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