Background: COVID-19 has challenged health systems worldwide, especially the health workforce, a pillar crucial for health systems resilience. Therefore, strengthening health system resilience can be informed by analyzing health care workers’ (HCWs) experiences and needs during pandemics. This review synthesizes qualitative studies published during the first year of the COVID-19 pandemic to identify factors affecting HCWs’ experiences and their support needs during the pandemic. This review was conducted using the Joanna Briggs Institute methodology for scoping reviews. A systematic search on PubMed was applied using controlled vocabularies. Only original studies presenting primary qualitative data were included.Results: 161 papers that were published from the beginning of COVID-19 pandemic up until 28th March 2021 were included in the review. Findings were presented using the socio-ecological model as an analytical framework. At the individual level, the impact of the pandemic manifested on HCWs’ well-being, daily routine, professional and personal identity. At the interpersonal level, HCWs’ personal and professional relationships were identified as crucial. At the institutional level, decision-making processes, organizational aspects and availability of support emerged as important factors affecting HCWs’ experiences. At community level, community morale, norms, and public knowledge were of importance. Finally, at policy level, governmental support and response measures shaped HCWs’ experiences. The review identified a lack of studies which investigate other HCWs than doctors and nurses, HCWs in non-hospital settings, and HCWs in low- and lower middle income countries.Discussion: This review shows that the COVID-19 pandemic has challenged HCWs, with multiple contextual factors impacting their experiences and needs. To better understand HCWs’ experiences, comparative investigations are needed which analyze differences across as well as within countries, including differences at institutional, community, interpersonal and individual levels. Similarly, interventions aimed at supporting HCWs prior to, during and after pandemics need to consider HCWs’ circumstances.Conclusions: Following a context-sensitive approach to empowering HCWs that accounts for the multitude of aspects which influence their experiences could contribute to building a sustainable health workforce and strengthening health systems for future pandemics.

Background: Malaria is a leading cause of death and reduced life span in Guinea and Sierra Leone, where plans for rolling out the malaria vaccine for children are being made. There is little evidence about caregiver acceptance rates to guide roll-out policies. To inform future vaccine implementation planning, this analysis aimed to assess potential malaria vaccine acceptance by caregivers and identify factors associated with acceptance in Guinea and Sierra Leone. Methods: A cross-sectional household survey using lot quality assurance sampling was conducted in three regions per country between May 2022 and August 2022. The first survey respondent in each household provided sociodemographic information. A household member responsible for childcare shared their likelihood of accepting a malaria vaccine for their children under 5 years and details about children’s health. The prevalence of caregiver vaccine acceptance was calculated and associated factors were explored using multivariable logistic regression modelling calculating adjusted odds ratios (aOR) with 95% confidence intervals (CI). Results: Caregivers in 76% of 702 sampled households in Guinea and 81% of 575 households in Sierra Leone were accepting of a potential vaccine for their children. In both countries, acceptance was lower in remote areas than in urban areas (Guinea: aOR 0.22 [95%CI 0.09–0.50], Sierra Leone: 0.17 [0.06–0.47]). In Guinea, acceptance was lower among caregivers living in the richest households compared to the poorest households (0.10 [0.04–0.24]), among those whose children were tested for malaria when febrile (0.54 [0.34–0.85]) and in households adopting more preventative measures against malaria (0.39 [0.25–0.62]). Better knowledge of the cause of malaria infection was associated with increased acceptance (3.46 [1.01–11.87]). In Sierra Leone, vaccine acceptance was higher among caregivers living in households where the first respondent had higher levels of education as compared to lower levels (2.32 [1.05–5.11]). Conclusion: In both countries, malaria vaccine acceptance seems promising for future vaccine roll-out programmes. Policy makers might consider regional differences, sociodemographic factors, and levels of knowledge about malaria for optimization of implementation strategies. Raising awareness about the benefits of comprehensive malaria control efforts, including vaccination and other preventive measures, requires attention in upcoming campaigns.

