BACKGROUND: Provider burnout and HIV-related stigma is an urgent, and frequently interconnected problem globally. In sub-Saharan Africa, health professionals often deliver care in under-resourced facilities to clients who lack the financial resources, social support, and/or understanding to fully adhere to medications. This confluence of challenges can lead to provider frustration, burnout, and moral trauma, resulting in poor care provision and client dissatisfaction. This study assessed factors influencing burnout and stigma among health professionals in Zambézia Province, Mozambique.
METHODS: We conducted a qualitative study employing in-depth interviews among health professionals providing HIV services in four health facilities, in Zambézia Province, between November 2022 and January 2023. A semi-structured interview guide probed potential factors impacting professional burnout, stigmatizing attitudes and behaviors, and suggestions for improving the well-being of health professionals. Thematic analysis was performed.
RESULTS: Forty-eight health professionals were interviewed, 23 (48%) men; median age was 30 years (IQR 27-37); 23 (48%) were clinicians, 9 (19%) lab/pharmacy technicians, 14 (29%) counselors/peer educators, 14 (4%) non-clinicians. Health professionals choose a career in the health sector wanting to help people, but stated that lack of materials, medicines, staff, support from their superiors, low salary, and attending clients deemed as difficult were factors causing frustration and burnout. They usually deal with frustrations through conversation with friends/family or taking a break from the clinic between client attendance. Defaulting persons, those complaining about their care, men, adolescents and educated persons were reported as those causing most frustration. The respondents felt that seeing individuals’ improvement, positive interactions with clients and colleagues and clients following recommendations, are factors contributing to their job satisfaction. For the improvement of their well-being, respondents suggested psychological support for health professionals, off-site trainings/workshops, improvement of infrastructure of health facilities, more staff, and salary increase.
CONCLUSIONS: Working with persons attending HIV services deemed as difficult, lacking support and limited resources (staff, medicines, materials) influence burnout and frustration of health professionals providing HIV services in Zambézia Province. Providing psychosocial support for health professionals, trainings on effective communication and coping with frustrations should be explored to improve their well-being, and to ensure provision of quality services for HIV care.