Prevalence of burnout among nurses in sub-Saharan Africa: a systematic review.

OBJECTIVE: The objective of this review was to determine the prevalence rates for burnout among nurses working in countries within the sub-Saharan Africa region. INTRODUCTION: Burnout is a response to chronic work-related stress. While there is ample information on its prevalence and risk factors in well-resourced settings in high-income countries, it remains poorly studied in the low- and middle-income countries of sub-Saharan Africa, which bear the larger share of the global burden of disease. INCLUSION CRITERIA: This review considered studies from sub-Saharan Africa that identified the prevalence of burnout among nurses using standard measurement tools. METHODS: A three-step search strategy was utilized to identify both published and unpublished studies in English. Databases (MEDLINE, Embase, CINAHL, and others) were searched from inception to January 2019. Study selection, critical appraisal, data extraction, and data synthesis were conducted according to JBI methodology. RESULTS: A total of 12 studies (n = 2543 nurses) from seven African countries were included in this review. Eight of these studies were cross-sectional by design while the others were either exploratory, longitudinal, surveys, or descriptive. Ten studies were deemed to be at low risk of bias. According to the Maslach Burnout Inventory (seven studies, n = 1923), the prevalence of emotional exhaustion was 66% (95% confidence interval [CI], 37% to 89%), 60% (95% CI, 31% to 85%) for depersonalization, and 49% (95% CI, 19% to 80%) for low personal achievement. The overall prevalence of burnout among studies that utilized the Professional Quality of Life Scale (three studies, n = 337) was 87% (95% CI, 54% to 100%). One study reported a prevalence of 51% (95% CI, 44% to 57%) using the Copenhagen Burnout Inventory (n = 237), and the final study reported a prevalence of 33% (95% CI, 21% to 47%) using an unspecified measuring tool (n = 46). CONCLUSIONS: Regardless of the measuring tool used, nurses in sub-Saharan Africa experience high levels of burnout in all its dimensions.