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Phillips G, Kendino M, Brolan CE, Herron LM, Kὃrver S, Motofaga S, Cox M. Women on the frontline: exploring the gendered experience for Pacific healthcare workers during the COVID-19 pandemic. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 42:100961. [PMID: 38022711 PMCID: PMC10658397 DOI: 10.1016/j.lanwpc.2023.100961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/24/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023]
Abstract
Background Women comprise 90% of patient-facing global healthcare workers (HCWs), yet remain underpaid, undervalued, and under-represented in leadership and decision-making positions, particularly across the Pacific region. The COVID-19 pandemic has exacerbated these health workplace inequalities. We sought to understand Pacific women HCWs experience from the COVID-19 frontline to contribute to policies aimed at addressing gendered gaps in regional health systems. Methods Our interpretative phenomenological study used critical feminist and social theory, and a gendered health systems analytical framework. Data were collected using online focus groups and in-depth interviews with 36 Pacific regional participants between March 2020 and July 2021. Gender-specific content and women's voices were privileged for inductive analysis by Pacific and Australian women researchers with COVID-19 frontline lived experience. Findings Pacific women HCWs have authority and responsibility resulting from their familial, biological, and cultural status, but are often subordinate to men. They were emancipatory leaders during COVID-19, and as HCWs demonstrated compassion, situational awareness, and concern for staff welfare. Pacific women HCWs also faced ethical challenges to prioritise family or work responsibilities, safely negotiate childbearing, and maintain economic security. Interpretation Despite enhanced gendered power differentials during COVID-19, Pacific women HCWs used their symbolic capital to positively influence health system performance. Gender-transformative policies are urgently required to address disproportionate clinical and community care burdens and to protect and support the Pacific female health workforce. Funding Epidemic Ethics/World Health Organization (WHO), Foreign, Commonwealth and Development Office/Wellcome Grant 214711/Z/18/Z. Co-funding: Australasian College for Emergency Medicine Foundation, International Development Fund Grant.
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Affiliation(s)
- Georgina Phillips
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Emergency Department, St Vincent's Hospital Melbourne, Melbourne, Australia
| | | | - Claire E. Brolan
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Lisa-Maree Herron
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Sarah Kὃrver
- TB Elimination, and Implementation Science, Burnet Institute, Papua New Guinea and Australia
| | - Silina Motofaga
- Clinical Services Program, Public Health Division, Pacific Community, Suva, Fiji
| | - Megan Cox
- Faculty of Medicine and Health, The University of Sydney, Australia
- The Sutherland Hospital, NSW, Australia
- NSW Ambulance, Sydney, Australia
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Mitchell R, Bornstein S, Piamnok D, Sebby W, Kingston C, Tefatu R, Kendino M, Josaiah B, Pole J, Kuk S, Körver S, Miller JP, Cole T, Erbs A, O'Reilly G, Cameron P, Sengiromo D, Banks C. Multimodal learning for emergency department triage implementation: experiences from Papua New Guinea during the COVID-19 pandemic. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 33:100683. [PMID: 36776620 PMCID: PMC9901330 DOI: 10.1016/j.lanwpc.2023.100683] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/13/2022] [Accepted: 01/02/2023] [Indexed: 02/08/2023]
Abstract
Background Triage implementation in resource-limited emergency departments (EDs) has traditionally relied on intensive in-person training. This study sought to evaluate the impact of a novel digital-based learning strategy focused on the Interagency Integrated Triage Tool, a three-tier triage instrument recommended by the World Health Organization. Methods A mixed methods study utilising pre-post intervention methods was conducted in two EDs in Papua New Guinea. The primary outcome was the mean change in knowledge before and after completion of a voluntary, multimodal training program, primarily delivered through a digital learning platform accessible via smartphone. Secondary outcomes included the change in confidence to perform selected clinical tasks, and acceptability of the learning methods. Findings Among 136 eligible ED staff, 91 (66.9%) completed the digital learning