Abstract
BackgroundFrontline healthcare workers (HCWs) in low- and middle-income countries (LMICs) represent a critical pillar of global health security. During protracted health crises, these individuals face immense pressure, leading to significant challenges in maintaining their well-being and ensuring workforce stability. This article examines the pervasive issue of burnout and its profound implications for the retention of frontline HCWs in LMICs amidst ongoing and emerging health emergencies.MethodsThis comprehensive review synthesizes findings from recent scholarly literature published up to January 2024, focusing on empirical studies and systematic reviews. A thematic analysis approach was employed to identify key drivers of burnout, its manifestations, and the direct and indirect consequences for HCW retention within LMIC contexts during health crises. The selected studies illuminated systemic vulnerabilities, individual experiences, and organizational responses.ResultsPrevalence rates of burnout components, particularly emotional exhaustion and depersonalization, were consistently high across various LMIC settings during crises. Key contributing factors included excessive workload, inadequate personal protective equipment (PPE), exposure to violence and abuse, insufficient remuneration, and lack of psychological support. These factors collectively exacerbate stress, leading to decreased job satisfaction, increased absenteeism, and ultimately, a significant intent to leave the profession or migrate, severely impacting the retention of experienced HCWs. Our analysis identified a critical gap in tailored interventions.ConclusionThe high prevalence of burnout among frontline HCWs in LMICs during protracted crises poses a severe threat to health systems and global health security. Urgent, context-specific interventions are required to mitigate burnout, enhance resilience, and improve retention. These must include investments in adequate resources, supportive leadership, mental health services, and fair compensation to safeguard the healthcare workforce and ensure effective crisis response capabilities in LMICs.