Health Seeking Behaviour of Community Health Volunteers Working With Survivors of Gender Based Violence in Relation to Burnout and Vicarious Trauma in Informal Settlements

Abstract

Background: Community Health Volunteers (CHVs) close the gap between communities and the formal health system. They have a very important role in referral, health promotion, and prevention at the community level. Continuous exposure to individuals experiencing trauma may lead to provider burnout. Study Objective: To determine the prevalence of burnout, vicarious trauma, and help-seeking behaviors of CHVs working with survivors of gender-based violence in an informal settlement in Nairobi County, Kenya. Methods: The study used a cross-sectional mixed-method survey design to determine the prevalence of burnout and vicarious traumas experienced by CHVs working with survivors of gender-based violence in informal settlements in Nairobi County and describe their help-seeking behavior. The independent variable of this study was secondary exposure to trauma while working as a CHV in the GBV services. The dependent variables were Burnout and Vicarious Trauma and help seeking behavior. Structured questionnaire was used to collect quantitative data, while focused group discussion (FGD) to collect Qualitative data. Data Analysis: Quantitative data were analyzed using both descriptive and inferential statistics. Descriptive analysis involved frequencies and proportions for categorical data and mean and standard deviations for continuous variables. Comparison between categorical variables was done using Chi-Square tests and comparisons between continuous variables were done using t-tests. Analysis of qualitative data was carried out using a thematic framework approach aided by QSR NVivo 12. Results from the quantitative data and qualitative data were triangulated as much as possible for context and for more in-depth understanding of the findings. Results: (21%) of the participants were found to have average burnout and close to 80% had low burnout levels. Females (22%) compared to the male CHVs (11%) were more likely to have average burnout. Older CHVs (21% for 41-50 years old and 25% for the >50 years old), were more likely to have average burnout compared to the younger CHVs (17% for <30 years old and 12% for the 30-40 years old). There was a significant negative correlation between compassion satisfaction score and burnout (r=-0.52, p<0.001), and a significant positive correlation between burnout and secondary traumatic stress (r=0.54, p<0.001). Both male and female CHVs were willing to seek help from a mental health profession, however most men would seek help from their spouses while women preferred seeking help from religious leaders. Conclusion: The level of burnout was low in this study, and satisfaction with work was associated with low levels of burnout and secondary traumatic stress, implying that most CHVs are well equipped with coping strategies and were receiving support from their supervisors