Uncovering the determinants of poor welfare among doctors in the Central Region of Uganda, East Africa

Abstract

Welfare is the general health, happiness, and safety of a person or group. Anything that threatens or undermines this living state is a direct cause of poor welfare. Poor welfare, which results from multiple contributing factors, is a common issue experienced by many doctors in low-income countries. Remuneration remains a strong contributing factor to the improvement of doctor’s welfare. This study aimed to uncover the determinants of poor welfare among doctors in the Central Region of Uganda, East Africa. This study presents data collected through a self-administered questionnaire within the Uganda Medical Association Central branch jurisdiction. Analytical cross-sectional design with mixed method approach was used. Results Using WHO-5 well-being index, on average, the total raw score was 9(36%), which is well below score 13. Thus, out of the 111 doctors, 72% of the doctors had score below 13 (below 50%), hence poor mental wellbeing. Using Patient Health Questionnaire (PHQ-9), 20% of doctors had mild depression (score 5–9), 29% had moderate depression (score 10–14) and 49.5% had severe depression, all of which point to poor welfare. Net monthly income (p = 0.000), levels of burnout (p = 0.001) and depression (p = 0.000) were found to be determinants of poor welfare. After controlling for confounders, respondents who earned 2–3 million Ugandan shillings were 2.7 times more likely to have poor welfare [aPR = 2.71 at 95% CI(1.03–2.09)] compared with their colleagues who earned more than 5 million Uganda Shillings. Respondents with high level of burnout were 3.9 times more likely to have poor welfare [aPR = 3.92 at 95% CI(1.18–6.76)]. Poor welfare among doctors is a multifaceted problem driven by a combination of financial, environmental and institutional factors. The key determinants include inadequate compensation, extreme workload pressures, poor working conditions and significant psychological stress, which often lead to burnout.