Pilot study seeks to understand and address health care worker burnout in Mozambique

Working in collaboration with Friends in Global Health (FGH), the Vanderbilt Institute of Global Health (VIGH) will collect interview data from health care workers to understand the challenges they face, the frustrations they feel, and the support they receive while providing HIV care and delivery in public hospitals. The VIGH and FGH teams will use this data to design and pilot two psychosocial interventions aimed at improving health care workers' mental health. The study team expects treatment retention of newly initiated HIV patients will improve at health facilities in Mozambique where health care workers receive this support. 

Carolyn Audet, PhD, MSci, Associate Director for Research at the Vanderbilt Institute for Global Health and associate professor of Health Policy at VUMC, will lead the project.

“We are excited to work with the Ministry of Health in Mozambique to develop interventions that can improve the mental health of health care workers in rural parts of the country. We believe that if we can improve the well-being of health care workers, we can reduce staff turnover and improve the quality of care provided at the facility,” said Audet.

While Mozambique has progressed towards its UNAIDS 95% goals for HIV testing, treatment, and viral suppression rates, only 65% of people newly initiated in HIV treatment remain in care at 12 months. One reason people do not engage in HIV treatment is the lack of compassionate health care services.

“I have been working in Mozambique as clinician and advisor, and understand the many challenges of long queues, lack of medication you need for the patient in front of you, bad infrastructure, just to name a few. This grant is a unique opportunity to work with health care professionals who are facing these working conditions day by day, and hopefully can improve how they feel and thus how they act. To be able to care for another, you need to care for yourself,” said Caroline De Schacht, MD, PhD, Evaluations Director at Friends in Global Health, who will oversee project implementation and is the Mozambican study lead.

With more than a decade of experience developing and testing HIV and associated mental health interventions in Mozambique, VIGH and FGH teams will implement Estamos Juntos (We are Together) to test a multi-prong intervention designed to address provider barriers to delivering compassionate care through two synergistic components: 

  • Resilience and well-being training for health care providers who have expressed low job satisfaction, frustration with delivering care in an extremely resource-limited setting, and burnout
  • Anti-stigma training for health care providers who treat patients with low socioeconomic status, and different beliefs about disease causation and treatment, as well as those non-adherent to their medication differently than they would expect treatment for themselves or their own families

This combination of two potentially high-impact interventions offers the opportunity to test a low-cost, provider-focused approach to improving HIV treatment. The team will explore a clinical trial designed to improve provider and patient health outcomes if the pilot effectively increases adherence and retention in care.