Health system resilience is defined as the ability of a system to prepare, manage, and learn from shocks. This study investigates the resilience of the German health system by analysing the system-related factors that supported health care workers, a key building block of the system, during the COVID-19 pandemic. We thematically analysed data from 18 semi-structured interviews with key informants from management, policy and academia, 17 in-depth interviews with health care workers, and 10 focus group discussions with health care workers. We identified six categories of factors which supported health care workers during the pandemic: (1) appreciation and encouragement; (2) team support and communication; (3) collaboration across professions and institutions; (4) informational, material and technical support; (5) leadership and participation; and (6) creativity and innovation. The analysis highlights the importance of systemic and organisational factors for maintaining health system resilience. The need to improvise and develop pragmatic solutions to deal with COVID-related challenges offered ample opportunities for participation, self-determination, innovation, and alternative work processes. Learning from adaptations made during the pandemic and implementing sustainable organisational and systemic changes to increase participation, conducive organisational cultures, and non-hierarchical working styles hold promising potential for health system transformation and health system strengthening.

Background: Global Health (GH) in Germany increasingly becomes subject of political priority and scientists and policy makers. The aim of this study was to gain understanding of the current state, potential barriers and enablers of interdisciplinarity in GH in the academic sector in Germany.Methods: Between October 2019 and February 2020, we conducted thirteen semi-structured interviews with ten academics and three policymakers engaged in GH in Germany. Purposive and maximum contrast sampling based on review of the literature was performed to ensure a heterogenous set of study participants.Findings: We found that interdisciplinary exchange in GH research and education is limited in the German academic setting. Several context-specific barriers of interdisciplinary collaboration in the academic sector in Germany were detected, including terminological ambiguities and more biomedical actors being involved in global health compared to other disciplines. At the same time, enablers such as promotion of young academics and fostering topic-specific collaboration in GH research and education were identified to improve interdisciplinary working.Conclusion: The importance of following an interdisciplinary approach is discussed and acknowledged across scientists working on GH in Germany. The current challenge is to identify which GH topics lend themselves to the collaboration of Germany-based scientists from various backgrounds and to establish common goals to advance interdisciplinarity research.

Introduction: Malaria remains a significant global health issue, particularly among children under 5 years of age and pregnant women. In Guinea and Sierra Leone, malaria care in these vulnerable groups remains suboptimal and may have deteriorated due to the COVID-19 pandemic. Thus, evidence on the state of the malaria care cascade is urgently needed to guide public health interventions after the COVID-19 pandemic. Methods: We conducted a cross-sectional household survey to evaluate the state of the malaria care cascade—in terms of care-seeking, diagnosis, treatment and outcomes—and explore factors associated with receiving malaria testing during an episode of fever among children under 5 years of age and pregnant women during the COVID-19 pandemic between May and August 2022. Steps of the care cascade were assessed against WHO recommendations, and factors associated with receiving a malaria test were explored by multivariable regression. Results: We surveyed caregivers of 1377 children under 5 years of age and 254 pregnant women with an episode of fever in three regions and three districts in Guinea and Sierra Leone, respectively. Reported malaria testing rates varied from 42% to 96% in children and 62% to 91% in pregnant women by region/district. Trust in the healthcare system, not avoiding health facilities, receiving informative messages about malaria and pregnant women attending antenatal care (ANC) services were factors associated with receiving a malaria test. Between 54% and 81% of children and 24% to 69% of pregnant women with malaria received treatment within 2 days of fever-onset by region/district, while delays were reported at all steps of the care cascade. Hospitalisation due to the malaria episode was reported by 6.5% and 4.3% of children, as well as 9.5% and 12% of pregnant women in Guinea and Sierra Leone, respectively. Conclusion: Our study reveals maintained reported use of malaria care services during the COVID-19 pandemic and heterogeneous potential for improvement along all steps of the malaria care cascade in Guinea and Sierra Leone. Interventions promoting trust in the healthcare system, informative malaria messages and ANC coverage among pregnant women may improve malaria care in both countries.