Resilient Healthcare Systems Research Articles

Examining the impact of psychosocial safety climate on working conditions, well-being and safety of healthcare providers: a scoping review

BackgroundIn contemporary healthcare systems, the well-being and safety of healthcare providers are pivotal for sustaining a resilient healthcare system. The concept of Psychosocial Safety Climate (PSC) emerges as a crucial framework influencing job design and employee perceptions in organisational settings, although its application within healthcare settings remains relatively underexplored. The aim of this review was to explore the buffering effect of PSC and its impact on working conditions, well-being and performance.MethodThis scoping review followed Arksey and O’Malley’s recommendations and PRISMA-ScR reporting checklist. Databases, including PubMed, Scopus, Central, JSTOR, and additional online sources such as Google Scholar were searched. Only peer-reviewed studies published in English that have measured PSC using PSC-12 or PSC-4 were included in this study.FindingsHigh PSC environments correlated with enriched job resources, fostering resilience, positive job performance, and reduced job demands. Conversely, low PSC settings were linked to increased job demands, compromised well-being, and adverse job performance outcomes. Notably, PSC acted as a buffer, mitigating the negative impacts of high job demands on well-being and reinforcing positive associations between job resources, support, and performance facets among healthcare professionals.ConclusionThis review highlights the pivotal role of PSC in shaping the work environment, well-being, and performance of healthcare providers. Prioritising PSC within healthcare settings is crucial to safeguarding the well-being of healthcare providers and improving patient outcomes. Future research should further explore the relationships between PSC, burnout, and other influencing factors, employing diverse methodologies to capture its comprehensive impact within healthcare settings.

Drug repurposing for sustainable antimicrobial use: exploring pharmacists’ awareness, attitudes, facilitators and barriers

ABSTRACT This study utilized a validated questionnaire that aimed to assess pharmacists’ awareness and attitude towards drug repurposing for antimicrobial use. Despite the reasonable awareness, pharmacists reported unfavourable attitudes. Pharmacists with a B.Pharm. or Pharm.D. degree reported less awareness than pharmacists with a master’s or PhD degree. In contrast, pharmacists who dispensed fewer than 10 prescriptions or 10–29 prescriptions had significantly higher awareness than those who dispensed 30 prescriptions daily or more. Pharmacists who had 1–5 years of experience and those who dispensed less than 10 prescriptions daily had significantly lower attitude scores than their counterpats. The most reported facilitator was the reduced risk of antimicrobial resistance, while the most reported barrier was patient safety. Pharmacists’ perception of drug repurposing for antimicrobial needs to improve via implementing educational sessions that highlight the impact of drug repurposing on supporting the fight against antimicrobial resistance and promoting a more sustainable and resilient healthcare system.

Diagnostic Challenges of Medullary Carcinoma of the Small Intestine During the COVID-19 Pandemic.

Background: Medullary carcinoma of the small intestine is an exceptionally rare subtype of gastrointestinal cancer, characterized by its solid growth pattern and lack of glandular structures, which complicate timely diagnosis. During the COVID-19 pandemic, diagnostic delays for rare cancers became increasingly common due to the prioritization of COVID-related cases and patient reluctance to seek medical attention. Methods and Result: We present the case of a 70-year-old male initially misdiagnosed with COVID-19, whose persistent symptoms led to the eventual discovery of medullary carcinoma. Imaging studies revealed focal lesions in the liver, spleen, and thickened small intestinal walls, prompting surgical resection of a 16 cm intestinal segment. Histopathological examination confirmed medullary carcinoma with lymph node and liver metastases, supported by immunohistochemistry, which showed positive markers (calretinin, pancytokeratin, cytokeratin 7) and excluded other malignancies. Conclusions: The diagnostic delay, exacerbated by the pandemic, highlights the challenges of distinguishing rare cancers from more common conditions during global health crises. This case underscores the importance of advanced diagnostic techniques, such as immunohistochemistry, for accurate identification. Maintaining robust cancer diagnostic pathways during emergencies is crucial to avoid delays in treatment. Future research should focus on improving screening methods for rare cancers and developing resilient healthcare systems to mitigate similar challenges in future crises.

