scholarly journals Prevalence and factors associated with burnout among frontline primary health care providers in low- and middle-income countries: A systematic review

2018 ◽  
Vol 2 ◽  
pp. 4 ◽  
Author(s):  
Sagar Dugani ◽  
Henrietta Afari ◽  
Lisa R. Hirschhorn ◽  
Hannah Ratcliffe ◽  
Jeremy Veillard ◽  
...  

Background: Primary health care (PHC) systems require motivated and well-trained frontline providers, but are increasingly challenged by the growing global shortage of health care workers. Burnout, defined as emotional exhaustion, depersonalization, and low personal achievement, negatively impacts motivation and may further decrease productivity of already limited workforces. The objective of this review was to analyze the prevalence of and factors associated with provider burnout in low and middle-income countries (LMICs). Methods: We performed a systematic review of articles on outpatient provider burnout in LMICs published up to 2016 in three electronic databases (EMBASE, MEDLINE, and CAB). Articles were reviewed to identify prevalence of factors associated with provider burnout. Results: A total of 6,182 articles were identified, with 20 meeting eligibility criteria. We found heterogeneity in definition and prevalence of burnout. Most studies assessed burnout using the Maslach Burnout Inventory. All three dimensions of burnout were seen across multiple cadres (physicians, nurses, community health workers, midwives, and pharmacists). Frontline nurses in South Africa had the highest prevalence of high emotional exhaustion and depersonalization, while PHC providers in Lebanon had the highest reported prevalence of low personal achievement. Higher provider burnout (for example, among nurses, pharmacists, and rural health workers) was associated with high job stress, high time pressure and workload, and lack of organizational support. Conclusions: Our comprehensive review of published literature showed that provider burnout is prevalent across various health care providers in LMICs. Further studies are required to better measure the causes and consequences of burnout and guide the development of effective interventions to reduce or prevent burnout.

2018 ◽  
Vol 2 ◽  
pp. 4 ◽  
Author(s):  
Sagar Dugani ◽  
Henrietta Afari ◽  
Lisa R. Hirschhorn ◽  
Hannah Ratcliffe ◽  
Jeremy Veillard ◽  
...  

Background: Primary health care (PHC) systems require motivated and well-trained frontline providers, but are increasingly challenged by the growing global shortage of health care workers. Burnout, defined as emotional exhaustion, depersonalization, and low personal achievement, negatively impacts motivation and may further decrease productivity of already limited workforces. The objective of this review was to analyze the prevalence of and factors associated with provider burnout in low and middle-income countries (LMICs). Methods: We performed a systematic review of articles on outpatient provider burnout in LMICs published up to 2016 in three electronic databases (EMBASE, MEDLINE, and CAB). Articles were reviewed to identify prevalence of factors associated with provider burnout. Results: A total of 6,182 articles were identified, with 20 meeting eligibility criteria. We found heterogeneity in definition and prevalence of burnout. Most studies assessed burnout using the Maslach Burnout Inventory. All three dimensions of burnout were seen across multiple cadres (physicians, nurses, community health workers, midwives, and pharmacists). Frontline nurses in South Africa had the highest prevalence of high emotional exhaustion and depersonalization, while PHC providers in Lebanon had the highest reported prevalence of low personal achievement. Higher provider burnout (for example, among nurses, pharmacists, and rural health workers) was associated with high job stress, high time pressure and workload, and lack of organizational support. Conclusions: Our comprehensive review of published literature showed that provider burnout is prevalent across various health care providers in LMICs. Further studies are required to better measure the causes and consequences of burnout and guide the development of effective interventions to reduce or prevent burnout.


2018 ◽  
Vol 2 ◽  
pp. 4 ◽  
Author(s):  
Sagar Dugani ◽  
Henrietta Afari ◽  
Lisa R. Hirschhorn ◽  
Hannah Ratcliffe ◽  
Jeremy Veillard ◽  
...  

