Frontline Workers Research Articles

Colonial necropolitics in responding to gender‐based violence amidst cascading disasters in Puerto Rico

AbstractThis article analyzes how the practice of cascading disaster responses and the relative erasure of increasing cases of gender‐based violence (GBV), including feminicidio, or feminicide, by the government in Puerto Rico evidence the structural and regularly reproduced vulnerability of marginalized populations. Drawn from fieldwork in southwestern Puerto Rico between 2019 and 2020, this essay juxtaposes the lived experience of frontline GBV service providers with the relative absence of GBV from the public record until 2022. For activists and scholars, the prevalence of GBV and its relative exclusion from state discourse and records is rooted in ideological, cultural, and operational concerns: operationally, GBV is too often excluded from planned disaster response. Culturally, state‐supplied statistics on GBV minimized and otherwise naturalized GBV into a cultural norm or reality‐to‐be‐expected. Ideologically, the exclusion of GBV is also tied to the colonial relationship between Puerto Rico and the United States. We argue that GBV and its relative exclusion from the public record sustains high levels of violence that have already fueled notable public protest and the constrained working conditions of GBV frontline service providers. The article's focus on frontline worker experiences highlights their important role at the forefront of decision‐making on how to mitigate GBV during and in the wake of cascading disasters.

Prevalence and associated factors of depression, anxiety and stress among clinical therapists in China in the context of early COVID-19 pandemic.

To study the socio-demographic characteristics and the prevalence of depression, anxiety, and stress among clinical therapists in China during the early Coronavirus disease 2019 (COVID-19) pandemic and to identify associated factors. This cross-sectional study was part of a multicenter, nationally representative survey conducted through WeChat from January 2021 to March 2021. Data, including socio-demographics, health-related behaviors, and information on whether they participated in the frontline work of treating COVID-19, were collected anonymously. Respondents also completed the Depression Anxiety Stress Scales-21 (DASS-21). In total, 396 clinical therapists in the selected hospitals completed the questionnaires, with a response rate of 89.0%. Respondents were predominantly female (77.3%). About 6.6% of the participants were current tobacco users, and 20.7% had participated in the frontline work of treating COVID-19. Overall, 22.0%, 17.9%, and 8.8% of participants were classified as having clinically meaningful depression, anxiety, and stress, respectively, based on DASS-21 scores. Multiple logistic regression in Model 1 and Model 2 showed that depression, anxiety, and stress were associated with regular physical activity and frequent insomnia (all, p < 0.05). In anxiety model 2, the associated factors for anxiety during the pandemic were identified as education (master's degree or more, OR=0.520; 95% CI=0.283-0.955), marital status (single, OR=2.064; 95% CI=1.022-4.168), tobacco use (OR=4.265; 95% CI=1.352-13.454), regular physical activity (OR=0.357; 95% CI=0.192-0.663), frequent insomnia (OR=6.298; 95% CI =2.522-15.729), and participation in the frontline work of treating COVID-19 (OR=3.179; 95% CI=1.697-5.954). The COVID-19 epidemic did not significantly increase the depression and stress levels among clinical therapists, but it did significantly increase anxiety levels. During the COVID-19 pandemic, depression, anxiety and stress were relatively common among clinical therapists in China. Regular physical activity and good sleep were important protective factors against emotional problems. Therefore, encouraging regular physical activity and actively addressing clinical therapists' sleep problems is beneficial to improving the ability to cope with negative emotions. The COVID-19 epidemic significantly increased anxiety, and awareness and interventions should be recommended to reduce anxiety among clinical therapists during the COVID-19 pandemic.

Time series analysis of malaria cases to assess the impact of various interventions over the last three decades and forecasting malaria in India towards the 2030 elimination goals

