AIM: To examine the organisational (i.e., perceived organisational support and psychologically safe environment) and individual (i.e., value, belief and norm) antecedents that strengthen healthcare workers' speaking-up behaviour in a developing economy. DESIGN: The study uses a cross-sectional design to gather the same data from healthcare workers within the Ashanti Region of Ghana. METHODS: The data collection happened between 15 June and 30 August 2023. A sample of 380 healthcare workers was selected from 20 facilities in the Ashanti Region of Ghana. A configurational approach, a fussy-set qualitative comparative analysis, was used to identify the configurations that caused high and low speaking-up behaviour among the study sample. RESULTS: The study results reveal that whereas four configurations generate high speaking-up behaviour, three configurations, by contrast, produce low speaking-up behaviour among healthcare workers. CONCLUSION: Results suggest that in so far as organisational support systems which take the form of a psychologically safe environment and perceived organisational support are vital in relaxing the hierarchical boundaries in a healthcare setting to improve healthcare workers' speaking-up behaviour, the individual value-based factors that take the form of values, beliefs and norms are indispensable as it provides the healthcare workers with the necessary inner drive to regard speaking-up behaviour on patient safety and care as a moral duty. IMPACT: Healthcare workers' speaking-up behaviour is better achieved when organisational support systems complement the individual norms, values and beliefs of the individual. REPORTING METHOD: Adhered to Strengthening Reporting of Observational Studies in Epidemiology guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

• Keywords
• Ghana, belief, fussy‐set qualitative comparative analysis, healthcare workers, norm, perceived organisational support, psychologically safe environment, speaking up, value,
• MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Organizational Culture * MeSH
• Attitude of Health Personnel * MeSH
• Cross-Sectional Studies MeSH
• Health Personnel * psychology   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Ghana MeSH