Management strategies for healthcare worker burnout in Sub-Saharan Africa: an integrative review

Abstract

Burnout among healthcare workers is widespread across Sub-Saharan Africa. There is limited evidence on addressing burnout in these settings. Therefore, this integrative review aimed to identify, map, and synthesize the strategies to mitigate burnout among healthcare workers. We conducted a systematic search on PubMed, EBSCOhost, Web of Science, and Google Scholar on studies published from 2015 to 2025. We included studies if they examined burnout management strategies among healthcare workers in Sub-Saharan Africa. Studies that focused solely on burnout prevalence or determinants, without describing any management strategy, were excluded. We identified 10, 057 articles, of which 3 were included. Additionally, 6 studies were identified through backward reference searching of included articles and supplementary Google Scholar. The studies were conducted in Uganda, Mozambique, Botswana, and South Africa. Sample sizes ranged from 10 to 1856 participants. Two overarching themes emerged: adaptive and maladaptive coping strategies. Evidence indicated that adaptive coping strategies, such as supportive supervision, workplace wellness activities, peer support, and culturally embedded coping practices, enhanced motivation, job satisfaction and emotional resilience. Although some strategies traditionally labeled as maladaptive, particularly self-distraction, may be associated with lower burnout levels in the short term, prolonged use may mask underlying stressors, reduce help-seeking behaviors, and increase vulnerability to chronic burnout. This review reveals that healthcare workers consistently employ a mix of adaptive and maladaptive coping strategies. Adaptive strategies were associated with reduced emotional exhaustion and improved resilience. Health systems should implement interventions that strengthen adaptive coping strategies to reduce emotional exhaustion and build resilience while addressing organizational conditions that perpetuate maladaptive coping.