BackgroundDespite the progress made in this decade towards malaria elimination, it remains a significant public health concern in India and many other countries in South Asia and Asia Pacific region. Understanding the historical trends of malaria incidence in relation to various commodity and policy interventions and identifying the factors associated with its occurrence can inform future intervention strategies for malaria elimination goals.MethodsThis study analysed historical malaria cases in India from 1990 to 2022 to assess the annual trends and the impact of key anti-malarial interventions on malaria incidence. Factors associated with malaria incidence were identified using univariate and multivariate linear regression analyses. Generalized linear, smoothing, autoregressive integrated moving averages (ARIMA) and Holt’s models were used to forecast malaria cases from 2023 to 2030.ResultsThe reported annual malaria cases in India during 1990–2000 were 2.38 million, which dropped to 0.73 million cases annually during 2011–2022. The overall reduction from 1990 (2,018,783) to 2022 (176,522) was 91%. The key interventions of the Enhanced Malaria Control Project (EMCP), Intensified Malaria Control Project (IMCP), use of bivalent rapid diagnostic tests (RDT-Pf/Pv), artemisinin-based combination therapy (ACT), and involvement of the Accredited Social Health Activists (ASHAs) as front-line workers were found to result in the decline of malaria significantly. The ARIMA and Holt’s models projected a continued decline in cases with the potential for reaching zero indigenous cases by 2027–2028. Important factors influencing malaria incidence included tribal population density, literacy rate, health infrastructure, and forested and hard-to-reach areas.ConclusionsStudies aimed at assessing the impact of major commodity and policy interventions on the incidence of disease and studies of disease forecasting will inform programmes and policymakers of steps needed during the last mile phase to achieve malaria elimination. It is proposed that these time series and disease forecasting studies should be performed periodically using granular (monthly) and meteorological data to validate predictions of prior studies and suggest any changes needed for elimination efforts at national and sub-national levels.

THE CHALLENGE OF ABSENTEEISM OF PUBLIC HEALTHCARE CENTERS WORKER IN THE RURAL AREA: A STUDY ON SYLHET DISTRICT, BANGLADESH

Absenteeism has been linked to ineffective healthcare delivery in several studies. This research looks at absenteeism in Bangladesh's public healthcare centers (PHCs), a health system level recognized as vulnerable to absenteeism. Front-line health workers, administrators, service consumers, and health propensity committee chairpersons were interviewed in detail and participated in focus groups. Absenteeism was shown to be quite common among healthcare employees, and it is much more of a problem in PHCs when lateness is included. Absenteeism influences the pair service consumers and associates, although it is not necessarily intentional. Even though there are measures to prevent absenteeism in PHCs, our results reveal that they are readily evaded and ineffectual due to utilization and formative difficulties. The Anti-Corruption Evidence (ACE) strategy, which aims to include and improve the stimulations of significant players in the system to support efficiency-renovating measures and, in turn, ensure efficient service delivery, might be relevant in this case. In this research, we will look at the issues of a lack of health workers in Bangladesh's PHCs, patient satisfaction and the quality of services at PHCs, and the effect of a lack of health workers in Bangladesh's rural public healthcare centers (PHCs).

Immune Response to COVID-19 Vaccination in Frontline Healthcare Workers.

This study evaluated the immune response to vaccination against COVID-19 in 534 healthcare frontline workers in Vilnius, Lithuania. The incidence of COVID-19 was reduced significantly after vaccination started in the healthcare sector. SARS-CoV-2 antibodies were detected in groups V-VII and this level of antibodies was found to be effective in preventing COVID-19. Sustained immune response was achieved after two vaccination doses, which remained stable for up to 6 months. After the booster dose, antibody levels remained high for an additional 12 months. Although SARS-CoV-2 antibody levels decreased after 6 months, even lower levels of antibodies provided protection against the Delta strain. The booster dose distributed the antibody titer in the high-level antibody groups, offering maximum protection at 12 months. However, even individuals with high antibody titers were observed to contract COVID-19 after vaccination with a booster dose and 6 months in the presence of the Omicron strain. Unfortunately, high levels of antibodies did not provide protection against the new strain of COVID-19 (the Omicron variant), posing a risk of infection. When comparing the antibody titer of vaccinated participants without COVID-19 and those with COVID-19, the change in antibodies after vaccination was significantly lower in infected participants. Individuals with comorbidities and specific conditions had lower antibody levels.

