Healthcare delivery in Nigeria's federal hospitals faces persistent challenges such as workforce shortages, heavy patient loads, and inadequate resources, which undermine clinical staff engagement and service quality. Although job crafting is recognized globally as a strategy to improve engagement, little empirical evidence exists within Nigeria. This study examined the influence of job crafting (role crafting, relationship crafting, and cognitive crafting) on the engagement of clinical staff in federal hospitals in South West Nigeria. Using the Job Demands-Resources (JD-R) theory, a cross-sectional survey design was adopted with a sample of 429 clinical staff from eight federal hospitals. Data were collected through a structured questionnaire and analysed with Partial Least Squares Structural Equation Modelling (PLS-SEM). The model explained 51.5% of the variance in engagement (R² = 0.515). All dimensions of job crafting had significant positive effects, with cognitive crafting exerting the strongest influence (β = 0.386, t = 7.377, p < 0.05), followed by relationship crafting (β = 0.229, t = 4.049, p < 0.05) and role crafting (β = 0.212, t = 3.993, p < 0.05). The study concludes that proactive job redesign enhances resilience, commitment, and service quality. It recommends integrating reflective programs, peer support systems, and flexible role policies into hospital management practices to sustain staff engagement and improve healthcare outcomes.
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