Psychosocial Stress Among Healthcare Workers in Rwanda: A Narrative Review

Abstract

Background: Psychosocial stress is a major occupational health issue worldwide, and it is especially severe among healthcare workers (HCWs) in resource-limited and post-conflict environments like Rwanda. Despite widespread acknowledgement of the burden, there is limited and fragmented evidence regarding its prevalence, contributing factors,and effective interventions for Rwandan HCWs.
Methods: This narrative review incorporated 35 peer reviewed studies, published from 2000 to 2025, which were
retrieved from PubMed, CINAHL, and Web of Science. The inclusion criteria for studies mandated an examination of psycho-social stress, burnout, anxiety, depression, or post-traumatic stress disorder (PTSD) within healthcare workers (HCWs) in Rwanda or comparable low and middle income country (LMIC) contexts. Thematic synthesis was employed across five key domains: prevalence, risk factors, coping strategies, organizational interventions, and health outcomes.
Results: The analysis indicated that Rwandan healthcare workers (HCWs) experienced considerable psychological and social distress. Specifically, over half of the HCWs at King Faisal Hospital reported burnout. In addition, 80% of the intensive care unit (ICU) nurses reported experiencing moderate to high levels of workplace stress. Major risk factors included high workloads, shortages of staff and medication, workplace violence, stigma, and lingering trauma from the 1994 genocide. Although adaptive coping mechanisms, including social support networks and religious practices, were frequently employed, maladaptive approaches such as alcohol consumption were also documented. Organizational interventions, such as mindfulness based programs, show potential; however, they necessitate cultural adaptation due to Rwanda’s predominant stigma and resource limitations.
Conclusion: Psychosocial stress affects HCWs’ mental health, job performance, and the safety of the patients. This poses a substantial threat to Rwanda’s healthcare system. There is an urgent need for culturally informed, scalable interventions and policy measures to safeguard HCW well-being and foster a resilient health workforce in Rwanda