• M Dylan Bould, Eugene Tuyishime, Charles Nkurunziza, Christophe Mpirimbanyi, Gedeon Mutabezi, Logan Wiwchar, Lydia Yilma, Christopher Charles, and Christian Rangel.
• Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, ON, Canada; Department of Innovation in Medical Education, University of Ottawa, Ottawa, ON, Canada. Electronic address: dbould@cheo.on.ca.
• Br J Anaesth. 2024 Nov 1; 133 (5): 105110611051-1061.

BackgroundThere is a lack of qualitative data on the negative effects of workplace stressors on the well-being of healthcare professionals in hospitals in Africa. It is unclear how well research methods developed for high-income country contexts apply to different cultural, social, and economic contexts in the global south.MethodsWe conducted a qualitative interview-based study including 64 perioperative healthcare professionals across all provinces of Rwanda. We used an iterative thematic analysis and aimed to explore the lived experience of Rwandan healthcare professionals and to consider to what extent the Maslach model aligns with these experiences.ResultsWe found mixed responses of the effects on individuals, including the denial of burnout and fatigue to the points of physical exhaustion. Responses aligned with Maslach's three-factor model of emotional exhaustion, decreased personal accomplishment, and depersonalisation, with downstream effects on the healthcare system. Other factors included strongly patriotic culture, goals framed by narratives of Rwanda's recovery after the genocide, and personal and collective investment in developing the Rwandan healthcare system.ConclusionsThe Rwandan healthcare system presents many challenges which can become profoundly stressful for the workforce. Consideration of reduced personal and collective accomplishment, of moral injury, and its diverse downstream effects on the whole healthcare system may better represent the costs of burnout Rwanda. It is likely that improving the causes of work-based stress will require a significant investment in improving staffing and working conditions.Copyright © 2024 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

20 keywords...

hide…