Exploring effort–reward imbalance and professional quality of life among health workers in Cape Town, South Africa: a mixed-methods study

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dc.contributor.authorJensen, N
dc.contributor.authorLund, C
dc.contributor.authorAbrahams, Z
dc.date.accessioned2022-04-12T08:42:21Z
dc.date.available2022-04-12T08:42:21Z
dc.date.issued2022-03-01
dc.date.updated2022-03-06T04:09:38Z
dc.description.abstractBackground In the context of a growing appreciation for the wellbeing of the health workforce as the foundation of high-quality, sustainable health systems, this paper presents findings from two complementary studies to explore occupational stress and professional quality of life among health workers that were conducted in preparation for a task-shifting intervention to improve antenatal mental health services in Cape Town. Methods This mixed-methods, cross-sectional study was conducted in public sector Midwife Obstetric Units and associated Non-Profit Organisations in Cape Town. Semi-structured interviews and a quantitative survey were conducted among facility-and community-based professional and lay health workers. The survey included demographic as well as effort–reward imbalance (ERI) and professional quality of life (PROQOL) questionnaires to examine overall levels of work-related psychosocial stress and professional quality of life, as well as differences between lay and professional health workers. Qualitative data was analysed using a thematic content analysis approach. Quantitative data was analysed using STATA 12. Results Findings from 37 qualitative interviews highlighted the difficult working conditions and often limited reward and support structures experienced by health workers. Corroborating these findings, our quantitative survey of 165 professional and lay health workers revealed that most health workers experienced a mismatch between efforts spent and rewards gained at work (61.1% of professional and 70.2% of lay health workers; p = 0.302). There were few statistically significant differences in ERI and PROQOL scores between professional and lay health workers. Although Compassion Satisfaction was high for all health worker groups, lay health workers also showed elevated levels of burnout and compassion fatigue, with community-based health workers particularly affected. Conclusions Findings of this study add to the existing evidence base on adverse working conditions faced by South African public-sector health workers that should be taken into consideration as national and local governments seek to ‘re-engineer’ South Africa’s Primary Health Care system. Furthermore, they also highlight the importance of taking into consideration the wellbeing of health workers themselves to develop interventions that can sustainably foster resilient and high-quality health systems.en_US
dc.identifier.apacitationJensen, N., Lund, C., & Abrahams, Z. (2022). Exploring effort–reward imbalance and professional quality of life among health workers in Cape Town, South Africa: a mixed-methods study. <i>Global Health Research and Policy</i>, 7(1), 7. http://hdl.handle.net/11427/36342en_ZA
dc.identifier.chicagocitationJensen, N, C Lund, and Z Abrahams "Exploring effort–reward imbalance and professional quality of life among health workers in Cape Town, South Africa: a mixed-methods study." <i>Global Health Research and Policy</i> 7, 1. (2022): 7. http://hdl.handle.net/11427/36342en_ZA
dc.identifier.citationJensen, N., Lund, C. & Abrahams, Z. 2022. Exploring effort–reward imbalance and professional quality of life among health workers in Cape Town, South Africa: a mixed-methods study. <i>Global Health Research and Policy.</i> 7(1):7. http://hdl.handle.net/11427/36342en_ZA
dc.identifier.ris TY - Journal Article AU - Jensen, N AU - Lund, C AU - Abrahams, Z AB - Background In the context of a growing appreciation for the wellbeing of the health workforce as the foundation of high-quality, sustainable health systems, this paper presents findings from two complementary studies to explore occupational stress and professional quality of life among health workers that were conducted in preparation for a task-shifting intervention to improve antenatal mental health services in Cape Town. Methods This mixed-methods, cross-sectional study was conducted in public sector Midwife Obstetric Units and associated Non-Profit Organisations in Cape Town. Semi-structured interviews and a quantitative survey were conducted among facility-and community-based professional and lay health workers. The survey included demographic as well as effort–reward imbalance (ERI) and professional quality of life (PROQOL) questionnaires to examine overall levels of work-related psychosocial stress and professional quality of life, as well as differences between lay and professional health workers. Qualitative data was analysed using a thematic content analysis approach. Quantitative data was analysed using STATA 12. Results Findings from 37 qualitative interviews highlighted the difficult working conditions and often limited reward and support structures experienced by health workers. Corroborating these findings, our quantitative survey of 165 professional and lay health workers revealed that most health workers experienced a mismatch between efforts spent and rewards gained at work (61.1% of professional and 70.2% of lay health workers; p = 0.302). There were few statistically significant differences in ERI and PROQOL scores between professional and lay health workers. Although Compassion Satisfaction was high for all health worker groups, lay health workers also showed elevated levels of burnout and compassion fatigue, with community-based health workers particularly affected. Conclusions Findings of this study add to the existing evidence base on adverse working conditions faced by South African public-sector health workers that should be taken into consideration as national and local governments seek to ‘re-engineer’ South Africa’s Primary Health Care system. Furthermore, they also highlight the importance of taking into consideration the wellbeing of health workers themselves to develop interventions that can sustainably foster resilient and high-quality health systems. DA - 2022-03-01 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - Global Health Research and Policy KW - South Africa KW - Health workers KW - Health system strengthening KW - Task shifting KW - Task sharing KW - Community health workers KW - PHC KW - Effort–reward imbalance KW - PROQOL KW - Equity KW - Common mental disorders LK - https://open.uct.ac.za PY - 2022 T1 - Exploring effort–reward imbalance and professional quality of life among health workers in Cape Town, South Africa: a mixed-methods study TI - Exploring effort–reward imbalance and professional quality of life among health workers in Cape Town, South Africa: a mixed-methods study UR - http://hdl.handle.net/11427/36342 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s41256-022-00242-6
dc.identifier.urihttp://hdl.handle.net/11427/36342
dc.identifier.vancouvercitationJensen N, Lund C, Abrahams Z. Exploring effort–reward imbalance and professional quality of life among health workers in Cape Town, South Africa: a mixed-methods study. Global Health Research and Policy. 2022;7(1):7. http://hdl.handle.net/11427/36342.en_ZA
dc.language.isoenen_US
dc.language.rfc3066en
dc.publisher.departmentDepartment of Public Health and Family Medicineen_US
dc.publisher.facultyFaculty of Health Sciencesen_US
dc.rights.holderThe Author(s)
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_US
dc.sourceGlobal Health Research and Policyen_US
dc.source.journalissue1en_US
dc.source.journalvolume7en_US
dc.source.pagination7en_US
dc.subjectSouth Africaen_US
dc.subjectHealth workersen_US
dc.subjectHealth system strengtheningen_US
dc.subjectTask shiftingen_US
dc.subjectTask sharingen_US
dc.subjectCommunity health workersen_US
dc.subjectPHCen_US
dc.subjectEffort–reward imbalanceen_US
dc.subjectPROQOLen_US
dc.subjectEquityen_US
dc.subjectCommon mental disordersen_US
dc.titleExploring effort–reward imbalance and professional quality of life among health workers in Cape Town, South Africa: a mixed-methods studyen_US
dc.typeJournal Articleen_US
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