Wellbeing Programmes and Workforce Retention in Hospitals: Evidence, Gaps, And Relevance for Health Systems in Low- And Middle-Income Countries

Background: The problem of workforce shortages, migration, burnout and increasing care complexity have placed the issue of hospital retention on the frontlines. Wellbeing programmes have been presented as part of the solution, yet the evidence is dispersed and not necessarily interpreted in a manner that can be helpful in lower-resource contexts. Objective: To review the evidence on hospital wellbeing programmes and their relationship with workforce retention, with a specific focus on low- and middle-income countries (LMICs). Methods: This narrative review was drawn from targeted search of peer-reviewed articles, WHO reports and reference lists, with a focus on systematic reviews, large-scale hospital studies, and LMIC or African evidence published between 2010 and January 2026. Results: Short-term psychological outcomes may be enhanced by individual interventions (mindfulness, resilience training and brief psychoeducational programmes), although the best retention indicators are found in more organisational interventions: supportive leadership, healthier practice environments, sufficient staffing, early-career transition support, schedule control, recognition and professional development. The evidence in LMICs is less and methodologically imbalanced but it is also consistent that poor working conditions, burnout, fatigue and low job satisfaction are associated with intention to leave. Conclusion: Wellbeing programmes are most likely to aid retention when they are part of staffing, supervision, workload management and career support, as opposed to being an independent add-on.