The impact of the COVID-19 pandemic on musculoskeletal disorders-related sick leave among healthcare workers: a retrospective analysis of Slovenian national data.

Musculoskeletal disorders (MSDs) are one of the main causes of health-related absenteeism. MSDs were a known problem among healthcare workers (HCWs) even before COVID-19. The pandemic, with its associated stresses and changes in working conditions, may have influenced the incidence and duration of MSDs-related sick leave (SL) among HCWs. The aim of this study was to compare the incidence and duration of MSDs-related SL among HCWs before and during the COVID-19 pandemic, with a focus on differences between age and gender groups. A retrospective analysis was conducted using Slovenian national SL data on work-related MSDs within NACE Rev. 2 "Human health activities" for 2019, 2020, and 2021, categorized by gender and age. The study found that older HCWs, particularly women, consistently had a higher incidence of work-related MSDs SL than their younger counterparts. However, during the pandemic, MSDs were more common among younger men, while the average duration of SL was longer among younger women. On the other hand, in older HCWs, the average SL incidence decreased during the pandemic, while the SL duration substantially increased. The dynamics of MSDs related SL among HCWs are complex and influenced by several factors, including the challenges posed by the COVID-19 pandemic. Healthcare managers should implement tailored strategies to address MSDs-related absenteeism among specific groups of HCWs to promote a healthier workforce and ensure a resilient healthcare system during health crises.

Health Trends and Its Implications during the COVID-19 Pandemic in Central Visayas, Philippines

The effects of the Covid-19 pandemic have underscored for the Philippines, in particular, and all countries in general, the importance of a resilient health care system to be able to manage health emergencies and disasters. The study aimed to do a situational analysis of the health sector during the COVID-19 pandemic in the Central Visayas, Philippines. The study collected data from national government agencies in the Philippines. The article identifies gaps in the health care system which may have affected not only COVID-19 outcomes but other health indicators which was highlighted due to the pandemic. The study provides health managers and policymakers information that could be used to promote reforms in the health sector to be able to manage future pandemics and health emergencies both in local and national levels.

Examining Inter-Sectoral Approaches to Address Maternal, Child, and Neonatal Under-Nutrition in Sindh A Policy Analysis

Worldwide, undernutrition persists as a public health concern, with significant implications on maternal, neonatal, and child health, including Pakistan. In response to the rising mortality rates in the province of Sindh, the Integrated Reproductive, Maternal, Newborn, Child & Adolescent Health and Nutrition (IRMNCAH&N) strategy was developed with a vision to improve maternal and child health by improving access to essential health services delivered through a resilient healthcare system, aligning with global health targets. This study evaluates the formulation, implementation, and effectiveness of the IRMNCAH&N strategy for neonates, children under 5 years, and pregnant and lactating women. Through the lens of the Health Policy Triangle (HPT), the analysis assesses the policy content, context, process, and stakeholders involved. Various multifaceted political, socio-economic, structural, cultural, and international interactions were identified in shaping policy formulation and implementation.  The study calls for a multi-sectoral collaboration, emphasizing the need to understand and navigate power dynamics and prioritization of women’s empowerment in addressing the root causes of maternal, neonatal, and child malnutrition especially in the presence of funding gaps, structural inequities, and social and cultural barriers. Drawing insights from successful initiatives of other countries, this policy analysis offers recommendations and lessons for policymakers and other stakeholders to enhance the effectiveness of policy interventions in Sindh ultimately contributing to improved maternal, neonatal, and child nutrition outcomes.

The Relationship Between Perceived Nursing Workload and Occupational Fatigue in Clinical Nurses: The Moderating Role of Nursing Teamwork.

