Night shift work, commonly defined as employment conducted between 6 PM and 6 AM, remains an essential component of healthcare systems worldwide, ensuring continuous patient monitoring and uninterrupted service delivery [1]. In hospital settings, healthcare personnel working night shifts are expected to maintain high levels of vigilance, clinical judgment, and productivity despite operating during biologically unfavorable hours. However, evidence increasingly demonstrates that night shift work disrupts circadian rhythms and is associated with adverse health outcomes such as sleep disturbances, cardiovascular disorders, mental fatigue, and reduced cognitive performance, all of which can compromise job efficacy and patient safety [2]-[4].

The effectiveness of night shift healthcare personnel is influenced by a complex interplay of economic, social, and environmental factors. Economically, inadequate financial incentives and irregular night-duty compensation have been linked to reduced motivation, increased occupational fatigue, and diminished work commitment, particularly in resource-limited settings [5][6]. In many low- and middle-income countries, healthcare workers often engage in additional income-generating activities to supplement insufficient salaries, thereby limiting rest and exacerbating fatigue during nocturnal duties [6]. Socially, night shift work disrupts family life, social interactions, and community participation, often resulting in work-family conflict, social isolation, psychological stress, and burnout, all of which negatively affect professional engagement and performance [7][8]. Environmental conditions within healthcare facilities also play a critical role in determining night shift efficacy. Adequate lighting, functional equipment, proper ventilation, and safe working conditions are essential for maintaining alertness and reducing clinical errors during night hours [9][10]. Conversely, poor infrastructure, excessive noise, uncomfortable temperatures, and limited rest areas can intensify fatigue and impair decision-making. These challenges are particularly pronounced in African healthcare settings, where limited resources, inadequate staffing, and high patient-to-provider ratios place additional strain on healthcare personnel [11][12].

In Cameroon, healthcare institutions continue to face persistent workforce shortages, suboptimal working environments, and inadequate institutional support systems that may adversely affect night shift performance [13]. At St. Blaise Catholic Hospital in Bamenda, healthcare personnel play a critical role in sustaining overnight clinical services; however, anecdotal evidence suggests that economic stressors, social disruptions, and infrastructural constraints may compromise their efficiency and the quality of patient care. Despite the importance of these challenges, empirical data examining the determinants of night shift efficacy at the institutional level remain scarce. This study therefore seeks to assess the economic, social, and environmental factors affecting night shift efficacy among healthcare personnel at St. Blaise Catholic Hospital Bamenda, with the aim of generating evidence to inform targeted interventions and improve healthcare delivery outcomes.

This study was conducted at Saint Blaise Catholic Hospital, a major faith-based healthcare institution located in Mankon, Bamenda, Cameroon, established by the Catholic Church in the 1940s and renowned for providing comprehensive medical services, including emergency care, surgery, obstetrics, and orthopedics, to the local and surrounding communities. An institutional based cross-sectional study design was employed over a one-month period from 10th February to 6th March 2026 to assess the economic, social, and environmental factors affecting the efficacy of night shift duty among healthcare personnel working night shifts. The study included consented night-duty healthcare workers and excluded those who declined participation or submitted incomplete questionnaires. A sample size of 50 participants was determined using Cochran’s formula and selected through simple random sampling to minimize selection bias. Data was collected using structured questionnaires comprising socio-demographic information and sections on economic, social, and environmental determinants of night shift efficacy. The questionnaire was pretested among 20 healthcare personnel at St. John Ntaghan to ensure validity and reliability. Data collection followed ethical procedures, including informed consent and participant confidentiality. Collected data was checked for accuracy, securely stored, and analyzed using Microsoft Excel, with results presented in tables, charts, and graphs. Inferential statistics, including Chi-square and regression analyses, was used to determine associations between variables, with statistical significance set at p ≤ 0.05. Ethical approval was obtained from the relevant academic department and hospital administration before commencement of the study.