Examining birth preparedness and complication readiness: a systematic review and meta-analysis of pregnant and recently delivered women in India

BackgroundBirth preparedness and complication readiness (BPCR) is an essential component of safe motherhood programs. This study aims to systematically identify and synthesize available evidence on birth preparedness and complication readiness among pregnant and recently delivered women in India.MethodsThe study followed PRISMA guidelines and used databases such as PubMed, Cochrane Library, and ProQuest. Joanna Briggs Institute [JBI] Tool was used for critical appraisal of studies. The meta-analysis was conducted using Comprehensive Meta-Analysis [CMA] tool and R studio software. Statistical heterogeneity was evaluated using visual inspection of the forest plot, Cochran’s Q test, and the I2 statistic results. Funnel plot and Egger’s tests were applied to explore the possibility of the publication bias in the studies [PROSPERO: CRD42023396109].ResultThirty-five cross-sectional studies reported knowledge on one or more components of birth preparedness [BP], whilst knowledge on complication readiness [CR] or danger signs was reported in 34 included studies. Utilizing the random effect model, the pooled result showed that only about half of the women [49%; 95% CI: 44%, 53%] were aware on BPCR components. This result ranged between 15% [95% CI: 12%, 19%] to 79% [95% CI: 72%, 84%] in Maharashtra and Karnataka respectively [I2 = 94%, p = < 0.01]. High heterogeneity [> 90%] is observed across all components [p < 0.01]. The result of subgroup analysis indicated no significant difference in the proportion on BPCR among pregnant women [50%; 95% CI: 45%, 55%] and recently delivered women [54%; 95% CI: 46%, 62%]. However, the southern region of India indicates relatively better [56%; 95% CI: 45%, 67%] prevalence.ConclusionOur study highlights the low prevalence of BPCR in India and the factors associated with it. Scaling up cost-effective interventions like BPCR that have a positive overall effect is necessary. Authors strongly suggests that birth preparedness and complication readiness should be given utmost importance to reduce maternal morbidity and mortality to achieve the Sustainable Development Goals. Consideration should be given to fortifying existing resources, such as frontline workers and primary healthcare, as a strategic approach to augmenting the effectiveness of awareness initiatives.

Point-of-care ultrasound, today, tomorrow, and the future – the place for task sharing

Background: Maternal and neonatal morbidity and mortality remain public health concerns. A study onmortality in Kenyan hospitals found that neonates comprise two-thirds of deaths in the pediatric agegroup (0–13 years). These deaths are caused by preventable conditions or those, which can bemanaged better if diagnosed early, such as placenta insufficiency, placenta previa, severe fetal growthrestriction, congenital abnormalities, multiple pregnancies, and breech presentation; these can all beidentified using point-of-care ultrasound (POCUS). Obstetrical ultrasound availability is limited to level 4and higher facilities, yet most women access lower levels of health care. Implementation of POCUS iscurrently limited because of a lack of appropriate training, limited scope of practice for frontline workers,and legal framework.Objective: The POCUS project is being undertaken to develop national guidelines to facilitate the roll outand scale-up of obstetrical POCUS.Methods: A collaborative participatory approach is planned for the development of the national POCUSguidelines. The key in this process is the identification of suitable frontline workers who, with adjustmentto their scope of practice, appropriate training, implementation of a supervision/referral system, canundertake obstetrical POCUS and gain buy-in from regulatory bodies, the inclusion of voices of relevantstakeholders, and leadership from government. A landscape and stakeholders analysis will also beundertaken as part of the process of the guideline development.Results: Narrative literature review shows that the WHO recommends effective and reliable antenatalultrasound services to be available to all pregnant women to optimize maternal and newborn healthoutcomes and at least one ultrasound scan up to 24 weeks of pregnancy. That there are deliberateefforts in Kenya to introduce POCUS with pilot training and implementation. Where obstetrical POCUS isimplemented, it is useful in diagnosing fetal malpresentation, placenta previa, congenital malformations,or multiple pregnancies. Appropriate interventions, such as reduction of cesarean delivery, induction oflabor, reduction of small for gestational age, low birthweight, preterm birth, and stillbirths, can improve thehealth outcome of the mother and neonate. There is a need to develop national POCUS guidelines.Conclusions: Implementation of POCUS may be riddled with difficulties, particularly where frontlineworkers’ current scope of practice may not allow them to perform such procedures, regulatoryframework, lack of knowledge, awareness, negative attitude, or behavior. The proposed guidelines willaddress these barriers.

