Prevalence, Characteristics, and Associated Factors of Workplace Violence Against Healthcare Professionals in India: A Systematic Review and Meta-analysis

Background Workplace violence (WPV) against doctors, nurses, and other healthcare professionals is a growing public health concern affecting health systems in low- and middle-income countries. In India, incidents of WPV against health workforce have become common in recent years. However, there is no synthesized evidence on the nationwide burden of WPV in healthcare. This study aims to systematically evaluate the current evidence on the prevalence, characteristics, and associated factors of WPV against healthcare professionals in India. Methods We systematically searched seven major databases and additional sources to retrieved published literature on WPV in India. We included empirical studies without any time restriction, which reported the prevalence of WPV against healthcare professionals in India. Following data extraction, we estimated the pooled prevalence of WPV using random-effects model in meta-analysis. The characteristics and associated factors of WPV were narratively synthesized from these empirical studies. Results Among 1065 articles retrieved from multiple sources, 15 studies met our inclusion and exclusion criteria. The pooled prevalence of WPV among 2849 participants in those 15 studies was 63% (95% confidence interval [CI], 54%-72%). In the subgroup analyses, the pooled prevalence for male and female was 64% (95% CI, 51%-78%) and 54% (95% CI, 47%-62%) respectively. Moreover, pooled prevalence in 12-months and lifetime was 55% (95% CI, 43%-67%) and 69% (95% CI, 61%-78%) respectively. Among the participants, the prevalence of verbal violence (52%; 95% CI, 45%-60%) was higher than physical violence (8%; 95% CI, 5%-11%). The emergency department was a common location of WPV, whereas the patients’ attendants were perpetrators in most studies. Major factors associated with WPV included ineffective patient-provider communication, less experience of the healthcare professionals, overcrowding, shortage of resources, long waiting hours, lack of security measures, dissatisfaction about health services, high cost of care, the negative role of media, and other socio-behavioral problems among the patients and healthcare professionals. Conclusion WPV is highly prevalent among healthcare professionals in India. Critical challenges within the healthcare and social context necessitate further research, better policymaking, and multipronged interventions to address the same and prevent WPV against healthcare professionals in India.