Table 1.

Characteristics of included studies.

Authors	Country	Population/variables studied	N	Method	Response Rate	Results
Abdellah et al., (2017)	Egypt	Health workers/workplace violence against health workers	142	Cross-sectional	94.4%	Prevalence: overall 59.7% Prevalence by staff: nurses (65.7%), doctors (45.3%), housekeeper (71.4%). By Gender: (60.9%) female, male (39.1%), by age: <30 yrs (54.6%), >35yrs (37.8%), by experience:< or = 5yrs (67.6%) Types: verbal (58.2%), physical (15.7%), Correlates: age (p < 0.00) more in the young people. Profession (p < 0.046) more in nursing than others, duration of work (p < 0.007) more at night, marital status (p < 0.004) more in singles and separated than married. Perpetrators: patients and patients' relatives (90%), Staff& supervisors (25%) Policy on violence: non-existent Cause of Violence: Patient waiting time, unmet patients' needs.
Samir et al. (2012)	Egypt	Nurses/workplace violence	500	Cross- sectional	83.2%	Prevalence: 86.1% in 6 months with 53% having three or more cases. Majority were young age <30 years. Perpetrators: patients (14.7%) patients' relatives (38.5%), colleagues (54.5%). Types: 78.1% (psychological), 27.2% (physical), 4.6% (Sexual). Causes: Workload (40.5%), Carelessness & malpractice (35.8%) & understaffing. Policy: Non-existent but procedure for reporting of violence exist Impacts: 87.2% reported serious impact Correlates: age <30yrs, sex more in females than male, marital status.
Yenealem et al., (2019)	Ethiopia	Health workers/workplace violence against	553	Cross-sectional	96.02%	Prevalence: 58.2% in 12 months. Prevalence by gender: female (verbal = 57.1%), physical attack (59%), Sexual (100%) generally more in females than males. Types: verbal (53.1%), physical attack (22%) and sexual harassment (7.2%) Perpetrators: Patients, patients' relatives & colleagues at work Correlates: emergency department (OR = 3.99,CI = 95%), Shiftwork (OR = 1.98, CI = 95%), Work Experience(OR = 3.09), Being a Nurse (OR = 4.06, CI = 95%) Policy: Non-existence of policy and procedure for violence was reported.
Kennedy et al., (2013)	South Africa	Nurses/workplace violence against	71	Qualitative	100%	Prevalence: 100%of the respondents Types: physical, psychological, verbal Perpetrators: patients, patients' relatives Policy on violence: No existing policy on violence was reported Impacts: feeling of rejection and low morale among the respondents were reported.
Azodo et al. (2011)	Nigeria	Dentist/workplace violence against	175	Cross-sectional	78.9%	Prevalence: 39.1% Causes: Long waiting time (27.3%), cancellation of appointment (13.6%), treatment outcome (11.4%), alcohol intoxication (9.1%), psychosis (6.8%), Patients' bill (4.5%), & others (27.3%). Types: physical violence: Shouting (50%), Verbal threat (22.7%), swearing (2.3%), bullying & hitting (18.2%); sexual violence (6.8%). Perpetrators: Patients (54.5%), patients' relatives (18.2%), colleagues (22.7%). Impacts: impaired job performance (15.9%), Psychological trauma (13.6%), Absenteeism from work (9.1%).
Abou- Elwafa et al. (2015)	Egypt	Nurses in Emergency & non- emergency units/workplace violence against	134and152	Cross-sectional	96.7%	Prevalence: 54.7%. 6.8% non-emergency nurses reported fear for violence, 28.1%of emergency nurses reported exposure to types of violence while 46.9% non-emergency reported one type of violence. Types: Verbal and sexual violence were the common types reported. Correlates: Work shift (OR = 0.5), Emergency unit (OR = 2.0), Age (OR = 1.9), Specialty (P < 0.001), Work experience (p < 0.001). Perpetrators: Patients' relatives: physical (61.8%), Verbal (63.6%) and Bullying (50.5%). Staff members (36.4%). Impacts: 24.7% desired to change work environment. Policy: None reported existence of policy of violence. 71.8%, 77.1% & 73,7% never reported nor took any action against violence.
