TY - JOUR
T1 - Burnout and use of HIV services among health care workers in Lusaka District, Zambia
T2 - A cross-sectional study
AU - Kruse, Gina R.
AU - Chapula, Bushimbwa Tambatamba
AU - Ikeda, Scott
AU - Nkhoma, Mavis
AU - Quiterio, Nicole
AU - Pankratz, Debra
AU - Mataka, Kaluba
AU - Chi, Benjamin H.
AU - Bond, Virginia
AU - Reid, Stewart E.
N1 - Funding Information:
The authors thank our study participants for their support and cooperation. We thank Mary Banda (Lusaka Urban District Health Management Team) and Graham Samungole (Lusaka Urban District Health Management Team) for their assistance in study implementation and recruitment. We thank Moffat Zulu and Martin Daka of CIDRZ for providing data management and data entry assistance. We acknowledge the Zambian Ministry of Health for consistent and high-level support of operations research in the context of HIV programme expansion. Investigators were supported by the Fogarty International Center (K01-TW06670) and the Doris Duke Clinical Scientist Award (2007061). Additional support was provided by the Department for International Development (DFID), United Kingdom Research Programme Consortia, Team for Applied Research Generating Effective Tools and Strategies for Communicable Disease Control (TARGETS) and Evidence for Action (EFA).
PY - 2009/7/13
Y1 - 2009/7/13
N2 - Background: Well-documented shortages of health care workers in sub-Saharan Africa are exacerbated by the increased human resource demands of rapidly expanding HIV care and treatment programmes. The successful continuation of existing programmes is threatened by health care worker burnout and HIV-related illness. Methods: From March to June 2007, we studied occupational burnout and utilization of HIV services among health providers in the Lusaka public health sector. Providers from 13 public clinics were given a 36-item, self-administered questionnaire and invited for focus group discussions and key-informant interviews. Results: Some 483 active clinical staff completed the questionnaire (84% response rate), 50 staff participated in six focus groups, and four individuals gave interviews. Focus group participants described burnout as feeling overworked, stressed and tired. In the survey, 51% reported occupational burnout. Risk factors were having another job (RR 1.4 95% CI 1.2-1.6) and knowing a co-worker who left in the last year (RR 1.6 95% CI 1.3-2.2). Reasons for co-worker attrition included: better pay (40%), feeling overworked or stressed (21%), moving away (16%), death (8%) and illness (5%). When asked about HIV testing, 370 of 456 (81%) reported having tested; 240 (50%) tested in the last year. In contrast, discussion groups perceived low testing rates. Both discussion groups and survey respondents identified confidentiality as the prime reason for not undergoing HIV testing. Conclusion: In Lusaka primary care clinics, overwork, illness and death were common reasons for attrition. Programmes to improve access, acceptability and confidentiality of health care services for clinical providers and to reduce workplace stress could substantially affect workforce stability.
AB - Background: Well-documented shortages of health care workers in sub-Saharan Africa are exacerbated by the increased human resource demands of rapidly expanding HIV care and treatment programmes. The successful continuation of existing programmes is threatened by health care worker burnout and HIV-related illness. Methods: From March to June 2007, we studied occupational burnout and utilization of HIV services among health providers in the Lusaka public health sector. Providers from 13 public clinics were given a 36-item, self-administered questionnaire and invited for focus group discussions and key-informant interviews. Results: Some 483 active clinical staff completed the questionnaire (84% response rate), 50 staff participated in six focus groups, and four individuals gave interviews. Focus group participants described burnout as feeling overworked, stressed and tired. In the survey, 51% reported occupational burnout. Risk factors were having another job (RR 1.4 95% CI 1.2-1.6) and knowing a co-worker who left in the last year (RR 1.6 95% CI 1.3-2.2). Reasons for co-worker attrition included: better pay (40%), feeling overworked or stressed (21%), moving away (16%), death (8%) and illness (5%). When asked about HIV testing, 370 of 456 (81%) reported having tested; 240 (50%) tested in the last year. In contrast, discussion groups perceived low testing rates. Both discussion groups and survey respondents identified confidentiality as the prime reason for not undergoing HIV testing. Conclusion: In Lusaka primary care clinics, overwork, illness and death were common reasons for attrition. Programmes to improve access, acceptability and confidentiality of health care services for clinical providers and to reduce workplace stress could substantially affect workforce stability.
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U2 - 10.1186/1478-4491-7-55
DO - 10.1186/1478-4491-7-55
M3 - Article
C2 - 19594917
AN - SCOPUS:68249138307
SN - 1478-4491
VL - 7
JO - Human Resources for Health
JF - Human Resources for Health
M1 - 55
ER -