Abstract
BackgroundA competent, responsive, and productive health workforce is central to a well-performing health system capable of providing universal access to high-quality care. Ensuring health workers’ psychological wellbeing is critical to sustaining their availability and productivity. This is particularly true in heavily constrained health systems in low- and lower-middle-income countries. Research on the issue, however, is scarce. This study aimed to contribute to filling the gap in knowledge by investigating levels of and factors associated with psychological wellbeing of mid-level health workers in Malawi.MethodsThe study relied on a cross-sectional sample of 174 health workers from 33 primary- and secondary-level health facilities in four districts of Malawi. Psychological wellbeing was measured using the WHO-5 Wellbeing Index. Data were analyzed using linear and logistic regression models.ResultsTwenty-five percent of respondents had WHO-5 scores indicative of poor psychological wellbeing. Analyses of factors related to psychological wellbeing showed no association with sex, cadre, having dependents, supervision, perceived coworker support, satisfaction with the physical work environment, satisfaction with remuneration, and motivation; a positive association with respondents’ satisfaction with interpersonal relationships at work; and a negative association with having received professional training recently. Results were inconclusive in regard to personal relationship status, seniority and responsibility at the health facility, clinical knowledge, perceived competence, perceived supervisor support, satisfaction with job demands, health facility level, data collection year, and exposure to performance-based financing.ConclusionsThe high proportion of health workers with poor wellbeing scores is concerning in light of the general health workforce shortage in Malawi and strong links between wellbeing and work performance. While more research is needed to draw conclusions and provide recommendations as to how to enhance wellbeing, our results underline the importance of considering this as a key concern for human resources for health.
Highlights
A competent, responsive, and productive health workforce is central to a well-performing health system capable of providing universal access to high-quality care
The latter, which we define as a continuum from perfect wellbeing at one end to clinically relevant, severe mental illness incapacitating a person’s daily functioning at the other end, is important considering that health workers have been identified as being at high risk of poor psychological wellbeing due to their specific work demands [3, 4]
This study focuses on work-related individual-level factors associated with Psychological wellbeing (PW), on factors potentially relevant to intervention design and on factors which can potentially be addressed by the health system
Summary
A competent, responsive, and productive health workforce is central to a well-performing health system capable of providing universal access to high-quality care. Ensuring health workers’ psychological wellbeing is critical to sustaining their availability and productivity This is true in heavily constrained health systems in low- and lower-middle-income countries. Ensuring health workers’ physical health as well as psychological wellbeing is crucial to sustaining their availability and productivity over time [2]. The latter, which we define as a continuum from perfect wellbeing at one end to clinically relevant, severe mental illness incapacitating a person’s daily functioning at the other end, is important considering that health workers have been identified as being at high risk of poor psychological wellbeing due to their specific work demands [3, 4]. Poor psychological wellbeing has been linked to low quality of care [8], patient safety issues [10], poor empathic ability [11], and absenteeism [12]
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