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‘Labouring’ on the frontlines of global health research: mapping challenges experienced by frontline workers in Africa and Asia

An innovative leadership development initiative to support building everyday resilience in health systems

Effective management and leadership are essential for everyday health system resilience, but actors charged with these roles are often underprepared and undersupported to perform them. Particular challenges have been observed in interpersonal and relational aspects of health managers’ work, including communication skills, emotional competence and supportive oversight. Within the Resilient and Responsive Health Systems (RESYST) consortium in Kenya, the authors worked with two county health and hospital management teams to adapt a package of leadership development interventions aimed at building these skills. This article provides insights into: (1) the content and co-development of a participatory intervention combining two core elements: a complex health system taught course, and an adapted communications and emotional competence process training; and (2) the findings from a formative evaluation of this intervention which included observations of the training, individual interviews with participating managers and discussions in regular meetings with managers.

Collective strategies to cope with work related stress among nurses in resource constrained settings: An ethnography of neonatal nursing in Kenya

Nursing is central to the provision of hospital-based care and is particularly so in the treatment of newborns. Continuous, effective provision of a basic set of interventions can have a highly positive impact on neonatal mortality, and most of these key interventions are delivered by nurses.  Unfortunately, neonatal wards in low income settings are typified by a high ratio of sick infants to nurses, which makes it difficult to deliver even basic care and limits the level of quality that is achievable. In the context of neonatal nursing in low-income countries, nursing stress is of particular concern because workloads are higher and the demands on individuals are greater. While a great deal of research has been directed towards nursing stress, the study of how stress affects nursing practice at the ward level has not been a priority, particularly in LMIC settings. Instead, the study of nursing over-work, burnout and resilience has largely been focused on individuals and their personal, psychological characteristics. In the course of this study, the authors found that theories of individualised burnout and resilience did not help to explain the practices that seemed most important in reducing nurses' exposure to stress. Their research question asks instead how nurses collectively cope with workload and stress and how this affects nursing practice. 

Supporting the Mental Health of Health Workers during COVID-19

“Working in the department, before screening, I have to screen the patients, the responsibility and the greater pressure and ensure the safety of all medical staff and patients. This line of work is also scary.”   Acknowledging the impacts of the challenging context of COVID-19 for health workers, this online workshop explored some of the experiences of health care workers in Vietnam and discussed strategies to support their mental health and wellbeing. 

COVID-19 in Africa: care and protection for frontline healthcare workers

  Sustaining safe and quality care in the SARS-CoV-2 pandemic hinges on the health and mental wellbeing of frontline healthcare workers. Medical staff face exhaustion, difficult triage decisions, separation from families, stigma and the pain of losing patients and colleagues, in addition to their own risks of infection.  In this literature review, the authors describe the infection risks and mental health challenges that healthcare workers face in the COVID-19 pandemic and propose interventions to counter these in Africa. Lessons from previous disease-control efforts on the continent are highlighted and draw on experiences with SARS-CoV-2 in other parts of the world.   

Mental health before and during the COVID-19 pandemic: a longitudinal probability sample survey of the UK population

How mental health care should change as a consequence of the COVID-19 pandemic

Occupational Stress Among Health Worker in a National Dermatology Hospital in Vietnam, 2018

Prevalence and associated factors of depression, anxiety and stress among health staff in the hospital of tropical diseases - Ho Chi Minh city-Vietnam

Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019

Managing mental health challenges faced by healthcare workers during covid-19 pandemic

Healthcare providers on the frontlines: a qualitative investigation of the social and emotional impact of delivering health services during Sierra Leone’s Ebola epidemic

Optimism of health care workers during a disaster: a review of the literature (2011)

Identifying factors for job motivation of rural health workers in North Viet Nam

Motivation or demotivation of health workers providing maternal health services in rural areas in Vietnam: findings from a Mixed-methods study

Communication between health workers and ethnic minorities in Vietnam

Vietnam has made notable progress in reducing maternal mortality rates during the past 2 decades, but this overall improvement conceals regional and ethnic inequalities. Ethnic minorities in Vietnam experience high rates of poverty and mortality, and they face communication and cultural barriers when accessing health services. Poor communication with health professionals combined with limited health literacy is concerning, particularly in the maternal health context, and may exacerbate existing inequalities.