Table 4 Examples of health workforce approaches

From: Health systems resilience in managing the COVID-19 pandemic: lessons from 28 countries

Subdomain Snapshot of health systems resilience measures in reviewed countries
Countries with the least deaths per 100,0000, with a population of over 20 million Countries with the most deaths per 100,0000, with a population of over 20 million Countries in the middle category in terms of deaths per 100,000 population
Strategies to rapidly expand health workforce capacity Uganda: additional healthcare manpower including epidemiologists, doctors, anesthetists, nurses, laboratory technologists, psychiatric clinical officers, ambulance assistants, drivers, emergency care assistance, among others, were contracted for 6 months and deployed to COVID-19 treatment centers and to support districts and points of entry for surveillance purposes. Thailand: The Ministry of Public Health contracted 150,000 temporary medical workers to respond to the pandemic, 40,000 of whom were approved to be converted into permanent civil servants due to their invaluable contributions to the healthcare system. Mexico: a national call was made to recruit specialized personnel in intensive care, emergency, internal medicine, pneumology, infectiology and anesthesiology to address the pandemic. The government also considered contracting foreign health workers as necessary to augment domestic health workforce capacity. Brazil: The Brazilian Health Ministry hired more health workers, including reinstating medical licenses for Cuban medical professionals who remained in Brazil from the Mais Medicos (More Doctors) program and to permit final-year medical students to bolster the existing medical workforce. New Zealand: a nationally coordinated online system was set up for retired or nonpracticing health workers to register to rejoin the workforce to assist in outbreak management. More than 2500 doctors, nurses, midwives and laboratory scientists came out of retirement or parental leave. A system was put in place to match returning health workers with suitable positions. India: the government had called on retired doctors, armed forces medical staff and private sector medical professionals to join the public health facilities. Over 30,000 responded to the government’s appeal. Final-year medical students and paramedical students were also deployed to conduct screenings, contact tracing and vaccination.
Reallocation of healthcare professionals China: in the initial stages of the pandemic, medical workers from all parts of China were reallocated to provide medical care for the people of the Hubei province. Vietnam: after receiving training, 97 senior medical students volunteered with the Hanoi Center for Disease control to conduct epidemiological investigation of cases; duties include providing counseling to people over the phone, collecting samples from suspected community groups, importing data into computers and cleaning and disinfection of congregate settings. United States: with its predominately private healthcare system and federal states, the United States implemented measures to increase staff in hot spots. Many states developed guidelines to allow recent medical graduates and health workers from other states to practice in hot spots. This was needed as different states in the United States have different licensure for practice. Spain: medical doctors from other specialties such as internal medicine, anesthesiology, pneumology and geriatrics, as well as trained nurses, teamed up with intensive care specialists to increase care capacity for people with severe or critical COVID-19. Uruguay: to alleviate the lack of intensive care physicians, the Uruguayan Society of Intensive Medicine (SUMI) and the Society of Anesthesiology announced an agreement that anesthetists can assist in critical-care tasks to augment intensive care manpower. South Korea: government employees from non-healthcare sectors were reassigned. Contact tracing was performed by repurposed low-level to middle-level government employees or those who were underemployed. It expanded its usual workforce of Epidemic Intelligence Service officers by quickly training these staff at approximately 250 local public health centers.
Pandemic-related training for healthcare professionals China: in Wuhan in January 2020, onsite training for infection control and patient management was provided to all health workers based on the ‘guideline for COVID-19 management and control’ and the ‘guideline for hospital infection of COVID-19’ before they started working in COVID-19 units. Sri Lanka: WHO worked with the Ministry of Health and Indigenous Medical Services and the Sri Lankan College of Microbiologists to design a set of training modules for health workers on IPC guidelines related to COVID-19 in Sri Lanka. Argentina: online training was provided to health workers on critical COVID-19 treatments involving ventilators, intubations and extubations, among other relevant skills for treatment of patients with COVID-19. Both entry-level and advanced training were available. Peru: military and civilian health professionals were trained through a Ministry of Defense initiative. The course is a 16-h theoretical and hands-on session to orient students to care for patients with severe COVID-19. The initiative started in May 2020, with service member-only classes that expanded to include civilians from June 2020. Russia: almost 1.6 million medical specialists were trained (remotely) to provide medical care to patients with COVID-19. Singapore: increased training of nurses for intensive care to bolster existing intensive unit staffing. Former and current professionals and personnel with no qualifications were trained for support and testing, while medical students and nurses were trained for specific tasks to augment the existing health workforce.
Mental health support for health workforce China: several measures were implemented to ensure the care of medical personnel and their families, such as regulations on shifts and leave arrangement to relieve frontline medical workers. Sri Lanka: hospitals arranged special meals to boost health worker morale; food sellers brought staple foods to hospitals so that staff did not have to visit markets or supermarkets to get groceries; a hotel chain offered 1,000 complimentary full-board holiday packages for frontline health workers. United States: the CDC advised that healthcare facilities establish a plan for providing additional support for health workers, considering aspects such as mental health, parenting, meals and nonpunitive sick policies. United Kingdom: free one-on-one support sessions with accredited psychologists or mental health experts available to NHS staff. A tool kit was also developed by the NHS to encourage conversation in the workplace and talk about mental and emotional health. New Zealand: Health Care New Zealand provides free counseling services for frontline healthcare workers and staff who seek mental health and well-being support. Help will be rendered through an appointment-based system with an experienced therapist, which will be kept confidential. Sweden: the government proposed funds to support staff in regional and municipal healthcare and elderly care in its autumn budget amendment for 2020. This provides additional funding for crisis support, counseling and trauma support during the pandemic.
Financial support for health workforce Thailand: offered financial support to health workers in case of adverse events: for death or permanent disability: THB 240,000–400,000 /USD 7,684–12,807; for organ loss or disability. Incentives offered to health workers were THB 1,500/USD 48 per shift for doctors and THB 1,000/USD 32 per shift for nurses and other paramedical staff. Vietnam: incentives were provided for field workers engaged in surveillance activities. Argentina: financial incentives granted to healthcare workers who managed and were exposed to patients with COVID-19 included four bonuses, in both the public and private sectors. Spain: COVID-19 infection is deemed a workplace accident for healthcare workers managing infected patients. Russia: since the beginning of the pandemic, incentive payments to health workers for special working conditions and additional workloads have been introduced or increased on a federal level; the government allocated more than USD 64,900,000 to pay medical workers increased vacation pay or compensation for vacation, which they had to give up due to the situation with the coronavirus. Germany: care workers can claim tax benefits of up to EUR 1,000/USD 1,200. The federal government announced it would expand the bonus payments given to nurses and care professionals in hospitals fighting COVID-19 to all hospital staff during the pandemic. Bavaria was the first state to announce a reward for all nursing and care staff in healthcare, long-term care, rehabilitation, emergency services and institutions for disabled people of a EUR 500/USD 600 bonus.
  1. Countries were selected according to the recorded number of deaths attributed to COVID-19 per 100,000 inhabitants on 6 November 2020.