program. The mean knowledge score on the post-training exam was 87.5% (SD 10.4), a mean increase of 12.9% (95% CI 10.7-15.1%, p < 0.0001) from the pre-training exam. There were statistically significant improvements in confidence for 13 of 15 clinical tasks, including undertaking a triage assessment and identifying an unwell patient.In an evaluation survey, 100% of 30 respondents agreed or strongly agreed the online learning platform was easy to access, use and navigate, and that the digital teaching methods were appropriate for their learning needs. In qualitative feedback, respondents reported that limited internet access and a lack of dedicated training time were barriers to participation. Interpretation The use of digital learning to support triage implementation in resource-limited EDs is feasible and effective when accompanied by in-person mentoring. Adequate internet access is an essential pre-requisite. Funding Development of the Kumul Helt Skul learning platform was undertaken as part of the Clinical Support Program (Phase II), facilitated by Johnstaff International Development on behalf of the Australian Government Department of Foreign Affairs and Trade through the PNG-Australia Partnership. RM is supported by a National Health and Medical Research Council Postgraduate Scholarship and a Monash Graduate Excellence Scholarship, while PC is supported by a Medical Research Future Fund Practitioner Fellowship. Funders had no role in study design, results analysis or manuscript preparation.
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Affiliation(s)
- Rob Mitchell
- Emergency & Trauma Centre, Alfred Health, Australia
- School of Public Health & Preventive Medicine, Monash University, Australia
- Corresponding author. Emergency & Trauma Centre, Alfred Health, Commercial Rd, Melbourne, Australia.
| | | | - Donna Piamnok
- Emergency Department, ANGAU Memorial Hospital, Papua New Guinea
| | - Wilma Sebby
- Emergency Department, ANGAU Memorial Hospital, Papua New Guinea
| | - Carl Kingston
- Emergency Department, Port Moresby General Hospital, Papua New Guinea
| | - Rayleen Tefatu
- Emergency Department, Port Moresby General Hospital, Papua New Guinea
| | - Mangu Kendino
- Emergency Department, Port Moresby General Hospital, Papua New Guinea
| | - Betty Josaiah
- Emergency Department, Port Moresby General Hospital, Papua New Guinea
| | - Jasper Pole
- Emergency Department, Port Moresby General Hospital, Papua New Guinea
| | - Sylvia Kuk
- Emergency Department, Port Moresby General Hospital, Papua New Guinea
| | - Sarah Körver
- Australasian College for Emergency Medicine, Australia
| | | | - Travis Cole
- Johnstaff International Development, Australia
| | | | - Gerard O'Reilly
- Emergency & Trauma Centre, Alfred Health, Australia
- School of Public Health & Preventive Medicine, Monash University, Australia
| | - Peter Cameron
- Emergency & Trauma Centre, Alfred Health, Australia
- School of Public Health & Preventive Medicine, Monash University, Australia
| | - Duncan Sengiromo
- Emergency Department, Port Moresby General Hospital, Papua New Guinea
| | - Colin Banks
- Townsville University Hospital, Australia
- College of Medicine and Dentistry, James Cook University, Australia
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Herron LM, Phillips G, Brolan CE, Mitchell R, O'Reilly G, Sharma D, Körver S, Kendino M, Poloniati P, Kafoa B, Cox M. "When all else fails you have to come to the emergency department": Overarching lessons about emergency care resilience from frontline clinicians in Pacific Island countries and territories during the COVID-19 pandemic. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 25:100519. [PMID: 35822061 PMCID: PMC9262465 DOI: 10.1016/j.lanwpc.2022.100519] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The COVID-19 pandemic continues to test health systems resilience worldwide. Low- and middle-income country (LMIC) health care systems have considerable experience in disasters and disease outbreaks. Lessons from the preparedness and responses to COVID-19 in LMICs may be valuable to other countries.This policy paper synthesises findings from a multiphase qualitative research project, conducted during the pandemic to document experiences of Pacific Island Country and Territory (PICT) frontline clinicians and emergency care (EC) stakeholders. Thematic analysis and synthesis of enablers related to each of the Pacific EC systems building blocks identified key factors contributing to strengthened EC systems.Effective health system responses to the COVID-19 pandemic occurred when frontline clinicians and 'decision makers' collaborated with respect and open communication, overcoming healthcare workers' fear and