The welfare of healthcare professionals has been the subject of intense scrutiny by several students in the Health Services Management programme for the M.Sc at the University of Technology Mauritius (UTM) since 2018. Two recent studies by graduates of the programme, Dr Nadia Narainen and Irisan Suryen, two frontliners (see note below), focused on burnout among healthcare professionals and the direct and indirect implications of increased workloads for service providers, patients, and the quality of services delivered. The economic implications of these findings raise serious concerns about the sustainability of our health system, as Gareth White, a health economist and an ad hoc lecturer at UTM, suggests.

As the article An assessment of the Mauritius Health Care Strategy by Prof. Reetoo Banarsee published in l’express on 2 March 2026 points out, the Mauritian health system has much to be proud of, having improved citizens’ life expectancy and continually sought to increase coverage. Decisionmakers are seeking opportunities to train their human resources, secure fair prices for medications, and improve equipment and infrastructure, as evidenced by partnerships with governments and stakeholders in Japan, India, and Pakistan. The Health Sector Strategic Plan 2025-30 is meant to act as both a catalyst and a roadmap for key pillars for the health sector – elderly care, the fight against non-communicable diseases and long-standing programmes, such as digital health to create a single patient ID system.

The vision is bold, and the annual health sector budget is indeed significant, with an estimated Rs 17.2 billion for 2025-26, potentially reaching Rs 18.17 billion by 2027-28. Making key indicators on patient satisfaction and health equity metrics available is a must to ensure that those in greatest need have access to appropriate services. What then, about those meant to take care of us, coach us and guide us as patients, and devise information services for the public – doctors, nurses, paramedics, technical staff and administrators? Are frontliners spearheading the change or cogs in a growing machine? The vision is set to yield concrete results with human resource capability – the actual heart of the health system – being a key theme.

Derived from the Human Capital paradigm developed by economists in the 1960s to guide investment in human resources at the population level, “Human capital for health” focuses on the knowledge, skills, experience, physical and mental well-being of the health workforce. The rationale for this is that the most advanced health technology does not amount to much without trained and willing professionals using it to produce quality services which improve the health status of patients. Investing in the health workforce involves developing adequate personnel through appropriate training, ensuring the right people are in the right places, keeping staff motivated, providing adequate pay, ensuring safe working conditions, supporting professional growth and continuous professional development. Global bodies, including the World Health Organization (WHO) and the Organisation for Economic Co-operation and Development, note a tightening labour supply in healthcare, driven by chronic staff shortages, post-pandemic burnout, and demographic pressures from an ageing workforce. McKinsey also monitored and made public the persistent issue of burnout among nurses in the United States post-Covid-19.

According to the WHO, the Mauritian health system remains among the most developed in Africa, with 3,800 medical doctors in 2022, indicating a doctor-to-population ratio exceeding 3 per 1,000, or several times the regional average. The nurse-topopulation ratio is even higher, at approximately 4.05 per 1,000. Such figures include health professionals (doctors, nurses and midwives) employed in the private sector who account for roughly 30% of the national health workforce, according to the National Integrated Care for Older People Strategic and Action Plan. This implies that the 8.8 million contacts during that same year in public health institutions – more than 5 million visits recorded at hospitals and primary healthcare facilities – were catered for by only 70% of the national workforce. Such figures suggest a significant individual workload and imply serious sustainability issues for the overall health system.

Burnout is a condition caused by prolonged workplace stress and is a common challenge in the healthcare industry. This psychological state manifests in three interconnected dimensions: it begins with emotional exhaustion, in which the individual feels physically and mentally depleted. This often leads to depersonalisation, a defensive detachment where healthcare providers develop a cynical or callous attitude toward their patients. Ultimately, these feelings result in a sense of reduced personal accomplishment, characterised by a declining belief in one’s professional competence and the feeling that one’s work no longer carries meaningful value or impact.

The first study, conducted in 2024, employed both quantitative and qualitative data collection tools to assess burnout among 204 nurses in Mauritius. The Maslach Burnout Inventory (MBI) was used for the quantitative component.

MBI for the quantitative component

Conducting 19 in-depth interviews with participants from the quantitative sample helped to gain deeper insights into burnout through firsthand experiences. The quantitative results revealed high levels of emotional exhaustion and depersonalisation.

