Burnout and use of HIV services among health care workers in Lusaka District, Zambia

A cross-sectional study

Gina R. Kruse, Bushimbwa Tambatamba Chapula, Scott R. Ikeda, Mavis Nkhoma, Nicole Quiterio, Debra Pankratz, Kaluba Mataka, Benjamin H. Chi, Virginia Bond, Stewart E. Reid

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Article number55
JournalHuman Resources for Health
Volume7
DOIs
StatePublished - Jul 13 2009

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Zambia
burnout
health care services
cross-sectional study
Cross-Sectional Studies
HIV
district
group discussion
Delivery of Health Care
worker
Focus Groups
illness
co-worker
Confidentiality
Health Services
health care
staff
death
Emotions
Patient Acceptance of Health Care

ASJC Scopus subject areas

  • Public Administration
  • Public Health, Environmental and Occupational Health

Cite this

Burnout and use of HIV services among health care workers in Lusaka District, Zambia : A cross-sectional study. / Kruse, Gina R.; Chapula, Bushimbwa Tambatamba; Ikeda, Scott R.; Nkhoma, Mavis; Quiterio, Nicole; Pankratz, Debra; Mataka, Kaluba; Chi, Benjamin H.; Bond, Virginia; Reid, Stewart E.

In: Human Resources for Health, Vol. 7, 55, 13.07.2009.

Research output: Contribution to journalArticle

Kruse, GR, Chapula, BT, Ikeda, SR, Nkhoma, M, Quiterio, N, Pankratz, D, Mataka, K, Chi, BH, Bond, V & Reid, SE 2009, 'Burnout and use of HIV services among health care workers in Lusaka District, Zambia: A cross-sectional study', Human Resources for Health, vol. 7, 55. https://doi.org/10.1186/1478-4491-7-55
Kruse, Gina R. ; Chapula, Bushimbwa Tambatamba ; Ikeda, Scott R. ; Nkhoma, Mavis ; Quiterio, Nicole ; Pankratz, Debra ; Mataka, Kaluba ; Chi, Benjamin H. ; Bond, Virginia ; Reid, Stewart E. / Burnout and use of HIV services among health care workers in Lusaka District, Zambia : A cross-sectional study. In: Human Resources for Health. 2009 ; Vol. 7.
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AU - Ikeda, Scott R.

AU - Nkhoma, Mavis

AU - Quiterio, Nicole

AU - Pankratz, Debra

AU - Mataka, Kaluba

AU - Chi, Benjamin H.

AU - Bond, Virginia

AU - Reid, Stewart E.

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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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