A systematic review of global interventions for sustainable strategies to reduce healthcare worker burnout and turnover in underserved areas of the United States

Abstract

Abstract Background Healthcare worker burnout and turnover are pressing global concerns, exacerbated by systemic inequities, workforce shortages, and occupational stress. A range of interventions—including community-driven, hospital-based, and primary care-based strategies—have been implemented to enhance the retention and well-being of healthcare providers. However, their effectiveness and long-term sustainability, particularly in the context of underserved U.S. communities, remains insufficiently understood. Main body This systematic review aimed to (1) assess global interventions—including community-driven, hospital-based, and primary care-based strategies—addressing healthcare worker burnout and workforce retention; (2) identify transferable components for underserved U.S. communities; and (3) examine systemic barriers and facilitators influencing implementation. A total of 29 studies were analyzed. Effective strategies featured leadership engagement, resource equity, and integrated support structures. Barriers included financial constraints, policy misalignment, and cultural resistance, while facilitators encompassed institutional commitment and cross-sector collaboration. Studies with higher methodological rigor demonstrated the value of embedding equity-driven, scalable solutions into healthcare systems. Conclusions Global interventions addressing burnout and retention provide transferable strategies that can enhance the U.S. healthcare workforce, particularly in underserved areas. Sustainability hinges on integrating these approaches into institutional policies, ensuring leadership support, and leveraging implementation science frameworks.