discontent. PICT EC clinicians demonstrated natural leadership and strengthened local EC systems, supporting essential healthcare. Despite resource limitations, PICT cultural strengths of relational connection and innovation ensured health system resilience. COVID-19 significantly disrupted services, with long-tail impacts on non-communicable disease and other health burdens.Lessons learned in responding to COVID-19 can be applied to ongoing health system strengthening initiatives. Optimal systems improvement and sustainability requires EC leaders' involvement in current decision-making as well as future planning. Search strategy and selection criteria Search strategy and selection criteria We searched PubMed, Google Scholar, Ovid, WHO resources, Pacific and grey literature using search terms 'emergency care', 'acute/critical care', 'health care workers', 'emergency care systems/health systems', 'health system building blocks', 'COVID-19', 'pandemic/surge event/disease outbreaks' 'Low- and Middle-Income Countries', 'Pacific Islands/region' and related terms. Only English-language articles were included. Funding Phases 1 and 2A of this study were part of an Epidemic Ethics/World Health Organization (WHO) initiative, supported by Foreign, Commonwealth and Development Office/Wellcome Grant 214711/Z/18/Z. Copyright of the original work on which this publication is based belongs to WHO. The authors have been given permission to publish this manuscript. The authors alone are responsible for the views expressed in this publication and they do not necessarily represent the views, decisions or policies of WHO. Co-funding for this research was received from the Australasian College for Emergency Medicine Foundation via an International Development Fund Grant. RM is supported by a National Health and Medical Research Council (NHMRC) Postgraduate Scholarship and a Monash Graduate Excellence Scholarship. GOR is supported by a NHMRC Early Career Research Fellowship. CEB is supported by a University of Queensland Development Research Fellowship. None of these funders played any role in study design, results analysis or manuscript preparation.
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Affiliation(s)
- Lisa-Maree Herron
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Georgina Phillips
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Emergency Department, St Vincent's Hospital Melbourne, Melbourne, Australia
| | - Claire E. Brolan
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Centre for Policy Futures, Faculty of Humanities and Social Sciences, The University of Queensland, Brisbane, Australia
| | - Rob Mitchell
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Emergency & Trauma Centre, Alfred Health, Australia
| | - Gerard O'Reilly
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Global Programs, Emergency & Trauma Centre, Alfred Health, Australia
| | - Deepak Sharma
- Emergency Department, Colonial War Memorial Hospital, Suva, Fiji
| | - Sarah Körver
- Australasian College for Emergency Medicine, Melbourne, Australia
| | | | | | - Berlin Kafoa
- Public Health Division, Secretariat of the Pacific Community, Suva, Fiji
| | - Megan Cox
- Faculty of Medicine and Health, The University of Sydney, Australia
- The Sutherland Hospital, NSW, Australia
- State Retrieval Consultant, NSW Ambulance, Sydney, Australia
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Phillips G, Kendino M, Brolan CE, Mitchell R, Herron LM, Kὃrver S, Sharma D, O'Reilly G, Poloniati P, Kafoa B, Cox M. Lessons from the frontline: Leadership and governance experiences in the COVID-19 pandemic response across the Pacific region. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 25:100518. [PMID: 35818573 PMCID: PMC9259208 DOI: 10.1016/j.lanwpc.2022.100518] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Background Universal access to safe, effective emergency care (EC) during the COVID-19 pandemic has illustrated its centrality to healthcare systems. The 'Leadership and Governance' building block provides policy, accountability and stewardship to health systems, and is essential to determining effectiveness of pandemic response. This study aimed to explore the experience of leadership and governance during the COVID-19 pandemic from frontline clinicians and stakeholders across the Pacific region. Methods Australian and Pacific researchers collaborated to conduct this large, qualitative research project in three phases between March 2020 and July 2021. Data was gathered from 116 Pacific regional participants through online support forums, in-depth interviews and focus groups. A phenomenological approach shaped inductive and deductive data analysis, within