Burnout and Work Stress among Healthcare Workers in Non-Governmental Organizations in Nigeria: A Scoping Review

Download Article

DOI: 10.21522/TIJMD.2013.09.01.Art008

Authors : Ozumba, P.J., Anzaku, A. A., Are, R., Ejilude, O., Oche, Y., Abiodun, P. O.

Abstract:

Burnout among healthcare workers continued to impact their health and productivity. This scoping review mapped and merged existing literature on burnout, work-related stress, and its factors among health professionals in non-governmental organizations(NGOs) in Nigeria. The implications and strategies for enhancing well-being were highlighted. This scoping review was conducted in five stages, and the report was aligned to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guideline. Multiple databases were searched for English-language articles posted between January 2003 and December 2024. Studies were filtered based on predefined inclusion and exclusion criteria. Data was collected using a customized Excel-based table and analyzed thematically. Twenty-one studies were reviewed across five regions (Asia, Europe, the Middle East, Africa, and Multiregional), with Nigerian studies representing 38%. Studies among the NGOs' health professionals were few. Most studies used the Maslach Burnout Inventory (MBI) and a combination of tools to measure burnout. Our study showed that the distribution of Burnout in Nigeria varied by cadre and settings. The burnout prevalence among primary care physicians was 13.6% driven by emotional exhaustion, 45% in public state facilities in Delta, 75.5% among tertiary hospital physicians in South-East, and 85% among Nurses and healthcare workers in private hospitals in Abuja. The common causes were excessive workload, limited resources, overcommitment, understaffing, and inadequate support. Research on burnout among NGO healthcare workers in Nigeria remained limited. Focused studies are needed to expand the evidence base, guide targeted interventions, and promote supportive workplace policies to enhance staff wellbeing.

References:

[1].   Muhibbu-Din, M. O., 2019, Assessing the roles of NGOs in health care services in Nigeria. Journal of Nation-building & Policy Studies, 3(2), 163–183.

[2].   World Health Organization, 2009, Nigeria: Global Health Observatory data repository. World Health Organization. https://apps.who.int/gho/data/view.main.HWF10v

[3].   Maslach, C., & Jackson, S. E., 1981, The measurement of experienced burnout. Journal of Organizational Behavior, 2(2), 99–113. https://doi.org/10.1002/job.4030020205

[4].   Okoroafor, S. C., Asamani, J. A., Kabego, L., Ahmat, A., Nyoni, J., Millogo, J. J. S., Illou, M. M. A., & Mwinga, K., 2022, Preparing the health workforce for future public health emergencies in Africa. BMJ Global Health, 7(Suppl. 7), e009592. https://doi.org/10.1136/bmjgh-2022-009592

[5].   De Hert, S., 2020, Burnout in healthcare workers: Prevalence, impact and preventative strategies. Local and Regional Anesthesia, 13, 171–183. https://doi.org/10.2147/LRA.S240564

[6].   Nigam, J. A. S., Barker, R. M., Cunningham, T. R., Swanson, N. G., & Chosewood, L. C., 2023, Vital signs: Health worker–perceived working conditions and symptoms of poor mental health—Quality of Worklife Survey, United States, 2018–2022. MMWR Morbidity and Mortality Weekly Report, 72(44), 1197–1205. https://doi.org/10.15585/mmwr.mm7244e1

[7].   Nwosu, A. D. G., Ossai, E., Onwuasoigwe, O., Ezeigweneme, M., & Okpamen, J., 2021, Burnout and presenteeism among healthcare workers in Nigeria. Journal of Public Health Research, 10(1), 1900. https://doi.org/10.4081/jphr.2021.1900

[8].   Dyrbye, L. N., West, C. P., Satele, D., Boone, S., Tan, L., Sloan, J., et al., 2014, Burnout among U.S. medical students, residents, and early career physicians. Academic Medicine, 89(3), 443–451. https://doi.org/10.1097/ACM.0000000000000134

[9].   Eckleberry-Hunt, J., Lick, D., Boura, J., Hunt, R., Balasubramaniam, M., Mulhem, E., et al., 2009, An exploratory study of resident burnout and wellness. Academic Medicine, 84(2), 269–277. https://doi.org/10.1097/ACM.0b013e3181938a45

[10].  Aiken, L. H., Clarke, S. P., Sloane, D. M., Sochalski, J., & Silber, J. H., 2002, Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. JAMA, 288(16), 1987–1993. https://doi.org/10.1001/jama.288.16.1987

[11].  Gundersen, L., 2001, Physician burnout. Annals of Internal Medicine, 135(2), 145–148. https://doi.org/10.7326/0003-4819-135-2-200107170-00023

[12].  Parker, P. A., & Kulik, J. A., 1995, Burnout, job performance, and absenteeism among nurses. Journal of Behavioral Medicine, 18(6), 581–599. https://doi.org/10.1007/BF01857897

[13].  Rathert, C., Williams, E. S., & Linhart, H., 2018, Evidence for the quadruple aim: A systematic review on physician burnout and patient outcomes. Medical Care, 56(12), 976–984. https://doi.org/10.1097/MLR.0000000000001012

[14].  Demerouti, E., Bakker, A. B., Nachreiner, F., & Schaufeli, W. B., 2001, The job demands–resources model of burnout. Journal of Applied Psychology, 86(3), 499–512. https://doi.org/10.1037/0021-9010.86.3.499

[15].  Abdo, S. A. M., El-Sallamy, R. M., El-Sherbiny, A. A. M., & Kabbash, I. A., 2016, Burnout among physicians and nursing staff in Egypt. Eastern Mediterranean Health Journal, 21(12), 906–915.

