Beyond the shift: The toll of night work and extended hours on healthcare workers in Sudan

Introduction: The impacts of night shift work and lengthened working days on physical, psychosocial and occupational outcomes have been described in some populations; however, evidence from underserved and high demand healthcare in sub-Saharan Africa is limited. Methods: Data were obtained via a hospital-based cross-sectional survey at two Khartoum, Sudan, tertiary hospitals from August 15, 2021 through January 31, 2022. A total of 530 health care workers completed the structured, self-reporting questionnaires (response rate 100%). Chi-square tests, one-way ANOVA and independent t-tests were performed to evaluate the associations between type of shift and working hours and different health outcomes. Results: Of the 530 participants, the majority were female (60.6%), aged 20-30 years (85.3%), and single (75.3%). Gastrointestinal symptoms (37.5%) and cardiovascular symptoms (23.6%) were the most commonly reported systemic symptoms. About 80.9% of the participants reported poor sleep quality, 83.0% reported adverse effects on social life, and 80.2% reported adverse effects on family life. Workers performing both day and night shifts had consistently higher rates across all outcome domains than day-shift-only workers (P<0.05). Extended 16–24 h shifts were correlated with large effects for family (P< 0.001) and social life (P< 0.001), and small effects on sleep quality (P< 0.001). Conclusion: Night shift work and long working hours exert small to moderate physical health effects and moderate to large psychosocial burdens for Sudanese healthcare workers. Workload management, mandatory rest days, and peer social services are viable and clinically necessary interventions, particularly under resource constraints.