This study investigated the association between perceived nursing workload and occupational fatigue in clinical nurses. We specifically focused on how nursing teamwork moderates this relationship. Hospital nurses often face heavy workloads, leading to significant fatigue. Understanding the link between workload, fatigue and teamwork is crucial to addressing nurse burnout. A cross-sectional study was conducted among 356 clinical nurses from five educational-therapeutic hospitals in Ardabil, Iran. Data were collected using validated instruments, including the Occupational Fatigue Exhaustion Recovery-15 (OFER) scale, the Quantitative Workload Inventory (QWI) and the Nursing Teamwork Survey (NTS). Hierarchical linear regression analysis assessed the relationships between perceived workload, occupational fatigue and nursing teamwork. The study's findings show that increased nursing workloads were significantly linked to higher levels of both acute (B = 5.70 to 6.76, p < 0.001) and chronic fatigue (B = 6.71 to 7.16, p < 0.001). Additionally, effective nursing teamwork, comprising trust, team orientation, support, shared mental models and team leadership was associated with reduced fatigue levels. Our study shows high workloads are linked to increased fatigue among nursing professionals. Teamwork can help lessen the adverse effects of workload on fatigue. Healthcare organisations should focus on optimising workload distribution and strengthening teamwork. Further research is needed to understand these dynamics and develop targeted interventions to support nursing staff in high-demand environments. The study emphasises the need for healthcare organisations to prioritise workload management and enhance teamwork among nursing staff. Implementing structured workload assessments and fostering a collaborative work environment, along with policies promoting work-life balance, can improve patient care quality, benefit nursing professionals and contribute to a more resilient healthcare system.

Scalable policy adoption and sustainable implementation of surgical care in the Americas.

On September 29, 2023, the Republic of Ecuador convened a meeting to address surgical system strengthening and urge political leaders to invest in surgical infrastructure. The meeting included experts in health diplomacy, innovative financing, implementation strategy and national surgical plans. The event occurred in parallel with the Sixtieth Directing Council of the Pan American Health Organization, Seventy-fifth session of the World Health Organization Regional Committee for the Americas. The meeting centered around four major areas: (i) building surgical capacity as a means to develop universal health care and emergency preparedness; (ii) developing policies and strategies for strengthening surgical systems; (iii) developing models for financing, sustaining, and improving surgical systems in low- and middle-income countries; and (iv) evaluating implementation strategies for funding these endeavors. National surgical plans represent a critical opportunity to build resilient health care systems by establishing comprehensive and sustainable policies. This article highlights the key messages from the event, which focused on Latin America, to inform the broader global health community.

Sustainable supply chain management in U.S. healthcare: Strategies for reducing environmental impact without compromising access

The U.S. healthcare sector’s supply chain operations are responsible for about 8.5% of all national greenhouse gas (GHG) emissions. In healthcare, traditional supply chain management has focused on cost efficiency to the detriment of environmental considerations leading to higher emissions, waste, and resource depletion. The focus of this study is to investigate strategies for making sustainable supply chain management (SSCM) in the U.S. healthcare system, while reducing environmental impact at minimal cost to patient care quality. The objectives of the study are to evaluate the current state of healthcare supply chains, explore sustainable practices, evaluate emerging technologies, propose an SSCM implementation framework, and explore policy implications. Sustainable supply chain management can be achieved by forming the key strategies: comprehensive waste reduction and recycling programs, adoption of energy efficient transportation and storage solutions, green energy sourcing, and use of data driven inventory management that would help optimize inventory, along with other technologies like blockchain, IoT and artificial intelligence that could achieve transparency and efficiency. The research wouldn't go into specific case studies but would likely look at institutions that have already been able to implement these practices. The findings indicate that considerable environmental footprint reduction of the U.S. healthcare sector is possible without sacrificing access to high quality care through adoption of SSCM practices. But it requires joint efforts from policymakers, healthcare providers and industry partners. The long-term goal is a sustainable, resilient healthcare system that will integrate environmental stewardship with high quality care, that will help mitigate climate change and acknowledge the interdependence of environmental and human health.