Abodunurin et al. (2014)	Nigeria	Health workers/workplace violence against	242	Cross-sectional	96.8%	Prevalence: Nurses (53.5%), Doctors (21.5%). Annually, 31doctors, 77 nurses, 36 others had violence. Perpetrators: patients (46.1%), patients' relatives (49.5%) Types: Verbal (64.6%), Physical (35.4%) Correlates: Age (young p < 0.0001), Work (p < 0.0045), Unit (p < 0.01). Policy: None reported
Boafo et al. (2016)	Ghana	Nurses/workplace violence against	685	Cross-sectional	86.4%	Prevalence: 64.2% Types: sexual (12.2%), verbal (52.7%) Perpetrators: Doctors (sexual 50%), patients' relatives. Policy: no policy but there is formal violence reporting procedure (72.9%). Correlates: Area of work (p < 0.01), Female (p < 0.01), age (p < 0.01), Marital status (p < 0.01). Impacts: verbal abuse was significantly correlated with quitting nursing (p < 0.05)
Khalil (2009)	South Africa	Nurses/workplace violence against	471	Ethno-phenomenology	84%	Prevalence: 54% Types: psychological (45%), Vertical (33%), covert (30%), horizontal violence (29%), overt violence (26%), physical violence (20%). Causes: lack of effective communication among nurses, lack respect among staff, lack of training on anger management among staff.
Olashore et al. (2018)	Botswana	Health Staff/workplace violence against	210	Cross-sectional	85.2%	Prevalence: 78.1%lifetime, 44.1% annual. Types: Hitting (41.1%), kicking (21.8%), pushing (20.2%) and shaking (12.1%) Perpetrators: patients. Areas: Higher incidence in acute wards (58.1%), other wards (22%). Causes: Provocation of patients (16.9%), attempt to calm patient down (33.3%) Impacts: 28% of the victims sustained injury, 18.5% of required medical attention, 72.6% required emotional support, 8.9%had other supports but 18.5%had no support. Higher level of job dissatisfaction was noted among the victims of violence than others. Correlates: Nursing (p < 0.01), work experience (P < 0.01). Policy: none reported to exist.
Boafo & Hancock2017	Ghana	Nurses/workplace violence against	592	Cross-sectional	100%	Prevalence: 9% Female (79.2%) & male (20.8%) Types: physical violence (9%) Perpetrators: Patients, Patients' relatives (58.5%), Doctors, nurses Impacts: extreme concerns about violence were reported, 20.8% got injured, 17% received medical attention for the injury 19.9% intend to quit nursing (p < 0.001), loss of least 11 days working days. Policy: no existing policy on violence Correlates: type of hospital (p < 0.01).
Tiruneh et al. (2016)	Ethiopia	Nurses/workplace violence against	386	Cross-sectional	90.2%	Prevalence: 26.7% Types: physical (60.2%), Psychological (39.8%). Gender: male (59.2%), Female (40.8%). Impacts: dissatisfaction with job (38.83%), absent from work (36.9%) Perpetrators: patients and patients' relatives (16.1%), staff (27.18%). Correlates: age (younger than 30yrs AOR = 0.324), Small number of staff (AOR = 2.024), working in male ward (AOR = 7.918), History of violence(AOR = 0.270), Marital status single(AOR = 9.153), Widowed/separated (AOR = 7.914). Policy: non-existent, no actions usually taken by management following notice of violence.
Seun-Fadipe et al., 2019	Nigeria	Health workers/workplace violence against	380	Cross-sectional	95%	Prevalence: 39% (12months) Types: physical (10.2%), verbal (31.9%), bullying (13.3%), sexual harassment (3.3%). Perpetrators: patients: (physical, 62.2%), verbal (26.1%), bullying (10.4%), sexual (16.7%); patients' relatives: physical (29.7%), verbal (50.4%), bullying (12.5%), sexual (16.7%); staff members: physical(5.4%), verbal(20.9%), bullying (70.9%), sexual (66.7%), supervisors: physical (2.7%), verbal (2.6%), bullying (6.3%) and sexual (0.0%). Impacts: 38.5% high risk for psychiatric morbidity linked to experience of violence (p = 0.037). Correlates: age (21–30yrs) (p < 0.001), gender (female) (p = 0.048), work setting (emergency & psychiatric units) (p < 0.001) were correlated with experience of violence at work.
