Burnout Among Labor and Birth Providers in Northern Tanzania: A Mixed-Methods Study.

Background: Burnout, characterized by emotional exhaustion, depersonalization, and a diminished sense of accomplishment, is a serious problem among healthcare workers. Burnout negatively impacts provider well-being, patient outcomes, and healthcare systems globally and is especially worrisome in settings with shortages of healthcare workers and resources. Methods: This study explores the experience of burnout among labor and delivery (L&D) providers in Tanzania, using three data sources. A structured assessment of burnout was collected at four timepoints from a sample of 60 L&D providers in 6 clinics. The same providers participated in an interactive group activity from which we drew observational prevalence data. Finally, we conducted in-depth interviews (IDIs) with 15 providers to further explore their experience of burnout. Results: Prior to any introduction to the concept, 18% of respondents met criteria for burnout. Immediately after a discussion and activity on burnout, 62% of providers met criteria. One and 3 months later, 29% and 33% of providers met criteria, respectively. In IDIs, participants saw the lack of understanding of burnout as the cause for low baseline rates and attributed the subsequent decrease in burnout to newly acquired coping strategies. The activity helped them realize they were not alone in their experience of burnout. High patient load, low staffing, limited resources, and low pay emerged as contributing factors. Conclusion: A lack of exposure to the concept of burnout leads to providers being unaware of the issue as a collective burden. Therefore, burnout remains rarely discussed and not addressed, thus continuing to impact provider and patient health.