title: Work experience, job-fulfillment and burnout among VMMC providers in Kenya, South Africa, Tanzania and Zimbabwe.
abstract: BACKGROUND
  Human resource capacity is vital to the scale-up of voluntary medical male circumcision (VMMC) services. VMMC providers are at risk of "burnout" from performing a single task repeatedly in a high volume work environment that produces long work hours and intense work effort.
  
  
  RESULTS
  The Systematic Monitoring of the Voluntary Medical Male Circumcision Scale-up (SYMMACS) surveyed VMMC providers in Kenya, South Africa, Tanzania, and Zimbabwe in 2011 (n = 357) and 2012 (n = 591). Providers self-reported on their training, work experience, levels of job-fulfillment and work fatigue/burnout. Data analysis included a descriptive analysis of VMMC provider characteristics, and both bivariate and multivariate analyses of factors associated with provider work fatigue/burnout. In 2012, Kenyan providers had worked in VMMC for a median of 31 months compared to South Africa (10 months), Tanzania (15 months), and Zimbabwe (11 months). More than three-quarters (78 - 99%) of providers in all countries in 2012 reported that VMMC is a personally fulfilling job. However, 67% of Kenyan providers reported starting to experience work fatigue/burnout compared to South Africa (33%), Zimbabwe (17%), and Tanzania (15%). Despite the high level of work fatigue/burnout in Kenya, none of the measured factors (i.e., gender, age, full-time versus part-time status, length of service, number of operations performed, or cadre) were significantly associated with work fatigue/burnout in 2011. In 2012, logistic regression found increases in age (p<.05) and number of months working in VMMC (p<.01) were associated with an increased likelihood of experiencing work fatigue/burnout, while higher career total VMMCs decreased the likelihood of experiencing burnout.
  
  
  CONCLUSIONS
  Given cross-country differences, further elucidation of cultural and other contextual factors that may influence provider burnout is required. Continuing to emphasize the contribution that providers make in the fight against HIV/AIDS is important.
authors.affiliation: Tulane University School of Public Health and Tropical Medicine, Department of Global Health Systems and Development, New Orleans, Louisiana, United States of America.
authors.forename: Linnea
authors.initials: L
authors.lastname: Perry
authors.affiliation: The Centre for HIV and AIDS Prevention Studies, Johannesburg, South Africa.
authors.forename: Dino
authors.initials: D
authors.lastname: Rech
authors.affiliation: Zimbabwe AIDS Prevention Project, University of Zimbabwe College of Health Sciences, Department of Community Medicine UZ, Harare, Zimbabwe.
authors.forename: Webster
authors.initials: W
authors.lastname: Mavhu
authors.affiliation: The Centre for HIV and AIDS Prevention Studies, Johannesburg, South Africa.
authors.forename: Sasha
authors.initials: S
authors.lastname: Frade
authors.affiliation: Jhpiego, Dar es Salaam, Republic of Tanzania.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Machaku
authors.affiliation: FHI 360, Kisumu, Kenya.
authors.forename: Mathews
authors.initials: M
authors.lastname: Onyango
authors.affiliation: Impact Research and Development Organization, Kisumu, Kenya.
authors.forename: Dickens S Omondi
authors.initials: DS
authors.lastname: Aduda
authors.affiliation: Ministry of Health and Social Welfare, Dar es Salaam, Republic of Tanzania.
authors.forename: Bennett
authors.initials: B
authors.lastname: Fimbo
authors.affiliation: National AIDS/STI Control Programme, Nairobi, Kenya.
authors.forename: Peter
authors.initials: P
authors.lastname: Cherutich
authors.affiliation: United States Agency for International Development, Washington, DC, United States of America.
authors.forename: Delivette
authors.initials: D
authors.lastname: Castor
authors.affiliation: United States Agency for International Development, Washington, DC, United States of America.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Njeuhmeli
authors.affiliation: Tulane University School of Public Health and Tropical Medicine, Department of Global Health Systems and Development, New Orleans, Louisiana, United States of America.
authors.forename: Jane T
authors.initials: JT
authors.lastname: Bertrand
mesh_terms: D000328:Adult; D002055:Burnout, Professional / Q000453:epidemiology* / Q000523:psychology; D002944:Circumcision, Male / Q000523:psychology*; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D007588:Job Satisfaction; D007630:Kenya; D008297:Male; D008875:Middle Aged; D013019:South Africa; D013636:Tanzania; D015030:Zimbabwe