Teaching comprehensive sexuality education in a traumatized society: recognizing teachers as sexual, reproductive, and mental health frontline workers

IntroductionResearch on school-based sexuality education in South Africa, taught within Life Orientation (LO), has mainly focused on learners’ responses, how teachers approach the subject, and the curriculum content. Critiques have included heteronormative biases, an emphasis on danger, disease and damage, a reinforcement of gendered binaries, and the lack of pleasure or well-being discourses. In contrast, our research focused on the unexpected moments teachers experience, i.e., the ethical, emotional or psychological challenges they encounter in their interactions with learners.MethodsWe interviewed 49 teachers across a range of schools in three provinces. Data were analyzed using narrative thematic analysis.ResultsTeachers’ narratives referred to an alarming array of traumas and psychosocial problems experienced by learners, including sexual abuse, substance abuse, neglect, HIV diagnosis, unsafe abortion, witnessing murders, and attempted suicide. Teaching particular topics, they indicated, triggered learner distress, although, sometimes, distress was triggered by innocuous topics. Teachers felt insufficiently skilled to teach certain topics sensitively to promote the well-being of learners who experienced current or past trauma. They also felt ill-equipped to deal with learners reporting trauma or psychosocial problems to them. Strategies narrated included allowing learners to skip relevant classes, building trust, understanding learners’ needs, being a learner’s advocate, and drawing on learners’ grounded expertise. Teachers spoke of experiencing burnout and secondary trauma themselves.DiscussionWe argue that LO teachers are, in effect, sexual, reproductive and mental health frontline workers. They need in-depth training in learner-centered and dialogical approaches to build trust within the classroom sensitively and in basic screening, containment, referral and lay counselling skills to assist distressed learners outside the class. A wellbeing approach to sexuality education requires providing LO teachers with ongoing support and consultation with peers and mental health professionals to avoid burnout and promote well-being.

Factors of success, barriers, and the role of frontline workers in Indigenous maternal-child health programs: a scoping review

BackgroundDespite considerable investment in maternal-child programs in Canada, there has been little positive impact on the health of Indigenous mothers and their children. The reasons for this are unclear and there is a need to identify how such programs can be successfully implemented. Community input is essential for successful programs; however, it is unclear what the contributions of frontline workers have been in the health program process, i.e., program development, delivery, and evaluation. Based on these identified gaps, this scoping review aimed to: (1) identify factors of success and barriers to successful Indigenous maternal-child community health programs for mothers and their children aged 0–6 years; and (2) explore how frontline workers are included in the program process.MethodsThis scoping review was completed using the Arksey and O’Malley framework, informed by Levac et al. Four data bases (Medline, CINAHL, Embase, and Scopus), grey literature, and reference lists were searched for relevant materials from 1990–2019. Data was extracted from included articles and analysed using descriptive statistics, thematic analysis with the Braun and Clarke framework, and a Principal Component Analysis.ResultsForty-five peer-reviewed and grey articles were included in the review. Factors of program success included: relationship building; cultural inclusion; knowledge transmission styles; community collaboration; client-centred approaches; Indigenous staff; and operational considerations. Barriers included: impacts of colonization; power structure and governance; client and community barriers to program access; physical and geographical challenges; lack of staff; and operational deficits. Frontline workers were found to have a role in program delivery (n = 45) and development (n = 25). Few (n = 6) had a role in program evaluation.ConclusionAlthough a better understanding of the frontline worker role in maternal-child health programs was obtained from the review, in a large proportion of literature the authors could not determine if the role went beyond program delivery. In addition, no direct input from frontline workers and their perspectives on program success or barriers were identified, suggesting areas to explore in future research. This review's findings have been applied to inform a community-based participatory research project and may also help improve the development, delivery, and evaluation of Indigenous maternal-child health programs.

Overcoming walls and voids: Responsive practices that enable frontline workers to feel heard.

