Burnout level and associated factors in a Sub-Saharan African medical setting: prospective cross-sectional survey.

Abstract Background Burnout, a real barrier to care, whose knowledge has often been established in the high-income medical context. However, in low and middle-income countries, such as sub-Saharan Africa, which is characterized by a precarious hospital situation and a high stakes linked to the Millennium Development Goals, burnout is poorly studied. The objective of our study was to evaluate, in the medical context of one sub-Saharan African country, the burnout level and associated factors.Methods a prospective cross-sectional study concerning doctors and doctoral student in medicine practicing clinical activity in Gabon. According to the Maslach Burnout Inventory Scale, the burnout symptom was defined by high level in at least one of the 3 dimensions and the severe burnout by high level in all 3 dimensions. Potential factors explored: demographic, socio-professional and psychometric. Multiple logistic regression, by backward method, established the model of factors associated with burnout symptom.Results out of 104 participants, severe burnout prevailed at 1.9% (95% CI: 0.2% -6.8%) and burnout symptom at 34.6% (95% CI: 25, 6% -44.6%). Model of factors associated with burnout symptoms: age (OR = 0.86, p = 0.004), clinical activity in a university hospital center (OR = 5.19, p = 0.006), the feeling of ease of access to the hospital (OR = 0.59, p = 0.012), the number of elderly dependents living with the practitioner (OR = 0.54, p = 0.012), living in a different borough from that of the hospital (OR = 0.24, p = 0.039) and the opinion score favorable to traditional medicine (OR = 1.82, p = 0.087).Conclusion in the Gabonese medical settings, almost one out of two practitioners is symptomatic of burnout. The young age, the university hospital center, the perceived difficulty to access the workplace and paradoxically the proximity to the hospital seems be at risk of burnout. The link between burnout and the perception of traditional medicine questions cultural issues in the doctor-patient relationship in this context.