Work-related psychological distress among teachers in southwest Nigeria: a rural and urban comparison

Background: The jobs of teachers involve high demand and low control, which predisposes them to psychological distress. Differences in the basic infrastructure in rural and urban areas may influence the psychological health status of teachers. Objectives: We assessed the prevalence of psychological distress and associated work-related factors among secondary school teachers in rural and urban areas of southwest Nigeria. Methods: A cross-sectional analytical study design was utilised. Teachers from rural (n = 578) and urban (n = 596) areas were selected using multistage sampling. Sociodemographic and occupational characteristics were recorded, and the 12-item General Health Questionnaire (GHQ-12) was used to assess psychological distress, using a cut-off score of ≥ 3 to indicate distress. Data were analysed using SPSS version 23. Chi-square analysis was used to test for differences between categorical variables and Student's t-test was used to check for differences in means. Logistic regression analysis was conducted to determine predictors of psychological distress. Statistical significance was set at 5%. Results: Rural-based teachers were significantly younger than those in urban locations (p = 0.013), had fewer mean years of work experience (p = 0.043), taught larger class sizes (p < 0.000), had more financial dependants (p = 0.001), and spent less time at work each day (p < 0.000). More rural- than urban-based teachers had other jobs in addition to teaching (p = 0.023). Overall, 38.1% of the teachers were psychologically distressed: 42.7% in rural and 33.6% in urban schools (p = 0.001). Factors associated with psychological distress were being married (p = 0.007), teaching in a public school (p = 0.007), and teaching > 5 subjects (p < 0.001). The adjusted odds of psychological distress were higher in teachers in rural schools (AOR 1.30, 95% CI 1.02­1.67), and in public schools (AOR 1.58, 95% CI 1.19­2.11). The adjusted odds increased by 19% for every additional subject taught, and by 2% for every hour spent teaching. Conclusion: Teachers in rural schools had more psychological distress than those in urban ones. Distress was associated with both individual and workrelated characteristics. Teachers' work conditions in rural schools need to be improved to provide an incentive for them to work and remain in remote