There is increasing recognition that beyond frontline workers' ability to speak up, their feeling heard is also vital, both for improving work processes and reducing burnout. However, little is known about the conditions under which frontline workers feel heard. This inductive qualitative study identifies barriers and facilitators to feeling heard among nurses in hospitals. We conducted in-depth semistructured interviews with registered nurses, nurse managers, and nurse practitioners across four hospitals ( N = 24) in a U.S. health system between July 2021 and March 2022. We coded with the aim of developing new theory, generating initial codes by studying fragments of data (lines and segments), examining and refining codes across transcripts, and finally engaging in focused coding across all data collected. Frontline nurses who spoke up confronted two types of challenges that prevented feeling heard: (a) walls, which describe organizational barriers that lead ideas to be rejected outright (e.g., empty solicitation), and (b) voids, which describe organizational gaps that lead ideas to be lost in the system (e.g., structural mazes). We identified categories of responsive practices that promoted feeling heard over walls (boundary framing, unscripting, priority enhancing) and voids (procedural transparency, identifying a navigator). These practices appeared more effective when conducted collectively over time. Both walls and voids can prevent frontline workers from feeling heard, and these barriers may call for distinct managerial practices to address them. Future efforts to measure responsive practices and explore them in broader samples are needed. Encouraging responsive practices may help ensure that frontline health care workers feel heard.

Retraction: Mental health problems among front-line healthcare workers caring for COVID-19 patients in Vietnam: a mixed methods study.

[This retracts the article DOI: 10.3389/fpsyg.2022.858677.].

Normalized Expendability: Navigating Immigrant Legal Status During A Global Pandemic

Using longitudinal qualitative data, we examine how undocumented immigrants in Florida navigated the first year of the COVID pandemic. Building on the concepts of compounded vulnerability and legal violence, we demonstrate how heightened exposure to COVID shaped immigrants’ well-being by virtue of being overrepresented among frontline workers, underserved by the healthcare industry, and excluded from government pandemic aid. We demonstrate how immigrants’ anxieties overlay onto existing vulnerabilities facing those without legal status; although undocumented immigrants were often at even greater risk for negative outcomes related to the pandemic, access to mitigation efforts was denied to them because of policies and laws that allow for—and normalize—the unequal treatment of noncitizens. Findings demonstrate that undocumented immigrants and their families experienced legal violence through the mechanisms of restricted government aid, for which they were ineligible, in addition to bureaucratic delays in immigration paperwork renewals that resulted in expiring work permits for some with Deferred Action for Childhood Arrivals. These experiences further compounded their economic and social marginalization, rendering immigrants an expendable social group. We identify coping strategies that allowed immigrants to persevere in the face of uncertainty and distress and discuss how policies can diminish some of these vulnerabilities and improve their well-being.

Use of mHealth in promoting maternal and child health in "BIMARU" states of India "A health system strengthening strategy": Systematic literature review.

Low-middle income countries like India bear a heavier burden of maternal, childcare, and child mortality rates when compared with high-income countries, which highlights the disparity in global health. Numerous societal, geopolitical, economic, and institutional issues have been linked to this inequality. mHealth has the potential to ameliorate these challenges by providing health services and health-related information with the assistance of frontline workers in the provision of prepartum, delivery, and postnatal care to improve maternal and child health outcomes in hard-to-reach areas in low- and middle-income countries (LMICs). However, there is limited evidence to support how mHealth can strengthen maternal and child health in India. The scoping review guideline in the Cochrane Handbook was used to retrieve studies from 4 international databases: CINAHL, Embase, Medline Ovid, and PubMed. This search strategy used combined keywords (MeSH terms) related to maternal and child healthcare, mHealth, and BIMARU in conjunction with database-controlled vocabulary. Out of 278 records, 8 publications were included in the review. The included articles used mHealth for data collection, eLearning, communication, patient monitoring, or tracking to deliver maternal and neonatal care. The results of these papers reflected a favourable effect of mHealth on the target population and found that it altered their attitudes and behaviours about healthcare. Higher job satisfaction and self-efficiency were reported by mHealth user care providers. Multiple barriers to the acceptance of mHealth exist, but the majority of the evidence points towards the feasibility of the intervention in a clinical setting. The mHealth has positive potential for improving maternal and child health outcomes in low-resource settings in India's BIMARU states by strengthening the healthcare system. The results of the study could be used in the tailoring of an effective mHealth intervention and implementation strategy in a similar context. However, there is a need for economic evaluation in the future to bridge the knowledge gap regarding the cost-effectiveness of mHealth interventions.

Effect of Inclusive Early Childhood Development (IECD) on Growth and Development of Children in the Rural Part of the Central India: A Cohort Study.

