnover, the mechanisms particularly through different job satisfaction dimensions remain underexplored in Malaysia’s public health context. Investigating this mechanistic pathway is crucial for designing effective retention policies. Objectives To determine whether job satisfaction mediates the association between perceived organisational support and turnover intention. Methods A cross-sectional online survey was conducted among healthcare workers from hospitals, health clinics, district health offices, and dental facilities under the Selangor State Health Department. Validated instruments measured POS, turnover intention, and nine job satisfaction facets. Structural Equation Modelling with 5000 bootstrap resamples was used to test direct and indirect effects. Results POS had significant positive effects on all nine job satisfaction facets (β = 0.415 0.550, p < .001) and a negative direct effect on turnover intention (β = 0.279, p < .001). Among satisfaction facets, only Promotion, Contingent Reward, and Nature of Work significantly predicted TOI. Mediation analysis revealed POS indirectly reduced Turnover Intention via Nature of Work (β = 0.079) and Contingent Reward (β = 0.076) but unexpectedly increased it via Promotion (β = 0.029). Conclusions Perceived organisational support influences turnover intention both directly and indirectly through specific job satisfaction facets. Interventions aimed at enhancing intrinsic job satisfaction and fair reward systems, alongside a critical review of promotion structures, are essential for improving retention among public healthcare workers in Malaysia. These findings contribute to the global understanding of workforce sustainability in health systems.
Keywords: Global Health Workforce, Perceived organization support, Job satisfaction, mediation, turnover intention
