Maternal Healthcare Provider Burnout in Ghana: Developing Interventions

Healthcare provider burnout is a global phenomenon, impacting not only individual providers but also care quality and system finances. While the evidence base originated primarily from high-income countries (HIC), burnout is present in low- and middle-income countries (LMIC) at rates equal to or even higher than those seen in HIC. Those working in certain areas of healthcare, such as maternal providers, report higher rates of burnout when compared to other specialties. The recent explosion of burnout-related research includes myriad interventions, though no one intervention has been shown to work across contexts, highlighting the complexity of burnout. The body of evidence in LMIC is small but growing rapidly, with most empirical investigation exploring the prevalence and contributing factors of burnout and very few focusing on interventions. The evidence gap is even more pronounced in sub-Saharan Africa, with virtually no quantitative evidence on burnout interventions. This dissertation explores burnout among maternal providers in Ghana, harnessing implementation science to provide guidance on the development of a pragmatic burnout-reduction intervention. This study seeks to understand provider perceptions, interventions undertaken, and determinants associated with intervention implementation through three aims: 1. Understand Ghanaian maternal providers’ perceptions on burnout and how it relates to poor outcomes 2. Conduct a systematic review of burnout interventions conducted in LMIC 3. Identify determinants and implementation strategies for eventual intervention implementation Healthcare provider burnout is an infrastructural problem requiring pragmatic solutions in all contexts. This dissertation explores the evidence base of burnout interventions in LMIC and the potential of implementation science in developing solutions.