To compare the difference between the growth and developmental status of the children who were residing in the area where Inclusive Early Childhood Development (IECD) project was being implemented and who had received interventions through trained Anganwadi workers (Frontline workers) under Integrated Child Development Services (ICDS) scheme with the children who had not received the Inclusive ECD project interventions. It was a mixed method cohort study, nested in an ongoing project in a medical college in which Inclusive ECD was used as an intervention through International Guide for Monitoring Child Development (GMCD) which is a tool for both monitoring and assessment with the help of existing government structures and personnel such as Anganwadi workers, Anganwadi supervisors and their contact points with communities. A sample of 200 children was selected; 100 each from intervention group (IECD cohort) and comparison group (Usual care cohort) and were followed till the child became 2 y of age. IECD intervention showed statistically significant effect on weight (p = 0.04) and height (p = 0.03) of the IECD cohort. Overall developmental assessment showed that the identified developmental issues (Concerns + Delays) were approximately half in IECD cohort (9.67%+5.37%=15.04%) as compared to usual care cohort (17.20%+11.82%=29.02%). The results from binomial logistic regression performed for developmental outcomes were statistically significant (p = 0.04) suggesting that children with IECD intervention have lower odds of developing developmental issues. The study indicates that it is possible to implement IECD interventions through frontline workers, which significantlyimproves the growth and development of the children.

Populist government support and frontline workers' self‐efficacy during crisis

AbstractFrontline workers who are confronted with crises need enormous resilience and the ability to deal with stress from crisis‐related increases in demands and risks. Simultaneously, populist governments with an illiberal agenda may undermine the work of street‐level bureaucracies for political reasons. Little is known about how deconstruction of the administrative state by populist government—through lacking government support when it is needed the most—affects frontline work. Thus, this article asks: how does lacking support by a populist government affect frontline workers' self‐efficacy when they face a crisis? Based on unique data from an online survey of 3229 Brazilian frontline workers during the early COVID‐19 pandemic, when the Bolsonaro government denied the existence of the pandemic, we test the relationship between government support, demands, and resources on frontline workers' perceived self‐efficacy. Results show that lacking government support from the federal and local government are negatively associated with frontline workers' self‐efficacy. At the same time, resources and managerial support exhibit positive associations—but they cannot always compensate for a lack of government assistance.

Feasibility and acceptability of a culturally adapted psychological first aid training intervention (Preparing Me) to support the mental health and well-being of front-line healthcare workers in China: a feasibility randomized controlled trial

ABSTRACT Background: Psychological first aid (PFA) training helps to prepare healthcare workers (HCWs) to manage trauma and stress during healthcare emergencies, yet evidence regarding its effectiveness and implementation is lacking. Method: A two-arm feasibility randomized controlled trial design was conducted in a Chinese tertiary hospital. Participants were randomly allocated to receive either a culturally adapted PFA training (the intervention arm) or psychoeducation (the control arm). Feasibility indicators and selected outcomes were collected. Results: In total, 215 workers who expressed an interest in participating in the trial were screened for eligibility, resulting in 96 eligible participants being randomly allocated to the intervention arm (n = 48) and control arm (n = 48). There was a higher retention rate for the face-to-face PFA training session than for the four online group PFA sessions. Participants rated the PFA training as very helpful (86%), with a satisfaction rate of 74.25%, and 47% reported being able to apply their PFA skills in responding to public health emergencies or providing front-line clinical care. Positive outcome changes were observed in PFA knowledge, skills, attitudes, resilience, self-efficacy, compassion satisfaction, and post-traumatic growth. Their scores on depression, anxiety, stress, and burnout measures all declined. Most of these changes were sustained over 3 months (p < .05). Repeated measures analysis of variance found statistically significant interaction effects on depression (F 2,232 = 2.874, p = .046, η p 2 = .031) and burnout (F 2,211 = 3.729, p = .018, η p 2 = .037), indicating a greater reduction in symptoms of depression and burnout with PFA compared to psychoeducation training. Conclusion: This culturally adapted PFA training intervention was highly acceptable among Chinese HCWs and was feasible in a front-line care setting. Preliminary findings indicated positive changes for the PFA training intervention on knowledge, skills, attitudes, resilience, self-efficacy, compassion satisfaction, and post-traumatic growth, especially a reduction of depression and burnout. Further modifications are recommended and a fully powered evaluation of PFA training is warranted.

