Strategies for maintaining and strengthening the health care workers during epidemics: a scoping review

(2023) 21:60 Valiee et al. Human Resources for Health https://doi.org/10.1186/s12960-023-00844-2 Human Resources for Health Open Access REVIEW Strategies for maintaining and strengthening the health care workers during epidemics: a scoping review Sadra Valiee1, Zahra Zarei Jelyani1, Mohammad Kia1, Ali Jajarmizadeh2* , Sajad Delavari3, Naseh Shalyari4 and Milad Ahmadi Marzaleh4 Abstract Introduction During epidemics such as COVID-19, healthcare workers (HCWs) face several challenges, leading to a shortage and weakening of human resources. To address this issue, employing effective strategies is essential in maintaining and strengthening human resources during outbreaks. This study aimed to gather and classify strategies that could retain and strengthen human health resources during epidemics. Methods In this scoping review, all studies published about strategies for maintaining and strengthening HCWs in epidemics were collected from 4 international databases, including PubMed, Embase, Scopus, and Web of Science. The English language articles published after 2000 up until June 2022 recommended specific strategies regarding the research question. Then, they were analyzed and classified according to thematic analysis based on Braun and Clarke 6 phases protocols. Results In total, 9405 records were screened, of which 59 articles were included, and their full texts were reviewed. Fifty factors were identified and classified into five themes: Instruction, Protection, Supporting, Caring, and Communication. Most of the suggestions were conducted in high-income countries and related to the Supporting theme. Discussion The majority of strategies discussed in the literature addressed only one or two aspects of human resources. This study provides a holistic perspective on these issues by providing a thematic map of different strategies for strengthening and maintaining HCWs during epidemics. Considering the multidimensionality of human nature, it is suggested that policymakers and managers of health systems provide facilities that simultaneously address a wide range of needs. Keywords Maintaining, Strengthening, Human resources, Health care workers (HCWs), Epidemics, Scoping review *Correspondence: Ali Jajarmizadeh Full list of author information is available at the end of the article © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativeco mmons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Valiee et al. Human Resources for Health (2023) 21:60 Introduction The World Health Organization (WHO) reported a pneumonia outbreak on December 31st, 2019, that seemed to be associated with a seafood wholesale market in Huanan, Wuhan Province, China [1]. It was identified in early January 2020 that the pathogenic agent was a novel beta-coronavirus with over 85% similarity to a bat SARS coronavirus (SARS-CoV). SARS-CoV-2 and Coronavirus disease 2019 (COVID-19) have been named the new virus and the disease, respectively. The epidemic of COVID-19 virus has spread globally through humanto-human transmission and was declared an international health emergency on January 30th, 2020. [1, 2]. According to official figures, as of September 7th, 2022, 230 countries, areas, or territories were affected, with 603,711,760 confirmed cases and 6,484,136 deaths [3]. In the wake of the epidemics, all capacities have been challenged in preparing for and responding to the disease. Different strategies are used in various countries to combat viral transmission. Nevertheless, the relative success of these strategies depends on the resilience of health systems across all levels. As a result of the COVID-19 pandemic, most health systems have revealed their limitations [4]. According to the WHO’s documents, the health workforce is considered one of the health systems’ main blocks and key input components [5]. It is a crucial element for the resilience of health systems in facing various natural and human disasters [6]. Also, these events, including epidemics, are typically followed by an increase in healthcare workers’ mortality, injury, and disease, along with a deterioration of healthcare systems’ human resources [7]. In the aftermath of epidemics, healthcare workers (HCWs) have to deal with the incredible pressure of physical and psychological issues [8]. From January 2020 to May 2021, mixed analytical approaches in WHO’s report estimated a range between 80,000 to 180,000 (with a central population-based estimate of 115 500) mortalities among HCWs from COVID-19 [9]. While HCWs represent approximately 1–3% of the population in different countries, about 14% of COVID-19 cases involved HCWs. Furthermore, this ratio can be as high as 35% in some countries [10]. Around the globe, it is estimated that stress, anxiety, depression, insomnia, anger, and fear represent only a tiny minority of all reported injuries among HCWs [11, 12]. Additionally, the medical staff is faced with a double burden of work challenges and psychological stress caused by increased workload, inadequate protective equipment, the observation of colleagues and patients dying, the fear of contracting and transmitting diseases to their family members, the necessity of tolerating quarantine as solitary confinement and social isolation, as well Page 2 of 12 as the dilemma of allocating drugs and hospital equipment to patients in the absence of their family members [12–22]. In these circumstances, many HCWs decide to cease employment. This problem has been noted in the United States [23] and is expected to worsen in low-income countries [24]. Various factors lead to the shortage of HCWs, some of which include their decision to quit their job, life-threatening infections, and the mortality of HCWs. This vicious cycle places renewed strain on the other organization’s resources and results in the health systems’ collapse [25, 26]. Therefore, one of the most critical issues during epidemic diseases is retaining and strengthening human health resources [27]. While many scattered approaches (...truncated)