Background: Primary health care (PHC) systems require motivated and well-trained frontline providers, but are increasingly challenged by the growing global shortage of health care workers. Burnout, defined as emotional exhaustion, depersonalization, and low personal achievement, negatively impacts motivation and may further decrease productivity of already limited workforces. The objective of this review was to analyze the prevalence of and factors associated with provider burnout in low and middle-income countries (LMICs). Methods: We performed a systematic review of articles on outpatient provider burnout in LMICs published up to 2016 in three electronic databases (EMBASE, MEDLINE, and CAB). Articles were reviewed to identify prevalence of and risk factors associated with provider burnout. Results: A total of 6,182 articles were identified, with 20 meeting eligibility criteria. We found heterogeneity in definition and prevalence of burnout. Most studies assessed burnout using the Maslach Burnout Inventory. All three dimensions of burnout were seen across multiple cadres (physicians, nurses, community health workers, and pharmacists). Frontline nurses in South Africa had the highest prevalence of high emotional exhaustion and depersonalization, while PHC providers in Lebanon had the highest reported prevalence of low personal achievement. Higher provider burnout was associated with high job stress, high time pressure and workload, and lack of organizational support. Conclusions: Our comprehensive review of published literature showed that provider burnout is an important problem across various health care providers in LMICs. Further studies are required to better measure the prevalence, causes and consequences of burnout, and guide the development of effective interventions to reduce or prevent burnout.


2020 ◽  
Vol 35 (8) ◽  
pp. 1070-1083
Author(s):  
Jae Kyoun Kim ◽  
Kyeong Han Kim ◽  
Yong Cheol Shin ◽  
Bo-Hyoung Jang ◽  
Seong-Gyu Ko

Abstract This paper reports the findings from the first systematic review of the utilization of traditional medicine (TM) in primary health care (PHC) in low- and middle-income countries (LMICs). PHC is an important component of health care and essential for achieving universal health coverage (UHC). For countries where there is a gap in PHC, TM plays a vital role. It is widely used and has the potential to increase the coverage of PHC and UHC. Hence in situations where TM is recognized in a considerable magnitude, there are scarce evidence and minimal regulation on it and TM practitioners (TMPs). This study aims to identify the current situation in the utilization of TM in PHC or UHC in LMICs. A systematic review and thematic synthesis of qualitative and quantitative studies have been conducted. A total of 56 articles met the criteria and were included in the review. In all, 14 analytic themes have been developed including the current use of TM in PHC, higher accessibility of TM, medical pluralism, national health system, national health policy and national health insurance to include TM, including TMPs in the referral system, utilizing TMPs as community health workers, the needs of scientific research on TM and the need for training both TMPs and conventional medical staffs for better collaboration. The study concluded that it is necessary to further focus on TM in the macro level on strengthening the referral system by including TM to establish a comprehensive service delivery network under UHC and in the micro level to focus on training the TMPs and conventional medicine health workers on both areas to attain more in-depth understanding of each other, which can lead to better collaboration and quality patient care.


Author(s):  
Ayu Rahajeng Dianing Negari ◽  
Annisa Nurida ◽  
Musa Ghufron ◽  
Muhammad Anas

Background: Satisfaction is a feeling that the consumers feel when the service they receive meets or surpass their expectations. Public satisfaction with health care services is still a significant issue for health institutions in improving the service quality. Despite various efforts that health care providers have made, some residents in an area were unsatisfied with the health services in their environment.Objective: To determine the effect of the dimensions of health service quality on patient satisfaction at the Primary Health Care 1 Melaya, Jembrana, BaliMethod: Analytical observational study, a cross-sectional design. The total sample was 70 respondents. Data collection was performed using questionnaires. Multiple linear regression was used to analyze the average value of patient satisfaction based on the five dimensions of quality of health care.Result: The dimensions of tangibility, responsiveness, assurance, and empathy have a significance value (p<0.05), while the reliability dimension has no significance value (p>0.05). So the formula used to predict patient satisfaction with health services received is as follows:y = 0,352+0,295*X1–0,104*X2–0,201*X3+0,334*X4+0,180*X5The dimension of health services that has the largest influence on the satisfaction of inpatients is assurance. Patients feel assured and satisfied when the health workers communicate their expertise and competencies before doing their work.Conclusion: Tangibility, reliability, responsiveness, and assurance were four of five dimensions of health services that have significantly influenced the satisfaction of inpatients.


