The Dynamics of Occupational Identity: Exploring The Combined Effects of Organizational Culture, Leadership Support, Professional Development, and COVID-19 on Job Satisfaction and Turnover Intentions in the Ghanaian Healthcare Sector

Occupational identity is a critical determinant of employee motivation, satisfaction, and retention, yet its dynamics within resource-constrained healthcare systems remain underexplored. This study examines how organisational culture, leadership support, and professional development jointly shape occupational identity and how this identity subsequently influences job satisfaction and turnover intentions among healthcare workers in Ghana. Guided by Social Identity Theory, the study employed a quantitative design and analysed data from 509 healthcare professionals using PLS-SEM. The results show that supportive organisational culture, effective leadership, and professional development significantly strengthen occupational identity. Strong occupational identity also enhances job satisfaction but, unexpectedly, is associated with higher turnover intentions—revealing an identity–retention paradox in the Ghanaian healthcare context. Furthermore, COVID-19 did not significantly moderate the relationships between occupational identity and the outcome variables. This study is among the first to offer an integrated examination of multiple organisational antecedents of occupational identity within a developing-country healthcare system. It contributes new evidence on the dual role of occupational identity, demonstrating that while it increases job satisfaction, it may also heighten turnover intentions when organisational conditions conflict with professional norms. The findings provide valuable theoretical and practical insights for managing identity-driven behaviour and strengthening workforce stability in low-resource healthcare environments.