Women represent an increasingly growing share of the medical workforce in high-income countries, with abundant research focusing on reasons and implications of the phenomenon. Little evidence is available from low- and middle-income countries, which is odd given the possible repercussion this may have for the local supply of medical services and, ultimately, for attaining universal health coverage. Drawing from secondary analysis of primary survey data, this paper analyses the proportion and characteristics of female physicians in Bissau, Maputo and Praia, with the objective of gaining insights on the extent and features of the feminization of the medical workforce in low- and middle-income settings. We used descriptive statistics, parametric and non-parametric test to compare groups and explore associations between different variables. Zero-inflated and generalized linear models were employed to analyse the number of hours worked in the private and public sector by male and female physicians. We show that although female physicians do not represent yet the majority of the medical workforce, feminization of the profession is under way in the three locations analysed, as women are presently over-represented in younger age groups. Female doctors distribute unevenly across medical specialties in the three cities and are absent from traditionally male-dominated ones such as surgery, orthopaedics and stomatology. Our data also show that they engage as much as their male peers in private practice, although overall they dedicate fewer hours to the profession, particularly in the public sector. While more research is needed to understand how this phenomenon affects rural areas in a broader range of locations, our work shows the value of exploring the differences between female and male physicians’ engagement with the profession in order to anticipate the impact of such feminization on national health systems and workforces in low- and middle-income countries.

Global Health Initiatives (GHIs), aiming at reducing the impact of specific diseases such as Human Immunodeficiency Virus (HIV), have flourished since 2000. Amongst these, PEPFAR and GFATM have provided a substantial amount of funding to countries affected by HIV, predominantly for delivery of antiretroviral therapy (ARV) and prevention strategies. Since the need for additional human resources for health (HRH) was not initially considered by GHIs, countries, to allow ARV scale-up, implemented short-term HRH strategies, adapted to GHI-funding conditionality. Such strategies differed from one country to another and slowly evolved to long-term HRH policies. The processes and content of HRH policy shifts in 5 countries in Sub-Saharan Africa were examined.

This article characterizes the problem of violence against health professionals in the workplace (VAHPITWP) in selected settings in Portugal. It addresses the questions of what types of violence are most frequent and who are the most affected health professionals. Three methodological approaches were followed: (i) documentary studies, (ii) a questionnaire-based hospital and health centre (HC) complex case study and (iii) semi-structured interviews with stakeholders. Of the different types of violence, all our study approaches confirm that verbal violence is the most frequent. Discrimination, not infrequent in the hospital, seems to be underestimated by the stakeholders interviewed. Violence seems much more frequent in the HC than in the hospital. In the HC, all types of violence are also most frequently directed against female health workers and, in the hospital, against male workers. These studies allow us to conclude that violence is frequent but underreported.

Background: Health and care workers (HCW) faced the double burden of the SARS-CoV-2 pandemic: as members of a society affected by a public health emergency and as HWC who experienced fear of becoming infected and of infecting others, stigma, violence, increased workloads, changes in scope of practice, among others. To understand the short and long-term impacts in terms of the COVID-19 pandemic and other public health emergencies of international concern (PHEICs) on HCW and relevant interventions to address them, we designed and conducted a living systematic review (LSR). Methods: We reviewed literature retrieved from MEDLINE—PubMed, Embase, SCOPUS, LILACS, the World Health Organization COVID-19 database, the ClinicalTrials.org and the ILO database, published from January 2000 until December 2021. We included quantitative observational studies, experimental studies, quasi-experimental, mixed methods or qualitative studies; addressing mental, physical health and well-being and quality of life. The review targeted HCW; and interventions and exposures, implemented during the COVID-19 pandemic or other PHEICs. To assess the risk of bias of included studies, we used the Johanna Briggs Institute (JBI) Critical Appraisal Tools. Data were qualitatively synthetized using meta-aggregation and meta-analysis was performed to estimate pooled prevalence of some of the outcomes. Results: The 1013 studies included in the review were mainly quantitative research, cross-sectional, with medium risk of bias/quality, addressing at least one of the following: mental health issue, violence, physical health and well-being, and quality of life. Additionally, interventions to address short- and long-term impact of PHEICs on HCW included in the review, although scarce, were mainly behavioral and individual oriented, aimed at improving mental health through the development of individual interventions. A lack of interventions addressing organizational or systemic bottlenecks was noted. Discussion: PHEICs impacted the mental and physical health of HCW with the greatest toll on mental health. The impact PHEICs are intricate and complex. The review revealed the consequences for health and care service delivery, with increased unplanned absenteeism, service disruption and occupation turnover that subvert the capacity to answer to the PHEICs, specifically challenging the resilience of health systems.

COVID-19 vaccine hesitancy (VH) has caused concerns due to the possible fluctuations that may occur directly impacting the control of the pandemic. In this study, we aimed to estimate the prevalence and factors associated with COVID-19 VH in Portuguese-speaking countries. We developed a web survey (N:6,843) using an online, structured, and validated questionnaire. We used Measurement Models, Exploratory Factor Analysis, Exploratory Structural Equation Models, and Confirmatory Factor Analysis for the data analysis. The overall prevalence of COVID-19 VH in Portuguese-speaking countries was 21.1%. showed a statistically significant direct effect for VH: vaccine-related conspiracy beliefs (VB) (β = 0.886), perceived stress (PS) (β = 0.313), COVID-19 Misinformation (MIS) (β = 0.259) and individual responses to COVID-19 (CIR) (β = −0.122). The effect of MIS and CIR for VH was greater among men and of PS and VB among women; the effect of PS was greater among the youngest and of VB and CIR among the oldest. No discrepant differences were identified in the analyzed education strata. In conclusion, we found that conspiracy beliefs related to the vaccine strongly influence the decision to hesitate (not to take or to delay the vaccine). Specific characteristics related to gender, age group, social and cognitive vulnerabilities, added to the knowledge acquired, poorly substantiated and/or misrepresented about the COVID-19 vaccine, need to be considered in the planning of vaccination campaigns. It is necessary to respond in a timely, fast, and accurate manner to the challenges posed by vaccine hesitancy.