Psychological Impact of COVID-19 on Healthcare Workers in Africa, Associated Factors and Coping Mechanisms: A Systematic Review

Mudenda, Steward; Chabalenge, Billy; Matafwali, Scott Kaba; Daka, Victor; Chileshe, Misheck; Mufwambi, Webrod; Mfune, Ruth Lindizyani; Chali, Josephine; Chomba, Mukuka; Banda, Michelo; Mwaweza, Racheal; Mutati, Ronald Kampamba; Muungo, Tyson Lungwani; Balidawa, John; Hikaambo, Christabel Nang’andu; James, Mark; Kasanga, Maisa; Mohamed, Shafiq

doi:10.4236/aid.2022.123038

Cited by 5 publications

(8 citation statements)

References 48 publications

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“…The sentiments shared by the participants showed both rewarding and positive experiences, as well as many challenges that ranged from those embedded in the context of wider institutional difficulties to more personalised and patient-led experiences. Interestingly, the more positive experiences reported have similarly been identified by other studies conducted in LMICs (Htay et al 2021 ; Mudenda et al 2022 ) and in qualitative investigations of British frontline HCWs (Griffin & Riley 2022 ). Furthermore, a lot of adaptation and flexibility was required in workspaces to respond to the unpredictable and fluctuating working conditions.…”

Section: Resultssupporting

confidence: 72%

“…Despite coping mechanisms being identified as buffers for psychological support, the severe strain experienced resulted in feelings of helplessness, loss of hope and sometimes to social isolation. There is an overwhelming support for these findings in the international literature (Fournier et al 2022 ; Sultan et al 2022 ; Ali et al 2020 ; Newman et al 2022 ) and more specially in LMICs (Mudenda et al 2022 ; Naidoo et al 2020 ; Curran et al 2021 ; Dawood, Tomita & Ramlall, 2022 ; Watermeyer, Madonsela & Beukes 2023 ), emphasising the increased burden of mental health disease in HCWs globally. These findings reinforce the urgent call for increased psychological support for HCWs to mitigate severe physical and emotional strain.…”

Section: Resultsmentioning

confidence: 96%

“…A systematic review of the psychological impact of COVID-19 on HCWs in Africa demonstrated a similar pattern of increased mental health disease. This review concluded that coping strategies of religion and social support were used to buffer the negative psychological impact of the pandemic (Mudenda et al 2022 ). Of the 18 studies included in this review, only two studies used qualitative interview methods to explore the experiences of psychological strain of HCWs.…”

Section: Introductionmentioning

confidence: 99%

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Experiences on the frontline: Qualitative accounts of South African healthcare workers during the COVID-19 pandemic

Kazadi,

Watermeyer,

Besharati

2024

Health SA Gesondheid

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Background The COVID-19 pandemic significantly impacted people’s mental health significantly. Frontline healthcare workers (HCWs) were arguably most affected, particularly in low-to-middle-income countries like South Africa. Understanding their experiences is important to inform interventions for social and psychological support for future pandemics. Aim This study explored the experiences of frontline HCWs in South Africa during the COVID-19 pandemic. Setting The sample included HCWs from various professions and health sectors who worked with COVID-19 patients across South Africa. Methods An exploratory descriptive qualitative design was used. Semi-structured interviews were conducted with 11 frontline HCWs recruited via purposive sampling. Data were analysed using principles of inductive thematic analysis. Results Four major themes were identified in the data: (1) Working during COVID-19 was an emotional rollercoaster; (2) Working during COVID-19 was physically and mentally exhausting; (3) Participants held negative attitudes towards the Department of Health; and (4) COVID-19 had a transformative impact on the daily life of HCWs. Conclusion HCWs’ experiences were diverse and marked by contradictions. Limited psychological support and resources aggravated experiences. However, a positive narrative of hope and gratitude also resonated with participants. Qualitative methodologies provided depth and insights into the diverse realities of frontline HCWs. Contribution This study provides significant insights into the experiences of a diverse group of frontline South African HCWs during COVID-19. It demonstrates a shift in the definition of a ‘frontline’ HCW and highlights the need for greater psychological support and individualised public health interventions during future pandemics.

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Section: Resultssupporting

confidence: 72%

Section: Resultsmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

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Experiences on the frontline: Qualitative accounts of South African healthcare workers during the COVID-19 pandemic

Kazadi,

Watermeyer,

Besharati

2024

Health SA Gesondheid

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“…Additionally, a survey among nurses working in a tertiary health facility in Kenya during COVID-19 reported depression, anxiety, insomnia, distress and burnout at 45.9, 48.2, 37.0, 28.8, and 47.9% ( 26 ). The risk factors for depression and anxiety were higher among females health workers, less than 30 years of age, not being married and those with less than 10 years of work experience ( 27 ). However, none of these studies reported the reliability or validity of the measures they employed to assess the mental health of the healthcare workers.…”