OGC SO04 - Impact of COVID-19 on Decision-making and Survival in Esophago-Gastric Cancer Treatment: Insights from a Multidisciplinary Approach

Abstract Background The COVID-19 pandemic necessitated rapid adaptation in healthcare delivery, affecting cancer care pathways. This study assesses the impact of these changes on multidisciplinary team (MDT) decision-making and survival outcomes in esophago-gastric cancer patients across pre-pandemic, peak pandemic, and post-pandemic periods. Method A retrospective cohort study involving patients referred to a UK tertiary EG cancer center during distinct six-month intervals mirroring the pandemic's evolution. Analysis focused on MDT recommendations, treatment pathways, and two-year survival rates, comparing deviations from standard care across periods. Results The study revealed a significant reduction in patient referrals and expedited treatment decisions during the pandemic peak, with a shift towards palliative care in post-pandemic cases. Although no statistically significant difference in two-year survival rates was observed, the post-pandemic period showed an increase in tumor aggressiveness and positive resection margins, suggesting potential long-term impacts of delayed diagnosis and treatment. Conclusion COVID-19 has significantly influenced MDT decision-making and patient pathways in esophago-gastric cancer care, underlining the necessity of resilient healthcare systems. Despite maintaining survival rates, the observed increase in tumor aggressiveness post-pandemic highlights the critical need for uninterrupted cancer diagnosis and treatment services during global health emergencies.

Future Nurses in a Changing Climate: Exploring the Relationship Between Environmental Literacy and Climate Anxiety.

Climate change significantly impacts public health, increasing the prevalence of respiratory, cardiovascular and mental health issues. Nurses, as frontline healthcare providers, need strong environmental literacy to manage these health challenges. This study explores how environmental literacy among nursing students relates to climate anxiety, aiming to improve educational strategies and mental health support for future nurses. Is to investigate how environmental literacy among nursing students affects their levels of climate anxiety. A cross-sectional survey was utilised on a representative sample of 620 nursing students from each academic year. Climate anxiety scale and the environmental literacy scale for adults were used to collect data. Environmental literacy and its components were positively linked to cognitive-emotional and functional impairments and climate anxiety. Gender differences were observed, with females experiencing higher climate anxiety. Increased environmental literacy generally reduced climate anxiety, particularly in females, emphasising gender differences in environmental literacy's impact on climate anxiety. Despite the model's low explanatory power (R2 = 0.026), the findings highlight the importance of gender differences in the relationship between environmental literacy and climate anxiety. Nursing students show promise in their environmental knowledge but face significant climate anxiety. Gender differences in anxiety levels warrant attention. Addressing these concerns is crucial for preparing nurses to effectively address climate change's health effects and ensuring a resilient healthcare system. The study underscores the importance of integrating environmental literacy into nursing education and promoting pro-environmental behaviours among nursing students and professionals. It highlights the crucial role of mental health support services, policy advocacy and ongoing research in addressing climate anxiety and preparing nurses to tackle the health impacts of climate change. No patient or public involvement.

How to ensure an appropriate oral health workforce? Modelling future scenarios for the Netherlands

