Psychosocial Interventions to Improve Resilience and Reduce Stigmatizing Attitudes Among Healthcare Workers in Mozambique
1
Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, United States
2
Department of Health Policy, Vanderbilt University Medical Center, Nashville, United States
3
Centro pela Saúde Global (C-Saúde), Quelimane, Mozambique
4
Centro pela Saúde Global (C-Saúde), Maputo, Mozambique
5
Department of Biostatistics, Vanderbilt University Medical Center, Nashville, United States
6
Health Training and Research Center, Beira Central Hospital, Beira, Mozambique
7
Institute of Tropical Medicine, Antwerp, Belgium
Popul. Med. 2026;8(Supplement Supplement 1):A2624
ABSTRACT
INTRODUCTION:
Challenges with delivering quality care in resource-constrained settings can contribute to burnout, depersonalization, reduced resilience, and the development of stigmatizing attitudes toward people with HIV among healthcare workers (HCW). Evidence-based psychosocial interventions for HCW in Mozambique are limited. This study evaluated the acceptability and preliminary effects of two low-cost interventions designed to improve resilience and reduce stigmatizing attitudes among HCW providing HIV care in Zambézia Province, Mozambique.
METHODS:
A mixed-methods pilot study was conducted in four health facilities from January-July 2024. Sites were randomized to receive a resilience intervention, anti-stigma intervention, both, or neither. Participants completed baseline and endline surveys measuring resilience, burnout, depersonalization, and HIV-related stigma. Linear mixed-effects models assessed the association between the interventions and psychosocial outcomes. In-depth interviews (IDI) with a subset of participants explored experiences and perceived impacts.
RESULTS:
Survey data were collected from 100 HCW, of whom 40 participated in IDI. Participants were predominantly female (63%), median age of 33 years, and worked in healthcare for median of 6.5 years. At baseline, average overall burnout (15.9 [standard deviation (SD) 9.85], average depersonalization (1.5 [SD 1.24]), and average HIV-related stigma (16.4 [SD 4.47]) were low, while average resilience was moderate (31.5 [SD 3.66]). In adjusted multivariable models, the anti-stigma intervention was associated with a significant reduction in work-related burnout (adjusted mean difference −8.85, p=0.033). The resilience intervention showed a non-significant trend toward improved resilience (p=0.065). Qualitative findings indicated both interventions had favorable acceptability, perceived benefits in communication and stress management, and reported application of skills in daily work.
CONCLUSIONS:
A significant reduction was seen in HCW work-related burnout with the anti-stigma intervention, and trends towards improved resilience with resilience intervention. The interventions were an acceptable method to reinforce HCW well-being. Further research is needed to understand effectiveness of resilience-building programs with varying lengths and settings.
Challenges with delivering quality care in resource-constrained settings can contribute to burnout, depersonalization, reduced resilience, and the development of stigmatizing attitudes toward people with HIV among healthcare workers (HCW). Evidence-based psychosocial interventions for HCW in Mozambique are limited. This study evaluated the acceptability and preliminary effects of two low-cost interventions designed to improve resilience and reduce stigmatizing attitudes among HCW providing HIV care in Zambézia Province, Mozambique.
METHODS:
A mixed-methods pilot study was conducted in four health facilities from January-July 2024. Sites were randomized to receive a resilience intervention, anti-stigma intervention, both, or neither. Participants completed baseline and endline surveys measuring resilience, burnout, depersonalization, and HIV-related stigma. Linear mixed-effects models assessed the association between the interventions and psychosocial outcomes. In-depth interviews (IDI) with a subset of participants explored experiences and perceived impacts.
RESULTS:
Survey data were collected from 100 HCW, of whom 40 participated in IDI. Participants were predominantly female (63%), median age of 33 years, and worked in healthcare for median of 6.5 years. At baseline, average overall burnout (15.9 [standard deviation (SD) 9.85], average depersonalization (1.5 [SD 1.24]), and average HIV-related stigma (16.4 [SD 4.47]) were low, while average resilience was moderate (31.5 [SD 3.66]). In adjusted multivariable models, the anti-stigma intervention was associated with a significant reduction in work-related burnout (adjusted mean difference −8.85, p=0.033). The resilience intervention showed a non-significant trend toward improved resilience (p=0.065). Qualitative findings indicated both interventions had favorable acceptability, perceived benefits in communication and stress management, and reported application of skills in daily work.
CONCLUSIONS:
A significant reduction was seen in HCW work-related burnout with the anti-stigma intervention, and trends towards improved resilience with resilience intervention. The interventions were an acceptable method to reinforce HCW well-being. Further research is needed to understand effectiveness of resilience-building programs with varying lengths and settings.
| eISSN: | 2654-1459 |
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