a previously identified Pacific EC systems building block framework. Findings Politics profoundly influenced pandemic response effectiveness, even at the clinical coalface. Experienced clinicians spoke authoritatively to decision-makers; focusing on safety, quality and service duty. Rapid adaptability, past surge event experience, team-focus and systems-thinking enabled EC leadership. Transparent communication, collaboration, mutual respect and trust created unity between frontline clinicians and 'top-level' administrators. Pacific cultural assets of relationship-building and community cohesion strengthened responses. Interpretation Effective governance occurs when political, administrative and clinical actors work collaboratively in relationships characterised by trust, transparency, altruism and evidence. Trained, supported EC leadership will enhance frontline service provision, health security preparedness and future Universal Health Coverage goals. Funding Epidemic Ethics/World Health Organization (WHO), Foreign, Commonwealth and Development Office/Wellcome Grant 214711/Z/18/Z. Co-funding: Australasian College for Emergency Medicine Foundation, International Development Fund Grant.
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Affiliation(s)
- Georgina Phillips
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Emergency Department, St Vincent's Hospital Melbourne, Melbourne, Australia
| | | | - Claire E. Brolan
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Centre for Policy Futures, Faculty of Humanities and Social Sciences, The University of Queensland, Brisbane, Australia
| | - Rob Mitchell
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Emergency & Trauma Centre, Alfred Health, Australia
| | - Lisa-Maree Herron
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Sarah Kὃrver
- Australasian College for Emergency Medicine, Melbourne, Australia
| | - Deepak Sharma
- Emergency Department, Colonial War Memorial Hospital, Suva, Fiji
| | - Gerard O'Reilly
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Emergency & Trauma Centre, Alfred Health, Australia
| | | | - Berlin Kafoa
- Public Health Division, Secretariat of the Pacific Community, Suva, Fiji
| | - Megan Cox
- Faculty of Medicine and Health, The University of Sydney, Australia
- The Sutherland Hospital, NSW, Australia
- NSW Ambulance, Sydney, Australia
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Cox M, Sharma D, Phillips G, Mitchell R, Herron LM, Brolan CE, O'Reilly G, Körver S, Kendino M, Poloniati P, Kafoa B. Lessons from the frontline: Documenting the pandemic emergency care experience from the Pacific region - Infrastructure and equipment. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 25:100516. [PMID: 35818575 PMCID: PMC9259041 DOI: 10.1016/j.lanwpc.2022.100516] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Background The COVID-19 pandemic highlighted challenges for all health systems worldwide. This research aimed to explore the impact of COVID-19 across the Pacific especially with regards to emergency care (EC) and clinicians' preparations and responses. Methods A collaboration of Australia and Pacific researchers conducted prospective qualitative research over 18 months of the pandemic. In this three phase study data were gathered from Emergency Clinicians and stakeholders through online support forums, in-depth interviews and focus groups. A phenomenological methodological approach was employed to explore the lived experience of participants. This paper discusses the findings of the study regarding the EC building block of 'Infrastructure and Equipment.' Findings Pre-existing infrastructure and equipment were not sufficient to help control the pandemic. Adequate space and correct equipment were essential needs for Pacific Island emergency clinicians, with donations, procurement and local ingenuity required for suitable, sustainable supplies and facilities. Adequate personal protective equipment (PPE) conferred a sense of security and increased Health Care Workers willingness to attend to patients. Interpretation Investing in adequate infrastructure and appropriate equipment is crucial for an effective response to the COVID-19 pandemic. The sustainability of such investments in the Pacific context is paramount for ongoing EC and preparation for future surge responses and disasters. Funding Phases 1 and 2A of this study were part of an Epidemic Ethics/World Health Organization (WHO) initiative, supported by Foreign, Commonwealth and Development Office/Wellcome Grant 214711/Z/18/Z. Co-funding for this research was received from the Australasian College for Emergency Medicine Foundation via an International Development Fund Grant.
