Burnout among primary health-care professionals in low- and middle-income countries: systematic review and meta-analysis

Journal article


Wright, Tanya, Mughal, Faraz, Babatunde, Opeyemi O., Dikomitis, Lisa, Mallen, Christian D. and Helliwell, Toby 2022. Burnout among primary health-care professionals in low- and middle-income countries: systematic review and meta-analysis. Bulletin of the World Health Organization. 100 (6), pp. 385-401A. https://doi.org/10.2471/BLT.22.288300
AuthorsWright, Tanya, Mughal, Faraz, Babatunde, Opeyemi O., Dikomitis, Lisa, Mallen, Christian D. and Helliwell, Toby
AbstractTo estimate the prevalence of burnout among primary health-care professionals in low- and middle-income countries and to identify factors associated with burnout. We systematically searched nine databases up to February 2022 to identify studies investigating burnout in primary health-care professionals in low- and middle-income countries. There were no language limitations and we included observational studies. Two independent reviewers completed screening, study selection, data extraction and quality appraisal. Random-effects meta-analysis was used to estimate overall burnout prevalence as assessed using the Maslach Burnout Inventory subscales of emotional exhaustion, depersonalization and personal accomplishment. We narratively report factors associated with burnout. The search returned 1568 articles. After selection, 60 studies from 20 countries were included in the narrative review and 31 were included in the meta-analysis. Three studies collected data during the coronavirus disease 2019 pandemic but provided limited evidence on the impact of the disease on burnout. The overall single-point prevalence of burnout ranged from 2.5% to 87.9% (43 studies). In the meta-analysis (31 studies), the pooled prevalence of a high level of emotional exhaustion was 28.1% (95% confidence interval, CI: 21.5-33.5), a high level of depersonalization was 16.4% (95% CI: 10.1-22.9) and a high level of reduced personal accomplishment was 31.9% (95% CI: 21.7-39.1). The substantial prevalence of burnout among primary health-care professionals in low- and middle-income countries has implications for patient safety, care quality and workforce planning. Further cross-sectional studies are needed to help identify evidence-based solutions, particularly in Africa and South-East Asia. [Abstract copyright: (c) 2022 The authors; licensee World Health Organization.]
KeywordsBurnout, psychological; Health personnel - psychology; Burnout, professional - epidemiology - psychology; COVID-19; Developing Countries; Humans; Prevalence
Year2022
JournalBulletin of the World Health Organization
Journal citation100 (6), pp. 385-401A
ISSN1564-0604
Digital Object Identifier (DOI)https://doi.org/10.2471/BLT.22.288300
https://doi.org/BLT.22.288300
Official URLhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9178426/
Publication dates
Online29 Apr 2022
Publication process dates
Accepted31 Mar 2022
Deposited28 Jun 2022
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