Prevalence and factors associated with depression and burnout among frontline healthcare workers in a resource-limited setting: a national multicentre cross-sectional study from Tanzania

Abstract

Objectives To assess the prevalence and factors associated with depression and burnout among frontline healthcare workers (HCWs) in Tanzania’s five largest public tertiary hospitals. Design National multicentre cross-sectional study. Setting Five tertiary referral hospitals in Tanzania (Muhimbili National Hospital, Kilimanjaro Christian Medical Centre, Mbeya Zonal Referral Hospital, Benjamin Mkapa Hospital and Bugando Medical Centre), March–June 2024. Participants A total of 202 frontline HCWs aged ≥18 years from emergency, intensive care, high dependency, medical, laboratory, radiology and related departments, recruited using convenience sampling through in-person and online survey methods. Interventions Not applicable. Main outcome measures Depressive symptom severity measured using the Patient Health Questionnaire-9 and burnout measured using the Maslach Burnout Inventory (emotional exhaustion, depersonalisation and personal accomplishment subscales). Factors associated with depression and burnout were examined using multivariable logistic regression, reported as prevalence ORs (PORs). Results Overall, 48.0% (97/202) of participants screened positive for depressive symptoms and 38.1% (77/202) met criteria for high burnout. Mild depression was most common (35.6%). High burnout was more frequent in direct patient-contact roles and high-intensity departments. In multivariable analysis, direct patient contact was associated with higher odds of burnout (adjusted POR 2.45; 95% CI 1.23 to 4.88; p=0.011). No sociodemographic factors were significantly associated with depression or burnout after adjustment. Conclusions Depression and burnout were common among frontline HCWs. Direct patient contact was associated with higher levels of burnout, while sociodemographic factors showed no associations. Findings highlight the need for organisational interventions to protect staff well-being in resource-limited settings.