The socio-demographic profile of respondents revealed a relatively young, moderately experienced, and predominantly female healthcare workforce, with most participants aged 26 - 35 years and females comprising 60% of respondents. This reflects workforce patterns commonly observed in low- and middle-income countries, where healthcare systems rely heavily on younger professionals due to ongoing workforce shortages and attrition [13][14]. The predominance of female healthcare personnel is consistent with global nursing trends and is particularly relevant in the context of night shift work, as female workers often experience greater work-family conflict and fatigue, which may affect shift performance [15][16]. The dominance of HND/SRN holders suggests that mid-level professionals constitute the backbone of service delivery, highlighting the importance of continuous professional development and supportive supervision to sustain clinical competence and effective workload management [17]. Additionally, the concentration of respondents in maternity services aligns with Cameroon’s national healthcare priorities emphasizing maternal and neonatal care [18].

Economic factors were identified as important determinants of night shift efficacy. Although a majority of respondents reported receiving some form of motivation for night duty and perceived institutional budgeting for night operations as sufficient, a substantial proportion indicated that their salaries were inadequate to meet basic needs. This finding supports earlier evidence that financial incentives significantly influence motivation, job satisfaction, and performance among healthcare personnel [5][19]. As noted in the introduction, inadequate remuneration and inconsistent compensation can contribute to occupational fatigue, reduced commitment, and diminished concentration during night duties [6]. The disparity between perceived institutional support and personal economic dissatisfaction suggests that financial planning alone may not adequately address individual motivation unless compensation is perceived as fair and commensurate with workload demands [20].

Social factors also significantly influenced night shift effectiveness. Positive social interaction among colleagues was widely recognized as enhancing job satisfaction and resilience, supporting previous findings that collegial support improves teamwork, reduces occupational stress, and promotes better patient care outcomes [21]. However, work-life imbalance emerged as a major challenge, with most respondents reporting that night shifts negatively affected family routines and personal well-being. This finding reinforces earlier evidence that night work disrupts social and family life, contributing to burnout, sleep deprivation, and decreased professional engagement [7][8]. Social support from family and friends appeared beneficial but varied across respondents, likely reflecting differences in personal responsibilities and household structures. Furthermore, negative cultural perceptions of night shift work may reduce professional recognition and morale, particularly in African settings where nocturnal work is often associated with hardship and limited social appreciation [22].

Environmental conditions were found to be major determinants of night shift performance. Most respondents identified poor lighting, excessive noise, and inadequate temperature or ventilation as factors that negatively affected their effectiveness. These findings are consistent with previous reports highlighting the importance of supportive physical environments in maintaining alertness, reducing fatigue, and minimizing clinical errors during night shifts [9][10]. Inadequate safety measures during night duty further raised concerns about occupational security and psychological well-being, both of which are critical for effective healthcare delivery [23]. Additionally, long residential distances from the hospital were reported by many respondents and may contribute to commuting fatigue, reduced sleep duration, and impaired readiness for duty. Overall, these findings support the evidence presented in the introduction that economic, social, and environmental stressors interact cumulatively to influence the efficacy of healthcare personnel working night shifts, ultimately affecting both staff well-being and quality of patient care [12].

Night shift efficacy at St Blaise Catholic Hospital Bamenda is influenced by an interplay of demographic, economic, social, and environmental factors. The workforce is predominantly young, moderately experienced, and female, which shapes both strengths and vulnerabilities in shift performance. Economic conditions are partially supportive at the institutional level, but individual salary dissatisfaction remains a key limitation. Socially, teamwork and support systems enhance performance, while work-life imbalance and cultural perceptions reduce effectiveness. Environmentally, poor working conditions and long commuting distances significantly undermine night shift efficiency.

This study had several limitations that should be considered when interpreting the findings. First, the use of a cross-sectional study design limited the ability to establish causal relationships between economic, social, and environmental factors and night shift efficacy. Second, data were collected through self-reported questionnaires, which may have introduced response bias, including social desirability and recall bias. Third, the relatively small sample size and focus on a single institution—Saint Blaise Catholic Hospital, may limit the generalizability of the findings to other healthcare settings in Cameroon. Additionally, time constraints during the one-month study period may have restricted broader participant engagement and more in-depth exploration of contextual factors influencing night shift performance.