How Excessive Workloads and Long Hours of Work Contribute to Occupational Stress and Burnout Among Clinical Officers at Public Hospitals in Malawi

ABSTRACT

In Malawi, there is a cadre of mid-level health workers called clinical officers (COs) who undertake duties conventionally performed by medical doctors in the wake of an acute shortage of the latter. This paper argues that excessive workload and long hours of work are psychosocial hazards at public hospitals in Malawi that contribute to occupational stress (OS) and burnout among COs. The study from which this paper is derived adopted a qualitative research design with a case study as a research strategy. The study was conducted at four district hospitals and one central hospital, which are state-owned in Malawi. This paper argues, firstly, that before the COVID-19 pandemic, COs experienced OS and burnout due to excessive workloads and long hours of work at public hospitals. Secondly, the COVID-19 pandemic aggravated the problem of excessive workloads and long hours of work at public hospitals. Thirdly, OS and burnout among COs are associated with various impacts that can be categorised as psychological consequences and physical consequences. The psychological and physical consequences of OS and burnout are manifestations of poor quality of life among COs, which ultimately negatively affects public health. Finally, this paper recommends formulating and implementing comprehensive occupational safety and health (OSH) policies at public hospitals. Among others, these OSH policies should provide frameworks for regularly assessing the impact of OSH hazards on the mental health of hospital staff and then informing the development of appropriate measures for mitigation.

KEYWORDS:

• clinical officers
• occupational stress and burnout
• excessive workloads
• long hours of work
• psychosocial hazards
• Malawi

Acknowledgements

This paper is based on research that was financially supported by the Centre for Global Work and Employment (CGWE) at Rutgers University and a trade union confederation in Norway called LO/Norway. I thank Dr Rajohane Matshidisho (late), Prof. Bridget Kenny and Dr Ben Scully for their valuable comments on the research from which this paper was derived and the two anonymous reviewers for their constructive feedback. I am also grateful to Chifuno Mlambe, Yobe Saka, Emmanuel Katema, Matsiame Mafa and Anne Kazembe who worked with me as research assistants.

Disclosure statement

No potential conflict of interest was reported by the author.

Interviews

Interview, Supervisor, 01, 12 January 2022.

Interview, 03/CO/R, 8 January 2022.

Interview, 05/CO/R, 8 January 2022.

Interview, 03/CO/01, 15 December 2021.

Interview, 05/CO/05, 12 December 2021.

Interview, 04/CO/01, 8 December 2021.

Interview, 02/CO/05, 5 December 2021.

Interview, 02/CO/03, 3 December 2021.

Interview, Key Informant 02, 19 November 2021.

Focus group discussions

Focus group discussion, 05B, 8 January 2022.

Notes

1 PAUM is a trade union that represents clinical officers in Malawi.

Additional information

Funding

This work was supported by the Centre for Global Work and Employment at the Rutgers University’™: [Grant Number N/A]; LO/Norway: [Grant Number N/A].