Section: Introductionmentioning

confidence: 99%

Psychometric evaluation of PHQ–9 and GAD–7 among community health volunteers and nurses/midwives in Kenya following a nation-wide telephonic survey

et al. 2023

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BackgroundNurses/midwives and Community Health Volunteers (CHVs) are exposed to chronic stressors putting them at risk of developing mental health problems. This has been exacerbated by the COVID-19 pandemic. There is limited empirical evidence of the burden of mental health problems among health care workers partly due to the lack of adequately standardized and validated measures for use among health care workers in Sub-Saharan Africa. This study aimed to perform the psychometric evaluation of the PHQ-9 and GAD-7 administered to nurses/midwives and CHVs across 47 counties in Kenya.MethodsBetween June and November 2021, a national survey on mental well-being and resilience among nurses/midwives and CHVs was conducted via telephone interviews. The survey had a total sample size of 1907 nurses/midwives and 2027 CHVs. Cronbach’s alpha and MacDonalds’ omega were used to evaluate the scale’s internal consistency. Confirmatory Factor Analysis (CFA) was used to test the one-factor structure of the scales. Multi-group CFA was applied to evaluate the generalizability of the scales across the Swahili and English versions, and among male and female health workers. The Spearman correlation was used to assess the tools’ divergent and convergent validity.ResultsThe internal consistency of PHQ-9 and GAD-7 was good, with alpha and omega values above 0.7 across study samples. CFA results indicated a one-factor structure of the PHQ-9 and GAD-7 for both nurses/midwives and CHVs. Multi-group CFA showed that both scales were unidimensional across both language and sex. The PHQ-9 and GAD-7 were positively correlated with perceived stress, burnout, and post-traumatic stress disorder, indicating convergent validity. The PHQ-9 and GAD-7 were also significantly positively correlated with resilience and work engagement, supporting divergent validity.ConclusionThe PHQ-9 and GAD-7 are unidimensional, reliable, and valid tools for screening depression and anxiety among nurses/midwives and CHVs. The tools can be administered in a similar population or study setting using either Swahili or English.

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“…In one of the few cross-sectional survey studies focusing on LMICs, including South Africa, Kenya, Uganda, Tanzania and Zimbabwe, Htay and colleagues (2021) reported positive coping mechanisms, such as family support and positive thinking, as a method to counteract increased psychological and physical strain. A recent systematic review of the psychological impact of COVID-19 on HCWs in Africa demonstrated a similar pattern of increased mental health disease, with coping strategies of religion and social support used to buffer the negative psychological impact of the pandemic (Mudenda et al 2022). However, of the 18 studies included in this review, only two studies used qualitative interview methods to explore the experiences of psychological strain of HCWs in Ghana and Uganda.…”

Section: Introductionmentioning

confidence: 95%

Narratives on the frontline: A qualitative investigation of the lived experiences of healthcare workers during the COVID-19 pandemic in South Africa

Kazadi1¹,

Watermeyer²,

Besharati³

2023

Preprint

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Background: During the COVID-19 pandemic, a mental health pandemic emerged. Frontline healthcare workers (HCWs) are arguably most affected, particularly in low-to-middle-income countries like South Africa. Understanding their experiences is needed to inform interventions for social and psychological support both now and for future pandemics. Aim: This study explored the lived experiences of frontline HCWs in South Africa during the COVID-19 pandemic using a lifeworld phenomenological framework.Methods: Semi-structured interviews were conducted and analysed using principles of reflexive thematic analysis.Setting: Our sample included 11 frontline HCWs from various professions and health sectors who worked with COVID-19 patients in South Africa. Results: HCWs’ lived experiences during the epidemic in South Africa were diverse and marked by contradictions. Work during COVID-19 was an emotional rollercoaster that was both mentally and emotionally exhausting, and the epidemic substantially impacted daily life. Limited psychological support and resources aggravated experiences. However, a positive narrative of hope and gratitude also resonated with participants.Conclusion: This study provides significant insights into the lived experiences of a diverse group of frontline South African HCWs during COVID-19. Qualitative methodologies provided depth and unique insights into the diverse realities of frontline HCWs.Contribution: This is one of the few studies in low-to-middle-income countries and the first in South Africa to use in-depth qualitative interviews to understand the lived experience of frontline HCWs. It demonstrates a shift in the definition of a ‘frontline’ HCW and highlights the need for greater psychological support and individualised public health interventions.

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Psychological Impact of COVID-19 on Healthcare Workers in Africa, Associated Factors and Coping Mechanisms: A Systematic Review

Cited by 5 publications

References 48 publications

Experiences on the frontline: Qualitative accounts of South African healthcare workers during the COVID-19 pandemic

Experiences on the frontline: Qualitative accounts of South African healthcare workers during the COVID-19 pandemic

Psychometric evaluation of PHQ–9 and GAD–7 among community health volunteers and nurses/midwives in Kenya following a nation-wide telephonic survey

Narratives on the frontline: A qualitative investigation of the lived experiences of healthcare workers during the COVID-19 pandemic in South Africa

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