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

Abstract

Primary health care (PHC) systems require motivated and Background: 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).We performed a systematic review of articles on outpatient provider Methods: burnout in LMICs published up to 2016 in three electronic databases (EMBASE, MEDLINE, and CAB). Articles were reviewed to identify prevalence of and risk factors associated with provider burnout.A total of 6,182 articles were identified, with 20 meeting eligibility Results: 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, 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 was associated with high job stress, high time pressure and workload, and lack of 1-3 4 5 1 6,7 8 9 10 1,11,12 Gates Open Research Discuss this article(0) Comments associated with high job stress, high time pressure and workload, and lack of organizational support.Our comprehensive review of published literature showed that Conclusions: provider burnout is an important problem across various health care providers in LMICs. Further studies are required to better measure the prevalence, causes and consequences of burnout, and guide the development of effective interventions to reduce or prevent burnout.

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“…Within the wider literature, burnout has been found to be associated with a wide range of health, mental health, and well-being indicators such as increased anxiety, depression, sleep problems, alcohol consumption, impaired memory, and neck and back pain (Peterson et al, 2008). Burnout is also related to lower motivation and productivity (Dugani et al, 2018), job dissatisfaction (Maslach et al, 2001), and future sick leave and mental and behavioral disorders (Toppinen-Tanner et al, 2005).…”

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