An innovative leadership development initiative to support building everyday resilience in health systemsby Jacinta Nzinga, Mwanamvua Boga, Nancy Kagwanja, Dennis Waithaka, Edwine Barasa, Benjamin Tsofa, Lucy Gilson and Sassy Molyneux
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 Kenyaby Jacob McKnighta, Jacinta Nzingab, Joyline Jepkosgeib, Mike English
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.
“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.
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.