Abstract
Healthcare establishments are unique and complex. The Indian healthcare system comprises of public and private healthcare establishments. Different challenges are encountered by the healthcare professionals in their daily operations. The sudden emergence of COVID-19 posed a new threat to the already burdened healthcare system. The pandemic changed the healthcare paradox with newer workplace and societal challenges faced by the healthcare personnel. The purpose of this study is to identify the antecedents of workplace and societal challenges faced by the healthcare personnel. Our study conducted in Kolkata and other adjoining areas of West Bengal included respondents who volunteered for individual in-depth interviews. The sample size was kept at n = 20 after due technical considerations. Freelisting and pile sorting was done to generate clusters. The qualitative study identified five constructs with 18 items under workplace challenges and three constructs with five items under societal/community challenges. Workplace challenges included resource availability, adequacy and allocation, financial issues, perceived managerial ineffectiveness, inconsistent guidelines and perceived occupational stress, while societal/community challenges included dread disease, social adaptiveness and challenges related to essential services. A salience threshold was established and the multidimensional scaling provided four major clusters: financial support and sustainability, adaptive resilience, infection risk mitigation and healthcare facility preparedness. Suggestive actions for the identified challenges were summed as enhanced production of diagnostic kits through public–private partnership models and industrial production reforms. Enhanced testing facility for COVID-19 will help to identify new cases. Financial stresses need long-term sustainable alternative that will avoid pay cuts and unemployment. Treatment regimen, diagnostic protocols, waste disposal guidelines should be worked upon and leading national agencies be consulted for technical support, research and development.
Highlights
The healthcare organisations are evolving to adapt to shifts pertaining to demography, epidemiology and societal mindsets that are emerging in the backdrop of several contexts, challenges and uncertainties
The different factors/ challenges suggested by the respondents during the pilot survey included ‘workplace settings’, ‘community/neighbourhood settings’, ‘health status of patient before entry to healthcare facility (HCF)’, ‘during the course of treatment’, ‘breaking bad news (BBN)’ and ‘communication on death’
The qualitative study identified the following major themes, which could be broadly categorised into workplace challenges and societal/community challenges, respectively
Summary
The healthcare organisations are evolving to adapt to shifts pertaining to demography, epidemiology and societal mindsets that are emerging in the backdrop of several contexts, challenges and uncertainties. The significant shortage of skilled human capital in healthcare for addressing the health needs of the current and emerging population across the world has been identified by World Health Organization (WHO, 2006). There have been some developments and improvements in global health workforce, still there are remarkable differences due to varied individualised healthcare challenges of the different health systems. The numerical shortage of human capital is one common challenge, the notable differentiation in skill mix, uneven distribution of human healthcare capital across geography, strenuous interprofessional collaborations, injudicious use of resources and burnout variations vary across nations (Figueroa et al, 2019). The studies conducted till date are largely country or region specific and have not been integrated from the multidimensional or international insight since a single defining global healthcare system is lacking (WHO, 2018)
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