BackgroundCurrent methods for oral health workforce planning lack responsiveness to dynamic needs, hampering efficiency, equity and sustainability. Effective workforce planning is vital for resilient health care systems and achieving universal health coverage. Given this context, we developed and operationalised a needs-adaptive oral health workforce planning model and explored the potential of various future scenarios.MethodsUsing publicly available data, including the Special Eurobarometer 330 Oral Health Survey, we applied the model in a hypothetical context focusing on the Dutch population’s dental needs from 2022 to 2050. We compared current and future provider supply and requirement and examined, in addition to a base case scenario, several alternative scenarios. These included epidemiological transition scenarios with different oral health morbidity trajectories, skill-mix scenarios with independent oral hygienists conducting check-ups and multiple dental student intake and training duration (5 instead of 6 years) scenarios.ResultsBased on the aforementioned historical data, our model projects that provider requirement will exceed supply for the planning period. If the percentage of people having all natural teeth increases by 10% or 20% in 2032, 34 or 68 additional full-time equivalent (FTE) dentists will be required, respectively, compared to the base case scenario. In the skill-mix scenario, the model indicates that prioritising oral hygienists for check-ups and shifting dentists’ focus to primarily complex care could address population needs more efficiently. Among the student intake and training duration scenarios, increasing intake to 375 and, to a lesser extent, reducing training to 5 years is projected to most effectively close the provider gap.ConclusionsThe study underscores the importance of understanding oral health morbidity trajectories for effective capacity planning. Due to limited dental epidemiological data, projections carry substantial uncertainty. Currently, demand for FTE dentists seems to exceed supply, though this may vary with epidemiological changes. Skill-mix strategies could offer efficiency gains by redistributing tasks, while adjustments in dental intake and training duration could also help address the requirement-supply gap. Resolving dentistry workforce challenges requires a multifaceted approach, including strengthening oral epidemiology projections, addressing the root causes of dental health issues and prioritising harmonious dental public health and general practice prevention measures.

Safe limits on work hours for the nursing profession: a rapid evidence review.

Persistent staffing shortages in health care driven by years of inadequate funding and deficiencies in human resources planning, which overlooked the impacts of population aging, have converged into a crisis in health care settings. An essential consequence of the widespread and growing staffing shortfalls in health care has been increased pressure on nurses to work longer hours. The present rapid review has two major objectives: (1) to systematically review and synthesize evidence considering the health and human consequences of excessive work hours, work-related fatigue and associated occupational health and safety hazards; and, (2) to identify policies and practices that demonstrate efficacy in managing or mitigating the adverse effects of occupational fatigue. Findings show that shifts lasting longer than 12 h elevate the risk of occupational fatigue, leading to several fatigue-based hazards. Despite governmental restrictions on long work hours and occupational fatigue in safety-critical industries such as transport, aviation, and nuclear sectors, health care remains largely unregulated in this regard. Ensuring safe and high-quality care over the long term requires implementing adequate regulatory supports for work hour limits for nurses. These measures not only improve workplace satisfaction but also enhance patient outcomes, ultimately fostering a healthier and more resilient health care system.

Societal Adaptation to Pandemic Challenges: Analysing the Role of Local Governance and Healthcare Systems in Madhya Pradesh

The COVID-19 pandemic posed unprecedented challenges, compelling communities globally to adapt rapidly to protect lives and maintain societal functions. This study examines the role of local governance and healthcare systems in Madhya Pradesh in addressing these challenges and fostering societal resilience. Drawing on quantitative data from government health agencies and qualitative insights from community feedback, this research explores how local governance structures facilitated public health response, resource allocation, and pandemic preparedness. Findings indicate that decentralized decision-making and robust healthcare infrastructure were instrumental in managing health crises, providing essential services, and supporting economic resilience at the grassroots level. Key results show that regions with stronger local governance exhibited a 30% lower infection rate compared to less governed areas, while areas with well-resourced healthcare systems saw a 20% higher recovery rate. Resource distribution, however, varied significantly, with urban areas receiving 60% more medical supplies than rural regions, creating disparities in healthcare access. Data analysis revealed that healthcare facilities that integrated digital solutions, such as telemedicine, were able to serve 45% more patients remotely, mitigating the risk of virus spread and reducing hospital overload. The study identifies the need for capacity-building initiatives, infrastructure strengthening, and data-driven decision-making to enhance future pandemic preparedness. Future prospects include continuous training programs for healthcare workers, increasing community awareness of health protocols, and leveraging technology for real-time data monitoring. These insights contribute to a comprehensive framework for building resilient healthcare systems in Madhya Pradesh, better prepared for future public health crises.