[16].  Ayisi-Boateng, N. K., Bankah, E. M., Ofori-Amankwah, G. K., Egblewogbe, D. A., Ati, E., Opoku, D. A., Appiah-Brempong, E., & Spangenberg, K., 2020, Burnout among doctors in Ghana. African Journal of Primary Health Care & Family Medicine, 12(1), a2336. https://doi.org/10.4102/phcfm.v12i1.2336

[17].  Bhagavathula, A. S., Abegaz, T. M., Belachew, S. A., Gebreyohannes, E. A., Gebresillassie, B. M., & Chattu, V. K., 2018, Burnout at Gondar University Hospital, Ethiopia. Journal of Education and Health Promotion, 7, 145. https://doi.org/10.4103/jehp.jehp_196_18

[18].  Dubale, B. W., Friedman, L. E., Chemali, Z., Denninger, J. W., Mehta, D. H., Alem, A., et al., 2019, Systematic review of burnout in sub-Saharan Africa. BMC Public Health, 19, 1247. https://doi.org/10.1186/s12889-019-7566-7

[19].  Gadzama, N. N., Wudiri, W. Z., Ofoli, J., Ede, V., & Stephen, Y., 2024, Burnout among HCPs in a private hospital in Abuja. Journal of Epidemiological Society of Nigeria, 7(1–2), 98–108. https://doi.org/10.5281/zenodo.13956755

[20].  Kim, M. H., Mazenga, A. C., Simon, K., Yu, X., Ahmed, S., Nyasulu, P., et al., 2018, Burnout among HIV-care HCWs in Malawi. PLoS ONE, 13(2), e0192983. https://doi.org/10.1371/journal.pone.0192983

[21].  Lar-Ndam, N., Madaki, J. K. A., Pitmang, L., Audu, M. D., Salihu, D., & Gyang, M., 2015, Burnout among primary care physicians in Jos-Plateau. Nigerian Journal of Family Practice, 6(2), 11–18.

[22].  Mbanga, C., Makebe, H., Tim, D., Fonkou, S., Toukam, L., & Njim, T., 2018, Determinants of burnout among nurses in Cameroon. BMC Research Notes, 11, 893. https://doi.org/10.1186/s13104-018-4004-3

[23].  Moyo, E., Dzobo, M., Moyo, P., Murewanhema, G., Chitungo, I., & Dzinamarira, T., 2023, Burnout during public health emergencies in sub-Saharan Africa. Human Factors in Healthcare, 3, 100039. https://doi.org/10.1016/j.hfh.2023.100039

[24].  Nwosu, A. D. G., Ossai, E. N., Mba, U. C., Anikwe, I., Ewah, R., Obande, B. O., & Achor, J. U., 2020, Physician burnout in Nigeria. BMC Health Services Research, 20, 863. https://doi.org/10.1186/s12913-020-05710-8

[25].  Ogungbamila, B., 2013, Occupational burnout among service employees in Nigeria. Psychological Thought, 6(1), 153–165. https://doi.org/10.5964/psyct.v6i1.47

[26].  Ojeogwu, C. I., Aboloje, E. A., Afamefuna, F. U., Osuvwe, C. O., & Israel, O. E., 2023, Occupational burnout in Delta State, Nigeria. African Journal of Tropical Medicine and Biomedical Research, 6(2), 44–53. https://doi.org/10.4314/ajtmbr.v6i2.5

[27].  Olley, B. O., 2003, Burnout among health professionals in a Nigerian teaching hospital. African Journal of Medicine and Medical Sciences, 32(3), 297–302.

[28].  Ozumba, L. N., & Alabere, I. D., 2019, Burnout among doctors and nurses in Port Harcourt. Archives of Medicine and Health Sciences, 7(1), 61–68. https://doi.org/10.4103/amhs.amhs_32_19

[29].  Solomonidou, A., & Katsounari, I., 2020, Stress and burnout among social workers in Cyprus. International Social Work, 65(1), 83–97. https://doi.org/10.1177/0020872819889386

[30].  Parlalis, S., & Hadjicharalambous, D., 2024, Burnout and job satisfaction among social workers. Global Academic Journal of Humanities and Social Sciences, 6(6). https://doi.org/10.36348/gajhss.2024.v06i06.009

[31].  Elbarazi, I., Loney, T., Yousef, S., & Elias, A., 2017, Burnout among health professionals in Arab countries: A systematic review. BMC Health Services Research, 17, 491. https://doi.org/10.1186/s12913-017-2319-8

[32].  Chemali, Z., Ezzeddine, F. L., Gelaye, B., Dossett, M. L., Salameh, J., Bizri, M., et al., 2019, Burnout in the Middle East: A systematic review. BMC Public Health, 19, 1337. https://doi.org/10.1186/s12889-019-7713-1

[33].  Bhui, K., Dinos, S., Galant-Miecznikowska, M., de Jongh, B., & Stansfeld, S., 2016, Work stress causes and interventions. BJPsych Bulletin, 40(6), 318–325. https://doi.org/10.1192/pb.bp.115.050823

[34].  Wright, T., Mughal, F., Babatunde, O. O., Dikomitis, L., Mallen, C. D., & Helliwell, T., 2022, Burnout among PHC professionals in LMICs. Bulletin of the World Health Organization, 100(6), 385–401A. https://doi.org/10.2471/BLT.22.288300

[35].  Oni, D. F., Azeez, I. A., Olaniyan, F. A., & Ilori, T. H., 2024, Predictors of job stress among HCWs in Nigeria. European Journal of Clinical and Experimental Medicine, 22(3), 514–523. https://doi.org/10.15584/ejcem.2024.3.3