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    Occupational Stress and Burnout among Clinical Officers at Public Hospitals in Malawi: Impact Shifting to the General Public
    (University of the Witwatersrand, Johannesburg, 2023-08) Chinguwo, Paliani; Kenny, Bridget; Matshiditsho, Rajohane; Scully, Ben
    In Malawi, there is a cadre of mid-level health workers called clinical officers who undertake duties conventionally designated for medical doctors in the wake of an acute shortage of the latter. The use of clinical officers as substitutes for medical doctors is one example of a strategy called task shifting that is implemented as a temporary remedy for the shortage of human resources in healthcare. This is a study on the experiences of clinical officers with occupational stress and burnout at public hospitals in Malawi. The study adopted a qualitative research design with a case study as a research strategy. The study was conducted at four district hospitals and one central hospital, all of which are state-owned. One shortcoming of the framing of occupational safety and health in Malawi is the narrow scope and coverage of the regulation on occupational safety and health. This narrow scope of the regulation of occupational safety and health is limited to physical, chemical, and biological hazards. The psychosocial hazards are therefore neglected by the regulation on occupational safety and health. Another shortcoming of the framing of occupational safety and health in Malawi is that the coverage of the regulation on occupational safety and health exempts service sectors like healthcare. This exemption, therefore, gives the impression that healthcare in Malawi is immune to occupational safety and health hazards. This study challenges the narrow scope and coverage of the regulation on occupational safety and health in Malawi that neglects psychosocial hazards and exempts healthcare. The overall aim of the study was to expose the impacts on public health that can be associated with the neglect of psychosocial hazards and the exclusion of healthcare from the regulation of occupational safety and health. This study demonstrates that there are psychosocial hazards at public hospitals that predispose clinical officers to occupational stress and burnout. These are excessive workload, long hours of work, poor interprofessional relations, restructuring, COVID-19 responses, and the absence of occupational and safety management systems. The study further illustrates that psychosocial hazards at public hospitals are a breeding ground for various health problems among clinical officers that emanate from occupational stress and burnout. These health problems include emotional and cognitive effects; injuries; high blood pressure (hypertension); muscle tension or pain; and severe headaches. These health problems negatively affect the quality of life among clinical officers and their performance on the job. The study, therefore, concludes that occupational stress and burnout among clinical officers ultimately affect health outcomes in the broader population. For instance, the study demonstrates how the consequences of OS and burnout among clinical officers are consequently externalised to patients and the general public through the poor quality of healthcare services. In this study, the externalisation of the negative effects of occupational stress and burnout on clinical officers to the patients and the general public, is referred to as impact shifting. This study conceptualises and proposes a theoretical framework for analysing occupational safety and health in Malawi, with a particular focus on psychosocial hazards at public hospitals. The theoretical framework comprises three theoretical perspectives, namely: attribution theory, job demands-resources model, and fundamental cause theory. This study, therefore, offers a theoretical foundation and empirical evidence drawn from the experiences of clinical officers with occupational stress and burnout. The theoretical foundation and empirical evidence can inform the reframing of the scope and coverage of the regulation on occupational safety and health. Finally, this study also conceptualises and proposes a framework for the formulation of a comprehensive policy on occupational safety and health for public health facilities in the context of Malawi.
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    Experiences of probation officers working at Department of Social Development, Gauteng, JHB Metro Region on occupational stress and their coping mechanisms
    (University of the Witwatersrand, Johannesburg, 2022) Monnye, Olebogeng
    The United Nations Children’s Fund (UNICEF) states that the majority of children in conflict with the law have committed petty crimes such as alcohol abuse, begging, absenteeism from school and vagrancy. Probation officers have an important role to play in the lives of people in conflict with the law. Some of their responsibilities include conducting thorough investigations to assess the offenders who have committed crimes. It can be understood that the nature of their job can at times cause occupational stress. The aim of the study was to explore the occupational stressors and coping mechanisms adopted by probation officers working at the Department of Social Development (DSD), Johannesburg (Jhb) Metro Region in the Gauteng province of South Africa. A qualitative approach was used to conduct the study. Fifteen participants were selected using non-probability purposive sampling. Face to face in-depth interviews were conducted to collect the data. The interviews were audio recorded and the data was analysed using thematic analysis. It was anticipated that insights into the occupational stressors and coping strategies adopted by probation officers would be revealed. This study revealed that probation officers have high caseloads, but have good coping mechanisms to curb occupational stress in that they confide in their supervisors and their colleagues. The significance of the study for social work was that it may help probation officers to determine how they can better deal with occupational stress. Little research has been conducted in South Africa regarding probation officers’ occupational stressors. Therefore, this study contributed to literature on the matter.