Exploring health worker absenteeism at public healthcare facilities in Chhattisgarh, India.

This study aims to assess the health worker absenteeism and factors associated with it in a high-focus district in Chhattisgarh, India. Human resources for health are among the key foundations to build resilient healthcare systems. Chhattisgarh is a high-focus Indian state with a severe shortage of health care workers, and absenteeism further aggravates the shortage. This study was conducted as a mixed-methods study employing sequential explanatory design. Absenteeism was defined as the absence of health worker in the designated position without a formal leave or official reason in two different unannounced visits. A facility survey across all the public healthcare facilities in Jashpur district, Chhattisgarh, was conducted through random, unannounced visits employing a checklist developed based on Indian Public Health Standards. Twelve participants were purposively sampled and interviewed from healthcare facilities to explore factors associated with absenteeism. Survey data were analysed descriptively, and thematic analysis was employed to analyse qualitative interviews. Among all the positions filled at primary health centre level (n = 339), close to 8% (n = 27) were absent, whereas among the positions filled at community health centre level (n = 285), only 1.14% (n = 4) were absent. Absenteeism was not found in the district hospital. Qualitative interviews reveal that macro-level (geographical location and lack of connectivity), meso-level (lack of equipment and amenities, makeshift health facilities, doctor shortage, and poor patient turnover), and micro-level (unmet expectations) factors contribute to health worker absenteeism. Health worker absenteeism was more at PHC level. Systemic challenges, human resource shortages, and infrastructural shortcomings contributed to health worker absenteeism.

Pandemic-induced healthcare shifts: an observational analysis of maternal and neonatal outcomes in adolescent pregnancies.

The COVID-19 pandemic caused widespread changes in healthcare delivery, particularly affecting vulnerable populations such as pregnant adolescents. These patients faced additional challenges, including developmental and gestational changes, stress from isolation, and altered healthcare access, which may have impacted the incidence and prevalence of maternal and neonatal complications. This study aims to compare maternal and neonatal outcomes in adolescent pregnancies before and during the pandemic, focusing on how shifts in healthcare delivery influenced these outcomes. A retrospective cohort study was conducted, including 340 adolescent pregnant patients who received prenatal care at a tertiary care institution. Patients were divided into two groups: pre-pandemic (n = 209) and pandemic (n = 131). Maternal data, including pre-BMI and gestational weight gain (GWG), were collected to evaluate maternal and neonatal outcomes. Statistical analysis was performed using chi-square tests, Fisher's exact tests, and odds ratio (OR) calculations. The pandemic group showed a statistically significant increase in cesarean deliveries (p = 0.002; OR = 1.99) and cervicovaginitis, particularly caused by Ureaplasma spp. Conversely, the pre-pandemic group had higher rates of psychoactive substance use, maternal urinary tract infections, and neonatal transient tachypnea. In the pandemic group, overweight pre-gestational BMI and cervicovaginitis were more prevalent in patients with adequate GWG, while inadequate GWG was associated with an increased risk of urinary tract infection (UTI). A significant association between pre-gestational overweight/obesity and excessive GWG was also observed (p < 0.05). The COVID-19 pandemic altered both healthcare delivery and maternal and neonatal outcomes in adolescent pregnancies. Changes in healthcare access, isolation, and shifts in medical management during the pandemic resulted in higher cesarean rates and infection rates among pregnant adolescents. These findings underscore the need for adaptable, resilient healthcare systems capable of maintaining comprehensive care even in the face of global crises. Further studies are needed to explore long-term effects on adolescent maternal and neonatal health.