Sethole et al. (2019)	South Africa	Radiographers/workplace violence against	65	Cross-sectional	57%	Prevalence & types: verbal abuse (73%), Emotional (46%), and physical (27%). Perpetrators: patients: verbal (8%), physical (15.8%) & non-verbal (4.1%). Patients' relatives: verbal (3.6%), physical (2.4%), non-verbal (2.8%). Nurses: verbal (7%), physical (0%), non-verbal (7.2%). Doctors: verbal (7.6%), physical (0%), non-verbal (4%).
Muzembo et al. (2015)	D. R. Congo	Health workers/workplace violence against	2210	Cross-sectional	99%	Prevalence: 80.1% (24.9% had once, 63.6% had two or more exposure). Types: verbal (57.4%), harassment (15.2%), physical (7.5%) & combined (11.9%). Perpetrators: patients (41%), patients' relatives (28–31%). Correlates: work experience (<5years) (p < 0.005), gender (p = 0.024) and marital status (p < 0.009).
Amkongo et al. (2019)	Namibia	Radiographers/workplace violence against	15	Cross-sectional	86.7%	Prevalence: 100% Types: verbal abuse (100%), verbal threat (84.6%), sexual harassment (84.6%), and physical assault (46.2%). Perpetrators: patients and patients' relatives. Impacts: anxiety (53.8%), feeling guilt or ashamed (7.7%), sad (38.5%), heartbroken (15.4%), afraid (38.5%) and others (15.4%).
Ogundipe et al. (2013).	Nigeria	Nurses/workplace violence against	81	Cross-sectional	90%	Prevalence: 88.6% witness and 65% victims, 15% threatened with weapon, 38% in the evening shifts. Perpetrators: patients' relatives. Impacts: declined productivity (24.5%), loss of confidence (15.2%), lack of job satisfaction (75.6%). Policy on Violence: non-existent with 83.6% reporting dissatisfaction with the way violence at work is being managed.
Sisawo et al. (2017)	Gambia	Nurses/workplace violence against	219	Mixed method	98.2%	Prevalence: 62.1% Types: physical (17.4%), verbal (60%), sexual harassment (10%). 22.5% of victims of physical violence had 2-4 times experience while 23% had been threatened with weapons. Perpetrators: patients: physical (33.6%), verbal (39.5%) and sexual (18.2%); patients' relatives: physical (54.2%), verbal (47.4%) & sexual (40.9%); staff: physical (5.34%), verbal (7.9%) and sexual (9.1%); Supervisors: physical (3.05%), verbal (2.6%) and sexual (4.5%). Correlates: Nurses Attendants (OR = 2.9, 95%, CI = 1.04–6.37); Area of work (OR = 2.9, 95%, CI = 1.16–7.35); General Nurses (OR = 4.1, 95%, CI = 1.09–2.59). Policy on violence: non-existent
Boafo (2018)	Ghana	Nurses/workplace violence against	592	Cross-sectional	58%	Prevalence: 73.9% (12 months). Types: Physical (9.0%), verbal (52.7%) and sexual (12.2%). Impact: the nurses were neither satisfied nor dissatisfied with their job due to violence.
Banda et al. (2016)	Malawi	Nurses/workplace violence against	190	Cross-sectional	60%	Prevalence:71% Types: physical assault (22%), sexual (16%), verbal abuse (95%), threatening behaviours (73%) and others (3%). Perpetrators: patients (71%), patients' relatives (47%), & colleagues (43%). Impacts: 80% nurses reported psychological trauma, loss of interest in nursing profession and low job performance.
Ukpong et al. (2011)	Nigeria	Mental health staff	120	Survey	84.2%	Prevalence: 49.5% with 12 months prevalence of 33.7% Profession: nurses (82.3%), doctors (17.6%) Types: push (44%), hit with object (28%), clothes torn (15%), attempted strangling (10%) and rape (2%). Impacts: 88% sustained injuries requiring medical attention. Perpetrators: patients Recommendation: formulation of policy on violence.
Akkani et al. (2019)	Nigeria	Mental health professionals	124	Cross sectional	85.5%	Prevalence: 62.1% career lifetime, 30.6% 12 months prevalence. Types: physical violence (hitting, kicking, striking with objects and attempted strangling). Common antecedent event: calming of aggressive patients, talking to patients, giving instructions to patients, and unprovoked. Impacts: 42.4% experience of posttraumatic stress disorders symptoms, 22.1% sustained injuries requiring hospital care. Correlates: age (p = 0.04), long years of practice (p = 0.01) and job dissatisfaction (0.05). Perpetrator: patients.