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Affiliation(s)
- Megan Cox
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- The Sutherland Hospital, Sydney, NSW, Australia
- NSW Ambulance, Sydney, Australia
| | | | - Georgina Phillips
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Emergency Department, St Vincent's Hospital Melbourne, Melbourne, Australia
| | - Rob Mitchell
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Emergency & Trauma Centre, Alfred Health, Melbourne, Australia
| | - Lisa-Maree Herron
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Claire E. Brolan
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Centre for Policy Futures, Faculty of Humanities and Social Sciences, The University of Queensland, Brisbane, Australia
| | - Gerard O'Reilly
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Emergency & Trauma Centre, Alfred Health, Melbourne, Australia
| | - Sarah Körver
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | | | | | - Berlin Kafoa
- Public Health Division, Secretariat of the Pacific Community, Suva, Fiji
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Mitchell R, O'Reilly G, Herron LM, Phillips G, Sharma D, Brolan CE, Körver S, Kendino M, Poloniati P, Kafoa B, Cox M. Lessons from the frontline: The value of emergency care processes and data to pandemic responses across the Pacific region. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 25:100515. [PMID: 35818576 PMCID: PMC9259010 DOI: 10.1016/j.lanwpc.2022.100515] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Background Emergency care (EC) addresses the needs of patients with acute illness and injury, and has fulfilled a critical function during the COVID-19 pandemic. 'Processes' (e.g. triage) and 'data' (e.g. surveillance) have been nominated as essential building blocks for EC systems. This qualitative research sought to explore the impact of the pandemic on EC clinicians across the Pacific region, including the contribution of EC building blocks to effective responses. Methods The study was conducted in three phases, with data obtained from online support forums, key informant interviews and focus group discussions. There were 116 participants from more than 14 Pacific Island Countries and Territories. A phenomenological approach was adopted, incorporating inductive and deductive methods. The deductive thematic analysis utilised previously identified building blocks for Pacific EC. This paper summarises findings for the building blocks of 'processes' and 'data'. Findings Establishing triage and screening capacity, aimed at assessing urgency and transmission risk respectively, were priorities for EC clinicians. Enablers included support from senior hospital leaders, previous disaster experience and consistent guidelines. The introduction of efficient patient flow processes, such as streaming, proved valuable to emergency departments, and checklists and simulation were useful implementation strategies. Some response measures impacted negatively on non-COVID patients, and proactive approaches were required to maintain 'business as usual'. The pandemic also highlighted the value of surveillance and performance data. Interpretation Developing effective processes for triage, screening and streaming, among other areas, was critical to an effective EC response. Beyond the pandemic, strengthening processes and data management capacity will build resilience in EC systems. Funding Phases 1 and 2A of this study were part of an Epidemic Ethics/World Health Organization (WHO) initiative, supported by Foreign, Commonwealth and Development Office/Wellcome Grant 214711/Z/18/Z. Co-funding for this research was received from the Australasian College for Emergency Medicine Foundation via an International Development Fund Grant.