Author(s):  
Ricky Indra Alfaray ◽  
Rahmat Sayyid Zharfan ◽  
Yudhistira Pradnyan Kloping ◽  
Yudith Annisa Ayu Rezkitha ◽  
Rafiqy Sa’adiy Faizun ◽  
...  

Abstract A preliminary study showed that most health workers in primary health care (PHC) claimed that they need a refreshing course because of their lack of updated knowledge and skill. This study enrolled 27 primary healthcare workers recruited from the PHC. The intervention used were classic lectures and workshops. The knowledge was evaluated using a paper-based test and practice, while the skill was evaluated using a practice test. Multiple questions (pre-test and post-test) based on current emergency management for pediatric were used for paper-based evaluation. Semi-structured interviews were conducted to confirm the subject's perspective on the intervention. A paired t-test was used for evaluating the pre- and post-test results, which was confirmed by a triangulation approach. There was a significant difference between the pre- and post-test results (p<0.001), and 8 of 10 subjects can demonstrate the procedure learned correctly after the intervention. A total of 14 interviewed subjects stated great effectiveness of the intervention, with several limitations on applicability in daily clinical practice. Classic lecture and workshop as an intervention in health education effectively increase health workers' knowledge and skill in PHC. This study might help other rural areas PHC apply the same method so the professionalism and quality of health workers in PHC providers can be maintained.Keywords                : primary health care, classic lecture; workshop; knowledge; skillCorrespondence     : [email protected]


2020 ◽  
Author(s):  
Ramonita J. Sencio ◽  
Mauro Allan Padua Amparado

Objectives: The study determined the awareness on Primary Health Care (PHC) services as perceived by the residents and the level of implementation of PHC services as perceived by the Volunteer Health Workers in Bulacao and Pardo, Cebu City, Cebu, Philippines. The findings served as basis for a series of re-orientation seminars on PHC programs. Specifically, the study answered the following questions:1.What is the level of awareness on PHC services as perceived by the residents in terms of:1.1.health education;1.2.locally endemic disease control;1.3.expanded program on immunization;1.4.maternal health, child health and family planning; 1.5.provision of essential drugs;1.6.adequate food and proper nutrition;1.7.control of communicable diseases;1.8.environmental sanitation; and1.9.provision of medical care and emergency treatment?2.What is the level of implementation on PHC services as perceived by Volunteer Health Workers in the same areas?3.Is there a significant difference in the level of awareness and the level of implementation of the PHC programs as perceived by the respondents?4.What problems were encountered by health care providers on the implementation of the PHC programs?5.Based on the findings of the study, what appropriate series of re-orientation seminars can be proposed?Methods:This study utilized the descriptive-evaluative design. The study was conducted in two villages in Cebu City, namely, Bulacao and Pardo. The study includes 379 community residents and 26 volunteer health workers. A researcher-made tool composed of 45 items on the nine components of PHC was used. An interview guide was prepared to gather more information and confirm responses from the tool. Findings and Conclusion:The study revealed that the residents were aware of the PHC services. It also showed that the level of implementation of the volunteer health workers on PHC services was high. There was a significant difference in the perceptions of the residents on the level of awareness and the volunteer health workers’ level of implementation of PHC services. The top three problems encountered by the health care providers were inadequate medicines, inadequate clinic space for consultation, and availability of medical doctors. In conclusion, when the targeted beneficiaries are aware of the primary health care services, the volunteer health workers will feel more determined to perform their roles to render improved primary health care services. Recommended citation:Sencio, Ramonita J. &amp; Amparado, M. A. P. (2010, March). PrimaryHealth Care Services of Urban Villages. 2010 Southwestern University Research Congress, 2(1), 22-24.


2020 ◽  
Author(s):  
Lu Yao ◽  
Jia Yin ◽  
Qiang Sun ◽  
Ruiting Huo ◽  
Ding Yang ◽  
...  