Inclusive leader and job crafting: the role of work engagement and job autonomy in service sector organisations

PurposeThe ever-demanding role of employees in the hospitality sector stimulates job crafting. This study examines the relationship between inclusive leadership and job-crafting dimensions under the mediating role of work engagement through the lens of conservation of resources (COR) theory. It also aims to analyse the boundary condition of job autonomy between inclusive leadership and work engagement.Design/methodology/approachThe data were collected in 3-time lags from 319 front-line workers in the hospitality sector. The adopted and adapted questionnaires were executed through a deductive approach and an applied research method. The data were analysed through SmartPLS by applying the structural equation modelling (SEM) technique.FindingsThis study provides evidence for a predictive relationship between inclusive leadership and job-crafting dimensions under the mediating psychological mechanism of work engagement. Additionally, the moderating role of job autonomy is established in the unique context of the hospitality sector of an underdeveloped country, Pakistan.Practical implicationsServices-based organisations need to endure the inclusive leadership style by establishing work engagement practices. Engaged employees result in better job-crafting behaviours through better training and subsequent performance.Originality/valueThis study established that work engagement and job autonomy are imperative forces that impact the relationship between inclusive leadership and job-crafting dimensions. The research study has time-lagged data and conveys meaningful theoretical and practical implications.

Employees’ perception of the impacts of global health crisis on work performance and sentiments about future career: the case of early childhood education

ABSTRACT Frontline workers who offered essential services in different industries during the outbreak of the COVID-19 pandemic faced enormous challenges. This study presents the outcome of a survey that investigates employees’ sentiments, perceptions, and ergonomics in early childhood education while weathering the pandemic storms during in-person opening amidst the global health crisis. The results show that employees faced increased workload, psychological burden, and heightened uncertainty about health and social life as the pandemic raged. The teaching and non-teaching staff attributed the increased workload to additional paperwork requirements and worker shortages due to quarantine and self-isolation. Public health safety became a priority at the preschool to keep the students, staff, and their families safe. Despite the uncertain future, employees were resolute about career choices in early childhood education. The ‘family advocacy’ services, a unit that liaises with families to improve kids’ learning outcomes, utilized virtual communication technology during the pandemic (e.g. Zoom and Microsoft Teams) to limit physical contact, which produced positive results, including significant improvement in productivity, performance efficiency, and quality. Most workers remained hopeful about overcoming the prevailing workplace challenges caused by the pandemic.

Factors Affecting Psychological Health in the COVID-19 Pandemic

Abstract: Global mental health has been put at risk by the coronavirus disease 2019 (COVID-19) pandemic, both directly and indirectly through disruptive social shifts and neuropsychiatric repercussions of SARS-CoV-2 infection. Despite a little rise in selfreported mental health issues, there has not been an increase in the population's rates of mental disorders, self-harm, or suicide that could be measured objectively. Demographic factors, such as sex, age, and profession, have emerged as key determinants, with women, younger individuals, and frontline workers facing elevated risks. In this review, we have addressed the key considerations that have impacted the mental well-being of the populace during COVID-19. A comprehensive literature search on the SCOPUS and PubMed databases was used to find the current research studies on the COVID-19 outbreak relevant to mental health. According to preliminary research, self-reported stress (8%) and symptoms of worry and depression (16–28%) have been prevalent psychological responses to the COVID-19 pandemic and they may have been linked to sleep disruption. This risk has been reported to be moderated by several individual and systemic factors. Acute and postacute neuropsychiatric consequences of COVID-19 have also been identified, with a significant prevalence of fatigue, cognitive decline, and anxiety and depression symptoms, even months after infection. Coping with challenges, such as social distancing, economic instability, and altered routines, has posed significant mental health concerns. Access to mental health resources and robust social support systems has, however, played pivotal roles in addressing these challenges. The review has underscored the urgent need for comprehensive mental health interventions, addressing social determinants, ensuring equitable access to healthcare, and recognizing the enduring effects of the pandemic.

Integrating humanities in healthcare: a mixed-methods study for development and testing of a humanities curriculum for front-line health workers in Karachi, Pakistan

Lady health workers (LHWs) provide lifesaving maternal and child health services to >60% of Pakistan’s population but are poorly compensated and overburdened. Moreover, LHWs’ training does not incorporate efforts to...