Why is there violence in our workplace? Perceptions of primary health care workers and managers in Gauteng Province
1
1. Gauteng Department of Health, Ekurhuleni Health District, Ekurhuleni, South Africa
2
2. Family Medicine, School of Clinical Medicine, Johannesburg, South Africa
3
3. School of Public Health, Faculty of Health Science, Johannesburg, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
The healthcare sector accounts for approximately 25% of all incidents of workplace violence (WPV) worldwide. Higher income countries have identified multi-level factors leading to WPV, such as: organisational (high workloads, weak leadership, lack of peer support); individual (emotional demands, low resilience); and, societal normalisation of violence. Little is known, however, about the experiences and perceptions of South African HCWs in primary health care (PHC) facilities and their understanding of the causes of WPV, despite being in public facing roles that heighten exposure to aggression.
AIM:
To explore the perceptions of healthcare workers (HCWs) and managers on the underlying reasons for WPV in one sub-district in Gauteng.
METHODS:
An exploratory qualitative study was conducted with participants from 26 PHC clinics, three community health centres and four ambulance centres. 32 in-depth interviews were held with 16 HCWs who volunteered to participate and 16 managers who were selected purposively. The transcripts were coded inductively with thematic analysis.
RESULTS:
Themes identified include: i) Mismatch between patient and HCW expectations in that patients present with unrealistic demands about entitlement to care, waiting times and emergency triage; ii) health systems challenges, including structural limitations and resource constraints as well as tensions between HCWs; iii) societal and political inequities such as poverty, unemployment, substance abuse and normalised violence that spill over into PHC facilities and act as upstream drivers of WPV displacing anger towards frontline HCWs; iv) Personnel stress and burnout that function both as outcomes of systemic pressures and as accelerators of WPV.
CONCLUSIONS:
Our study reveals the complex dynamics underpinning WPV in PHC settings, pointing to the need for multifaceted prevention and mitigation strategies. The reasons for WPV identified here can serve as starting points to address workplace safety in PHC, which is the backbone of the health care system in South Africa.
The healthcare sector accounts for approximately 25% of all incidents of workplace violence (WPV) worldwide. Higher income countries have identified multi-level factors leading to WPV, such as: organisational (high workloads, weak leadership, lack of peer support); individual (emotional demands, low resilience); and, societal normalisation of violence. Little is known, however, about the experiences and perceptions of South African HCWs in primary health care (PHC) facilities and their understanding of the causes of WPV, despite being in public facing roles that heighten exposure to aggression.
AIM:
To explore the perceptions of healthcare workers (HCWs) and managers on the underlying reasons for WPV in one sub-district in Gauteng.
METHODS:
An exploratory qualitative study was conducted with participants from 26 PHC clinics, three community health centres and four ambulance centres. 32 in-depth interviews were held with 16 HCWs who volunteered to participate and 16 managers who were selected purposively. The transcripts were coded inductively with thematic analysis.
RESULTS:
Themes identified include: i) Mismatch between patient and HCW expectations in that patients present with unrealistic demands about entitlement to care, waiting times and emergency triage; ii) health systems challenges, including structural limitations and resource constraints as well as tensions between HCWs; iii) societal and political inequities such as poverty, unemployment, substance abuse and normalised violence that spill over into PHC facilities and act as upstream drivers of WPV displacing anger towards frontline HCWs; iv) Personnel stress and burnout that function both as outcomes of systemic pressures and as accelerators of WPV.
CONCLUSIONS:
Our study reveals the complex dynamics underpinning WPV in PHC settings, pointing to the need for multifaceted prevention and mitigation strategies. The reasons for WPV identified here can serve as starting points to address workplace safety in PHC, which is the backbone of the health care system in South Africa.
| eISSN: | 2654-1459 |
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