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      Systematic review of burnout among healthcare providers in sub-Saharan Africa

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          Abstract

          Background

          Burnout is characterized by physical and emotional exhaustion from long-term exposure to emotionally demanding work. Burnout affects interpersonal skills, job performance, career satisfaction, and psychological health. However, little is known about the burden of burnout among healthcare providers in sub-Saharan Africa.

          Methods

          Relevant articles were identified through a systematic review of PubMed, Web of Science (Thomson Reuters), and PsycINFO (EBSCO). Studies were selected for inclusion if they examined a quantitative measure of burnout among healthcare providers in sub-Saharan Africa.

          Results

          A total of 65 articles met our inclusion criteria for this systematic review. Previous studies have examined burnout in sub-Saharan Africa among physicians ( N = 12 articles), nurses ( N = 26), combined populations of healthcare providers ( N = 18), midwives ( N = 2), and medical or nursing students ( N = 7). The majority of studies assessed burnout using the Maslach Burnout Inventory. The highest levels of burnout were reported among nurses, although all healthcare providers showed high burnout. Burnout among healthcare providers is associated with their work environments, interpersonal and professional conflicts, emotional distress, and low social support.

          Conclusions

          Available studies on this topic are limited by several methodological challenges. More rigorously designed epidemiologic studies of burnout among healthcare providers are warranted. Health infrastructure improvements will eventually be essential, though difficult to achieve, in under-resourced settings. Programs aimed at raising awareness and coping with burnout symptoms through stress management and resilience enhancement trainings are also needed.

          Electronic supplementary material

          The online version of this article (10.1186/s12889-019-7566-7) contains supplementary material, which is available to authorized users.

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          Most cited references108

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          Early predictors of job burnout and engagement.

          A longitudinal study predicted changes in burnout or engagement a year later by identifying 2 types of early indicators at the initial assessment. Organizational employees (N = 466) completed measures of burnout and 6 areas of worklife at 2 times with a 1-year interval. Those people who showed an inconsistent pattern at Time 1 were more likely to change over the year than were those who did not. Among this group, those who also displayed a workplace incongruity in the area of fairness moved to burnout at Time 2, while those without this incongruity moved toward engagement. The implications of these 2 predictive indicators are discussed in terms of the enhanced ability to customize interventions for targeted groups within the workplace. PsycINFO Database Record (c) 2008 APA, all rights reserved.
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            The Relationship Between Professional Burnout and Quality and Safety in Healthcare: A Meta-Analysis.

            Healthcare provider burnout is considered a factor in quality of care, yet little is known about the consistency and magnitude of this relationship. This meta-analysis examined relationships between provider burnout (emotional exhaustion, depersonalization, and reduced personal accomplishment) and the quality (perceived quality, patient satisfaction) and safety of healthcare.
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              Determinants and prevalence of burnout in emergency nurses: a systematic review of 25 years of research.

              Burnout is an important problem in health care professionals and is associated with a decrease in occupational well-being and an increase in absenteeism, turnover and illness. Nurses are found to be vulnerable to burnout, but emergency nurses are even more so, since emergency nursing is characterized by unpredictability, overcrowding and continuous confrontation with a broad range of diseases, injuries and traumatic events.
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                Author and article information

                Contributors
                617-432-1071 , bgelaye@hsph.harvard.edu
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                11 September 2019
                11 September 2019
                2019
                : 19
                : 1247
                Affiliations
                [1 ]ISNI 0000 0001 1250 5688, GRID grid.7123.7, Department of Psychiatry, , Addis Ababa University, ; Addis Ababa, Ethiopia
                [2 ]ISNI 000000041936754X, GRID grid.38142.3c, Department of Epidemiology, , Harvard T.H. Chan School of Public Health, ; 677 Huntington Ave, Kresge 505, Boston, MA 02115 USA
                [3 ]ISNI 0000 0004 0386 9924, GRID grid.32224.35, The Chester M. Pierce, M.D. Division of Global Psychiatry, Department of Psychiatry, , Massachusetts General Hospital, ; Boston, MA USA
                [4 ]ISNI 000000041936754X, GRID grid.38142.3c, Benson Henry Institute for Mind Body Medicine at Massachusetts General Hospital, , Harvard Medical School, ; Boston, MA USA
                Author information
                http://orcid.org/0000-0001-7934-548X
                Article
                7566
                10.1186/s12889-019-7566-7
                6737653
                31510975
                3b9eb3f3-dbbb-412c-8839-da6de2b09573
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 2 April 2019
                : 29 August 2019
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100008460, National Center for Complementary and Integrative Health;
                Award ID: K23AT009218
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Public health
                burnout,sub-saharan africa,health personnel
                Public health
                burnout, sub-saharan africa, health personnel

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