Original Research

Factors associated with burnout among healthcare providers in a rural context, South Africa

Alexandra C. Moses, Abigail R. Dreyer, Lesley Robertson
African Journal of Primary Health Care & Family Medicine | Vol 16, No 1 | a4163 | DOI: https://doi.org/10.4102/phcfm.v16i1.4163 | © 2024 Alexandra C. Moses, Abigail R. Dreyer, Lesley Robertson | This work is licensed under CC Attribution 4.0
Submitted: 22 May 2023 | Published: 23 January 2024

About the author(s)

Alexandra C. Moses, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Abigail R. Dreyer, Department of Family Medicine and Primary Care, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Lesley Robertson, Department of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

Abstract

Background: Healthcare providers (HCPs) are at risk of burnout in sub-Saharan Africa. However, there is little research in rural and primary care settings.

Aim: To evaluate burnout and its associated factors among public sector HCPs in South Africa.

Setting: Primary health care clinics, community health centres and district hospitals in Nkomazi Local Municipality, Mpumalanga province.

Methods: Quantitative study design using a cross-sectional survey. Healthcare providers (n = 1139) working in Nkomazi Local Municipality were invited to participate. Burnout was assessed using the Maslach Burnout Inventory. A demographic and occupational questionnaire, the General Help-Seeking Questionnaire and the Health and Safety Executive Indicator Tool were used.

Results: A total of 302 HCPs, between 23 and 61 years, mostly female (n = 252; 83.44%) and nurses (n = 235; 77.81%) participated. High burnout was observed for Emotional Exhaustion (median score 26 [IQR {interquartile range}: 34–16]) and Personal Accomplishment (median score 29 [IQR: 34–25]). Most participants (n = 215; 71.19%) would seek help if they had an emotional problem. Bivariate analysis revealed significant associations between workplace demands, control, management support, peer support, relationships, role and change with all subscales of burnout. Multivariate regression analysis found that Personal Accomplishment improved by 0.49 (95% CI: 0.10–0.89) for every point in improved work demands, by 0.84 (95% CI: 0.01–1.67) for every point towards improved management support and by 1.19 (95% CI: 0.48–1.90) for every point towards having an improved role.

Conclusions: During 2022, HCPs working in a rural area in South Africa displayed high levels of burnout for Emotional Exhaustion and Personal Accomplishment but not for Depersonalisation.

Contributions: Improvements in work demands, managerial support and role clarity may reduce burnout among HCP in a rural, primary care setting.


Keywords

burnout; healthcare workers; South Africa; rural; primary health care; sub-Saharan Africa; mental health; occupational stress; public health.

Sustainable Development Goal

Goal 3: Good health and well-being

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