The potential clinical impact and cost-effectiveness of the updated COVID-19 mRNA Autumn 2024 vaccines in the United Kingdom

Aims To estimate the potential clinical impact and cost-effectiveness of a United Kingdom (UK) Autumn 2024 vaccination campaign with an updated Moderna COVID-19 vaccine in adults ≥65 years and eligible persons 6 months to 64 years of age over a 1-year time horizon (September 2024–August 2025). Materials and methods A compartmental Susceptible-Exposed-Infected-Recovered model was adapted to reflect COVID-19 cases in the UK. Numbers of symptomatic infections, COVID-19–related hospitalizations and deaths, costs, and quality-adjusted life-years (QALYs) were predicted using a decision tree. The incremental cost-effectiveness ratio (ICER) of an updated Moderna mRNA vaccine (Moderna Autumn 2024 Campaign) was compared to No Autumn 2024 vaccine and to an updated Pfizer-BioNTech mRNA Autumn 2024 vaccine, from a healthcare perspective. Results The Moderna Autumn 2024 Vaccination Campaign is predicted to decrease the expected 8.3 million symptomatic infections with no vaccination by 19% to 6.7 million. Hospitalizations, long COVID cases, and deaths are expected to decline by 27,000 (−38%), 59,000 (−19%), and 6,000 (−43%), respectively. The Moderna Autumn 2024 Campaign will increase QALYs by 78,000 and costs by £665 million, yielding an ICER of £8,500/QALY gained. Sensitivity analyses suggest that vaccine effectiveness (VE) and waning, symptomatic infection incidence, hospitalization rates, and mortality rates drive cost-effectiveness. Vaccination remains cost-effective when lowering the target population to ≥50 years. Use of the Moderna vaccine is expected to prevent 8,000 more hospitalizations and 1,700 more deaths than the updated Pfizer-BioNTech vaccine. Conclusions Vaccination of the eligible population would contribute to significant reductions in hospitalizations, deaths, and long COVID in the UK in the 2024–2025 season. Expanding the target population continues to be cost-effective. Use of the Moderna Autumn 2024 Campaign is predicted to reduce SARS-CoV-2 infections and associated outcomes in a cost-effective manner and will contribute to a more resilient healthcare system in the UK.

Building resilience of the Ghanaian healthcare system: Lessons from a global health stage: Preparedness for the next pandemic: A scoping review

Background The coronavirus disease (COVID-19) pandemic has underscored the need for resilient health systems. However, Ghana does not seem to achieve commensurate results, suggesting potential gaps in critical interventions. This study examines these gaps by drawing on global experiences to guide Ghana's preparedness for future emergencies. Methods A scoping review based on the synthesis of published journal articles and grey literature was used to gather relevant evidence to address the study’s objective. Peer-reviewed literature searches were conducted in databases, including Medline, Scopus, and Health Sources, supplemented by searches on organizational websites to identify grey literature. We adopted the Organization for Economic Co-operation and Development (OECD) framework to explore how health systems responded to the COVID-19 pandemic globally and draw lessons for strengthening Ghana's health system resilience. We analyzed policy responses in three main areas: pandemic preparedness, crisis management, and response and recovery. Results Ten strategies emerged from the study as critical in strengthening health system resilience against future pandemics. These strategies include whole-of-government engagement, financing for preparedness, community engagement and trust, robust surveillance systems, emergency medical care, diverse workforce development, digital health integration, critical health infrastructure, well-planned commodities/products, and social capital. Each strategy plays a vital role in enhancing preparedness, response, and recovery efforts, highlighting the multifaceted approach needed to mitigate the impact of future pandemics on health systems. Conclusions The identified strategies align with the attributes of a resilient healthcare system. By adopting these strategies, Ghana can build a resilient healthcare system that effectively addresses future challenges, guided by global insights and experiences.