A significant association was found between patient loads and emotional exhaustion. Moreover, a substantial portion of nurses reported a feeling of low personal accomplishment, and burnout was associated with worse patient care, as evidenced by increased medical errors (r = -0.31, p < 0.01). Factors such as high patient loads, inadequate staffing, and prolonged working hours were identified as major contributors to burnout. Coping resources such as exercise, leisure activities, and social networks were found to be helpful, but organisational support was considered inadequate.

The second study, carried out in 2025, examined the relationship between burnout and work-life balance through a sample of 110 Mauritian doctors. The study was motivated by rising concerns over the increase in workplace stress and the increasing difficulty Mauritian doctors face in finding the perfect work-life balance following the Covid-19 pandemic. The data collected included: demographic information, burnout dimensions, emotional exhaustion, depersonalisation, personal accomplishment as well as workload, control, reward, community, fairness and values. The high level of prevailing emotional exhaustion (65.5%) and depersonalisation (70.9%), observed in early career public sector doctors, highlighted the acute pressure existing in our resource-limited setting.

The analysis also revealed a high level of resilience for personal accomplishment, implying that despite high burnout levels, Mauritian doctors still take pride in their medical role. The negative relationship between some domains of worklife balance and burnout indicators highlighted the avenues requiring more attention. The study acknowledged these constraints and argued that burnout in the Mauritian context is multifaceted and systemic. Both studies converge on several key findings and recommendations for preventing and mitigating this pervasive issue.

Recommendations for prevention and mitigation

• Increase staffing: Both studies stress the need for more healthcare staff to reduce workload, improve patient to professional ratios, and support better worklife balance for doctors and nurses.

• Strengthen mental health support: Regular checkins, counselling, peer groups, resilience training, and stress management programmes should be expanded, with a shift toward proactive rather than reactive support.

• Reduce administrative load: Streamlining paperwork and delegating nonclinical tasks – especially for nurses – can ease pressure, with technology playing a key role.

• Promote worklife balance: Flexible schedules, shift options, part-time roles, and greater autonomy over working hours are recommended, particularly for doctors.

• Invest in development: Ongoing training in stress management, clinical skills, and leadership can boost satisfaction, career progression, and resilience.

• Improve workplace culture: A supportive environment built on teamwork, open communication, recognition, and fair treatment is essential, especially for doctors who value perceived fairness.

• Address systemic issues: Policy-level changes are needed to ensure safe staffing, fair hours, and adequate resources. More research is required to assess the impact of such reforms.

• Tailor interventions: Strategies should be adapted to the distinct needs of different professional groups rather than relying solely on broad, systemwide solutions.

Conclusion

While the Ministry’s decision to recruit professionals from abroad is a commendable effort, systemic action is required. By implementing these recommendations as part of a distinct and inclusive “Human Resource Strategy for Healthcare”, organisations and policymakers in Mauritius can create a healthier and more sustainable work environment for healthcare professionals, ultimately benefiting both their well-being and the quality of patient care.

Key learnings on burnout among healthcare professionals

• High prevalence: Burnout is widespread among doctors and nurses, with both groups showing strong emotional exhaustion and depersonalisation. Nurses also report fluctuating personal accomplishment, confirming burnout affects multiple professions.

• Drivers: Shared causes include long hours, heavy workloads, and poor work–life balance. Nurses additionally face high patient loads, critical cases, staff shortages, and administrative strain. For doctors, lack of control, limited recognition, and perceived unfairness are major contributors. Cultural acceptance of overwork may explain why workload feels less decisive for them.

• Effects on care and health: Burnout undermines empathy, communication, and teamwork, affecting patient care. It also harms physical and mental health, contributing to fatigue, sleep issues, anxiety, and depression.

• Coping and support gaps: Professionals rely on exercise, hobbies, and social support. Organisational support exists but is viewed as inconsistent and insufficient, with calls for more proactive, sustained interventions.

• Cultural influence: Mauritian norms shape resilience and expectations. The doctors’ sense of high personal accomplishment despite exhaustion suggests strong professional pride and community support, alongside a cultural normalisation of overwork.

Note: The dissertations written for the MSc Health Services Management programme were analysed with the permission of the authors reserving their rights to intellectual property.

“Burnout among nurses in Mauritius: a mixed method study” (June 2024) by Irisan Suryen, [email protected]

“Exploring the relationship between burn-out and work-life balance among medical practitioners – a case study in Mauritius (February 2025) by Dr Nadia Narrainen, [email protected]