The impact of job demands on service delivery through the mediating role of emotional exhaustion among public healthcare workers in South Punjab

Abstract The sustainability of public health systems relies heavily on the mental health and well-being of the healthcare workforce. In resource-constrained settings like South Punjab, Pakistan, excessive job demands pose a significant risk to both employee welfare and the quality of healthcare delivery. This study examines the impact of job demands on job performance, specifically investigating the mediating role of emotional exhaustion as a critical determinant of public health service effectiveness. Grounded in the Job Demands–Resources (JD-R) model and Effort–Reward Imbalance (ERI) theory, this research utilized a quantitative cross-sectional design. Data were collected through a structured questionnaire administered to a purposively selected sample of 249 healthcare professionals, including doctors, nurses, and paramedical staff, from public sector institutions. Structural Equation Modeling (SEM) using the Partial Least Squares (PLS) technique was employed to test the hypothesized relationships. The findings indicate that high job demands exert a significant positive effect on emotional exhaustion (β = 0.835), which subsequently degrades job performance. Emotional exhaustion was found to significantly mediate the relationship between job demands and performance (β = 0.426), suggesting that workforce burnout is a primary pathway through which systemic pressures undermine healthcare service quality.