Sex differences, prevalence, and factors associated with burnout among healthcare workers in Nigeria: a systematic review and meta-analysis

Abstract Background: Burnout threatens healthcare workers' wellbeing, care quality and safety, and retention in an already depleted Nigerian health workforce, yet national estimates remain fragmented across cadres, instruments, and case definitions. We estimated burnout prevalence and its dimensions among Nigerian healthcare workers, compared women and men, and examined sources of variation, temporal change, and determinants. Methods: We searched multiple databases from inception to 28 August 2026, updated to 24 September 2026, with African Journals Online and citation searching. Observational studies reporting burnout among Nigerian healthcare workers were eligible. Prevalence was pooled with random-effects models on the logit scale, with 95% prediction intervals. Heterogeneity, robustness, and small-study effects were examined by subgroup analyses, meta-regression, leave-one-out and sensitivity analyses, and funnel-based tests. Determinants were frequency-counted and certainty graded with GRADE (PROSPERO CRD420261488318). Results: Forty-two studies were included. Pooled burnout prevalence was 42.0% (95% CI 29.9 to 55.1; 26 studies; 6,430 participants). In full MBI-HSS studies, 36.1% (25.0 to 49.0) had high emotional exhaustion, 35.0% (24.6 to 47.1) high depersonalisation, and 45.3% (29.9 to 61.6) low personal accomplishment. Burnout affected 39.6% of men (22.4 to 59.8) and 37.7% of women (20.8 to 58.1) across the 13 studies reporting both, with no difference in the paired within-study comparison (prevalence ratio 0.96, 0.69 to 1.33). Prevalence rose from 22.6% before 2020 to 56.4% during 2020 to 2022 and 62.2% from 2023 onward (p = 0.003). Case definition explained 65.5% of between-study variance, and northern and multi-regional samples had higher estimates than southern samples (p = 0.028). Adverse work environment, call-duty hours, and psychological distress were the most consistently reported correlates. Certainty was very low for all outcomes. Conclusions Burnout affects a substantial, and apparently rising, share of Nigerian healthcare workers, but its measured magnitude depends heavily on how it is defined. Standardised measurement, national surveillance across all zones and levels of care, and organisation-directed interventions targeting workload, staffing, and working conditions are needed to protect the workforce and sustain health service delivery.