Prevalence and factors associated with burnout among frontline primary health care providers in low- and middle-income countries: A systematic review

Abstract

Background: Primary health care (PHC) systems require motivated and well-trained frontline providers, but are increasingly challenged by the growing global shortage of health care workers. Burnout, defined as emotional exhaustion, depersonalization, and low personal achievement, negatively impacts motivation and may further decrease productivity of already limited workforces. The objective of this review was to analyze the prevalence of and factors associated with provider burnout in low and middle-income countries (LMICs). Methods: We performed a systematic review of articles on outpatient provider burnout in LMICs published up to 2016 in three electronic databases (EMBASE, MEDLINE, and CAB). Articles were reviewed to identify prevalence of factors associated with provider burnout. Results: A total of 6,182 articles were identified, with 20 meeting eligibility criteria. We found heterogeneity in definition and prevalence of burnout. Most studies assessed burnout using the Maslach Burnout Inventory. All three dimensions of burnout were seen across multiple cadres (physicians, nurses, community health workers, midwives, and pharmacists). Frontline nurses in South Africa had the highest prevalence of high emotional exhaustion and depersonalization, while PHC providers in Lebanon had the highest reported prevalence of low personal achievement. Higher provider burnout (for example, among nurses, pharmacists, and rural health workers) was associated with high job stress, high time pressure and workload, and lack of organizational support. Conclusions: Our comprehensive review of published literature showed that provider burnout is prevalent across various health care providers in LMICs. Further studies are required to better measure the causes and consequences of burnout and guide the development of effective interventions to reduce or prevent burnout.

Burnout among Healthcare Professionals in Ghana: A Critical Assessment

“…The extent of burnout among the various groups of health professionals was found to be 9.90%. This confirms reports indicating the presence of burnout among various healthcare providers in low-and middle-income countries [21]. On the other hand, results from this current study disagree with a similar study by Pavelková and Bužgová [22], Whitebird et al [23], and Alkema et al [24] where burnout scores were low.…”

“…The challenges and nature of healthcare affect the psyche of these healthcare workers. Thus, in addition to addressing psychological factors, management of hospitals should improve physical working conditions of health workers and engage them in various exercises occasionally to prevent burnout situations [6,21,25].…”

Content and outcomes of narrative medicine programmes: a systematic review of the literature through 2019

“…Given current concerns surrounding stress and burnout among professionals in medicine and health sciences,100–105 a need exists to identify and implement sustainable programming for cultivating resilience. Five well-described programmes evaluated the impact of NM education on resilience and burnout detection and/or mitigation 22 39 50 70 81 90.…”

Mindfulness y la relación clínica: pasos hacia una resiliencia en medicina

“…Cultivar la empatía y compasión en medicina no es fácil. Son muy diversos los factores que contribuyen a que actitudes empáticas y compasivas se agoten [64][65][66][67][68][69][70] . Entre muchos otros, destacan la idea de trauma vicario 66 , exposición prolongada a estrés 64,65 , historia y características personales 67,68 y estar en la primera línea de atención 66,67 .…”