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Abstract
BackgroundHuman resource capacity is vital to the scale-up of voluntary medical male circumcision (VMMC) services. VMMC providers are at risk of “burnout” from performing a single task repeatedly in a high volume work environment that produces long work hours and intense work effort.Methods and findingsThe Systematic Monitoring of the Voluntary Medical Male Circumcision Scale-up (SYMMACS) surveyed VMMC providers in Kenya, South Africa, Tanzania, and Zimbabwe in 2011 (n = 357) and 2012 (n = 591). Providers self-reported on their training, work experience, levels of job-fulfillment and work fatigue/burnout. Data analysis included a descriptive analysis of VMMC provider characteristics, and both bivariate and multivariate analyses of factors associated with provider work fatigue/burnout. In 2012, Kenyan providers had worked in VMMC for a median of 31 months compared to South Africa (10 months), Tanzania (15 months), and Zimbabwe (11 months). More than three-quarters (78 – 99%) of providers in all countries in 2012 reported that VMMC is a personally fulfilling job. However, 67% of Kenyan providers reported starting to experience work fatigue/burnout compared to South Africa (33%), Zimbabwe (17%), and Tanzania (15%). Despite the high level of work fatigue/burnout in Kenya, none of the measured factors (i.e., gender, age, full-time versus part-time status, length of service, number of operations performed, or cadre) were significantly associated with work fatigue/burnout in 2011. In 2012, logistic regression found increases in age (p<.05) and number of months working in VMMC (p<.01) were associated with an increased likelihood of experiencing work fatigue/burnout, while higher career total VMMCs decreased the likelihood of experiencing burnout.ConclusionGiven cross-country differences, further elucidation of cultural and other contextual factors that may influence provider burnout is required. Continuing to emphasize the contribution that providers make in the fight against HIV/AIDS is important.
Highlights
Scaling-up voluntary medical male circumcision (VMMC) to reach and maintain 80% coverage among men ages 15–49 in 13 priority countries would require performing 20.33 and 8.42 million circumcisions between 2011 – 2015 and 2016 – 2025, respectively [1]
Continuing to emphasize the contribution that providers make in the fight against HIV/AIDS is important
Tanzania has just.37 nurses per 1,000 population followed by Zimbabwe (.72), Kate Macintyre assisted on sampling (Kenya) (1.14) and South Africa (4.08) [3]
Summary
Scaling-up voluntary medical male circumcision (VMMC) to reach and maintain 80% coverage among men ages 15–49 in 13 priority countries would require performing 20.33 and 8.42 million circumcisions between 2011 – 2015 and 2016 – 2025, respectively [1]. This ambitious target requires significant human resource investments in settings where health systems and providers are already taxed [2]. Tanzania has just. physicians per 1,000 population, followed by Kenya (.14) Zimbabwe (.16) and South Africa (.77). Tanzania has just. nurses per 1,000 population followed by Zimbabwe (.72), Kenya (1.14) and South Africa (4.08) [3]. VMMC providers are at risk of ‘‘burnout’’ from performing a single task repeatedly in a high volume work environment that produces long work hours and intense work effort
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