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Affiliation(s)
- Rob Mitchell
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Emergency & Trauma Centre, Alfred Hospital, Melbourne, Australia
| | - Gerard O'Reilly
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Emergency & Trauma Centre, Alfred Hospital, Melbourne, Australia
| | - Lisa-Maree Herron
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Georgina Phillips
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Emergency Department, St Vincent's Hospital Melbourne, Melbourne, Australia
| | - Deepak Sharma
- Emergency Department, Colonial War Memorial Hospital, Suva, Fiji
| | - Claire E. Brolan
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Centre for Policy Futures, Faculty of Humanities and Social Sciences, The University of Queensland, Brisbane, Australia
| | - Sarah Körver
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Mangu Kendino
- Emergency Department, Port Moresby General Hospital, Port Moresby, Papua New Guinea
| | | | - Berlin Kafoa
- Public Health Division, Secretariat of the Pacific Community, Suva, Fiji
| | - Megan Cox
- Faculty of Medicine and Health, The University of Sydney; NSW, Australia
- The Sutherland Hospital, NSW, Australia
- NSW Ambulance, Sydney, Australia
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Brolan CE, Körver S, Phillips G, Sharma D, Herron LM, O'Reilly G, Mitchell R, Kendino M, Poloniati P, Kafoa B, Cox M. Lessons from the frontline: The COVID-19 pandemic emergency care experience from a human resource perspective in the Pacific region. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 25:100514. [PMID: 35815241 PMCID: PMC9253868 DOI: 10.1016/j.lanwpc.2022.100514] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Background This study explores emergency care (EC) and other frontline healthcare worker (HCW) experiences responding to the COVID-19 pandemic in the Pacific region. The crisis has reinforced the crucial role well-trained, resourced, and supported EC providers play in supporting vital health systems and services in all global regions not only during 'business as usual' periods, but in times of tremendous stress and surge. Methods Qualitative data were collected from EC providers and relevant stakeholders in three research phases in 2020 and 2021. Data on the World Health Organization's (WHO) Human Resources Building Block, adapted for the Pacific EC context, was thematically analysed. Key findings were further analysed to identify enablers and barriers to effective EC pandemic management. Findings 116 participants from across the Pacific region participated in this study. Five themes emerged: (1) EC providers performed multiple pandemic roles; (2) Importance of authorities' valuing frontline HCWs; (3) HCW mental health and exhaustion; (4) HCW tension managing stigma, personal/professional expectations, and chronic health needs; and (5) Building health and human resource capacity. Interpretation This study significantly contributes to the limited scientific literature on HCW experiences responding to COVID-19 across the Pacific. Recommendations arising out of this research align with consensus priorities and standards that were identified pre-pandemic by health stakeholders across the Pacific for enhancing EC system development. With limited HCWs available for many Pacific nations, it is imperative the dignity and welfare of local HCWs is genuinely prioritised. Funding Epidemic Ethics/WHO, Foreign, Commonwealth and Development Office/Wellcome Grant 214711/Z/18/Z. Co-funding: Australasian College for Emergency Medicine Foundation, International Development Fund Grant.
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Affiliation(s)
- Claire E. Brolan
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Centre for Policy Futures, Faculty of Humanities and Social Sciences, The University of Queensland, Brisbane, Australia
| | - Sarah Körver
- Australasian College for Emergency Medicine, Melbourne, Australia
| | - Georgina Phillips
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Emergency Department, St Vincent's Hospital Melbourne, Melbourne, Australia
| | - Deepak Sharma
- Emergency Department, Colonial War Memorial Hospital, Suva, Fiji
| | - Lisa-Maree Herron
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Gerard O'Reilly
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Global Programs, Emergency & Trauma Centre, Alfred Health, Australia
| | - Rob Mitchell
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Emergency & Trauma Centre, Alfred Health, Australia
| | | | | | - Berlin Kafoa
- Public Health Division, Secretariat of the Pacific Community, Suva, Fiji
| | - Megan Cox
- Faculty of Medicine and Health, The University of Sydney, Australia
- The Sutherland Hospital, NSW, Australia
- NSW Ambulance, Sydney, Australia
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