Abstract Background: Irrational antibiotic use, especially at primary health care institutions accelerates the spread of antibiotic resistance (ABR). It is important to systematically review the effects of interventions at the primary health care to give evidence for future studies about interventions of providers’ antibiotic prescriptions. A systematic review was conducted to explore the effects of interventions targeted to the primary health care providers for improving the rational use of antibiotics. Methods: The literatures were searched in Ovid Medline, Web of Science, PubMed, Cochrane Library, and two Chinese databases with a time limit from January 1st, 1998 to December 1st, 2018. Only articles in the English and Chinese language were considered. Studies had to be the design of randomised control trial, controlled before-and-after studies or interrupted time series. Outcomes had to measure the change in providers’ behaviors. The Cochrane Collaboration criteria was used to assessed the risk of bias of the studies by two reviews. Narrative analysis was performed. Results: Of 4422 studies identified, we included 17studies. Most studies were conducted in the Europe or the United States and 4 of the studies were conducted in low-income and-middle-income countries (LMICs). Most studies had moderate to high risk of bias. There was moderate-strength evidence that interventions targeted at primary health care providers’ prescription behaviors were associated with decreases in antibiotic prescribing and promote the rational use of antibiotic.Conclusions: Provider-targeted interventions in primary health care could decrease the antibiotic prescription and promote the providers’ behaviours of irrational use of antibiotic However, we cannot compare the effects between different interventions because of heterogeneity of interventions and outcomes.


2019 ◽  
Vol 13 (2) ◽  
pp. 144-153 ◽  
Author(s):  
Lucas N.C. Pelegrini ◽  
Gabriela M.P. Mota ◽  
Caio F. Ramos ◽  
Edson Jesus ◽  
Francisco A.C. Vale

ABSTRACT. Dementia is a public health issue making the screening and diagnosing of dementia and its prodromal phases in all health settings imperative. Objective: using PRISMA, this systematic review aimed to identify how low-, middle-, and high-income countries establish dementia and cognitive dysfunction diagnoses in primary health care. Methods: studies from the past five years in English, Spanish, and Portuguese were retrieved from Scopus, PubMed, Embase, Lilacs, Scielo, and Web of Science. Of 1987 articles, 33 were selected for analysis. Results: only three articles were from middle-income countries and there were no studies from low-income countries. The most used instrument was the Mini-Mental State Examination (MMSE). Mild Cognitive Impairment (MCI) and dementia criteria were based on experts’ recommendation as well as on the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD-10), respectively. Conclusion: differences between these criteria among high- and middle-income countries were observed.


2021 ◽  
pp. 002073142110412
Author(s):  
Qian Gao ◽  
A. Matthew Prina ◽  
Yuteng Ma ◽  
David Aceituno ◽  
Rosie Mayston

The objective of this research was to systematically review and synthesize quantitative studies that assessed the association between socioeconomic inequalities and primary health care (PHC) utilization among older people living in low- and middle- income countries (LMICs). Six databases were searched, including Embase, Medline, Psych Info, Global Health, Latin American and Caribbean Health Sciences Literature (LILACS), and China National Knowledge Infrastructure, CNKI, to identify eligible studies. A narrative synthesis approach was used for evidence synthesis. A total of 20 eligible cross-sectional studies were included in this systematic review. The indicators of socioeconomic status (SES) identified included income level, education, employment/occupation, and health insurance. Most studies reported that higher income, higher educational levels and enrollment in health insurance plans were associated with increased PHC utilization. Several studies suggested that people who were unemployed and economically inactive in older age or who had worked in formal sectors were more likely to use PHC. Our findings suggest a pro-rich phenomenon of PHC utilization in older people living in LMICs, with results varying by indicators of SES and study settings.


Author(s):  
Maria G. N. Musoke

This article summarises findings from a qualitative study conducted in rural Uganda, East Africa. The main aim of the study was to investigate the accessibility and use of health information in the lower echelons of Primary Health Care (PHC). Women, as PHC providers in an African family, were the focus as well as health workers. An interview schedule that consisted of open questions and one relating to health information critical incidents were used. A holistic inductive paradigm was adopted with a grounded theory analysis. The findings highlight a model of information behaviour that was driven by the value and impact of information unlike previous information models, which have been driven by information needs. The value and effect of information on PHC was as experienced and reported by the interviewees. Implications of the study and areas for further research are highlighted.


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