The resilience of the Hospital of Mali to COVID-19 in a context of penuries

Abstract

The objective of this research is to report the strategies of resilience mobilized by the Hospital of Mali to face Coronavirus disease (COVID-19). The data collected within the hospital covered the first months of the pandemic (April to July 2020). A total of 32 semi-structured interviews and 53 observation sessions were conducted. Data analyses were based on a conceptual framework and were conducted using a deductive approach. The results show that, due to the multiple effects of the COVID-19 such as the aggravation of staff penuries, the high workloads, the need to create dedicated infrastructures, the drastic decrease in revenue due to the drop in hospital's attendance, the hospital and its staff implemented multiple strategies (e.g., reduction or postponement of some expenses, requisition of facilities, recruitment of contractual staff and redeployment of some healthcare workers). Those strategies generally allowed to maintain patients access to care, although there were many restrictions for non-COVID-19 patients. The hospital was able to build absorptive resilience. This qualitative research provides a better understanding of hospitals' resilience processes to the COVID-19 pandemic in a hospital setting. Lessons learned from this study should help hospitals managers to design more appropriate and effective responses to future health crises.