Bridging the Gap: Analyzing Healthcare Access and Inequalityin Ghana

Ghana’s National Health Insurance Scheme (NHIS) has made tremendous progress towards the aimof obtaining universal healthcare coverage. By boosting access to key healthcare services, the NHIS hasplayed a vital role in improving healthcare outcomes across the country. However, despite these advancements, major discrepancies in healthcare access exist, especially among low-income households and rural communities. These inconsistencies show fundamental injustices in the distribution of healthcare services and raise doubts about the NHIS’s potential to effectively serve themost vulnerable parts of society. This research tries to explore the difficulties of healthcare access in Ghana by delving into NHIS membership data. Through an analysis of this data, the study shows patterns of inequality related to both economic status and geographic location. By concentrating on how different economic quintiles connect with the NHIS, the research highlights important hurdles to enrollment and continuing access to healthcare. Additionally, the spatial research indicates considerable inequalities, illustrating how rural residents often experience more severe obstacles in getting healthcare compared to their urbancounterparts. Furthermore, the quality of healthcare services given under the NHIS is severely assessed. Issues such as inconsistent service delivery, poor resource allocation, and different levels of patient satisfaction emerge as important concerns that must be addressed to increase the overall success of the plan. Beyond Ghana’s boundaries, the research encompasses a comparative review of health insurancemodels from Rwanda, South Africa, Mexico, and Kenya—each country presenting a unique approach to healthcare funding and insurance coverage. Rwanda’s community-based health insurance, South Africa’s progressive changes, Mexico’s focus on service quality, and Kenya’s required enrollment offer useful lessons for resolving the inadequacies in Ghana’s NHIS. By drawing on these different models, the study intends to highlight best practices and lessons that could drive policy suggestions customizedto Ghana’s specific social, political, and economic setting. The study offers three critical policy reforms that might strengthen the NHIS and improve healthcare access across the country. Enhancing community participation is regarded as a critical way to enhance NHIS enrollment, particularly among underrepresented populations. Moreover, improving the subsidy mechanisms to better support low-income households is advocated as a manner of eliminating financial obstacles to healthcare. The study also advocates for specific measures to addressthe regional imbalances in healthcare infrastructure, noting the need for increased access in rural areas. Ultimately, these steps are not only meant to eliminate the gaps in coverage but also to secure the long-term sustainability of the NHIS, positioning it to continue offering fair healthcare to all Ghanaians. By tackling these problems and implementing targeted changes, Ghana can make considerable steps toward obtaining true universal healthcare coverage. The NHIS has the potential to become amore inclusive and resilient healthcare system, capable of fulfilling the requirements of the entire population.

Transforming healthcare with integrated inter-professional education in a research-driven medical school

Singapore, located strategically at the meeting point of the Malacca Strait and the South China Sea, has established itself as a global financial and economic hub. Despite its small geographical size, Singapore is home to over 5 million people from diverse cultural backgrounds. The city-state’s medical education landscape has evolved significantly over the past century. Originally, Singapore had only one undergraduate medical school, the NUS Yong Loo Lin School of Medicine, established in 1905. Over time, this institution has grown into Singapore’s largest and oldest medical school. NUS Medicine’s vision centres on developing highly competent, values-driven, and inspired healthcare professionals to transform the practice of medicine and improve health worldwide. A curriculum overhaul in 2020 introduced new educational components to prepare future healthcare professionals for the challenges of Singapore’s resilient healthcare system. This includes proficiency in integrated care, collaboration across disciplines, and leveraging AI and data science in clinical decision-making. The introduction of a common curriculum in August 2023 for Medicine, Nursing, Dentistry, and Pharmacy undergraduates further aligns with Singapore’s 'Healthier SG' vision, ensuring that graduates are well-equipped to meet the evolving needs of the healthcare landscape. The common curriculum aims to address professional hierarchies and foster interprofessional collaboration among students from diverse academic backgrounds. By promoting frequent interaction and a team-oriented mindset, the curriculum seeks to instil a collective approach to healthcare, emphasising the importance of interprofessional practice in achieving the broader goals of healthcare delivery. This paper describes the reforms that took place and how the challenges were mitigated in a research-intensive top-ranked academic medical institution. This strategic alignment of medical education with national healthcare priorities underscores NUS Medicine’s commitment to transforming medical practice and improving health outcomes in Singapore and beyond.