|
COVID-19 testing, surveillance, communication and care management
|
| Zafar, S et al [36] |
Pakistan |
Testing, contact tracing and risk communication |
Lady Health Workers and Dengue Outreach Workers (CHWs) |
COVID-19 surveillance hubs were established and CHWs were trained briefly before being deployed into communities As HRH were moved to surveillance, maternal health services and immunisation programs were ignored Need to improve information systems and TS during emergencies was highlighted
|
| Gudza-Mugabe, M et al [37] |
Zimbabwe |
Testing, contact tracing and reporting |
Laboratory technologists |
HRH were trained in antigen rapid diagnostic test protocols and testing was decentralised from 1 to over 1000 centres Access to and uptake of testing increased Turnaround time of reporting reduced to less than a day Staff burnouts decreased
|
| Honda, C et al [38] |
Japan |
Contact tracing, reporting and hospital coordination |
Part time public health nurses (PHN) |
Acute workloads caused full time PHN fatigue, anxiety and confusion at public health centres Full time PHN shifted workloads of epidemiological surveys, patient hospitalisation coordination, health monitoring of patient contacts and consultation to residents to part time PHNs as a measure to prevent burnouts and organisational dysfunction
|
| Chidavaenzi, NZ et al [39] |
USA |
Testing, contact tracing, reporting and isolating |
Public health staff at health department, Staff at detention centre and casino (non-healthcare staff) |
|
| Raskin, SE et al [40] |
USA |
Testing, contact tracing, reporting and telephone-based risk communication |
Dental assistants and dental hygienists |
Clinic closures and acute demands pulled HRH into surveillance and community mobilisation Practices experienced significant call offs from assistants, hygienists and front desk operators, which burdened HRH further
|
| Mohammed, A et al [41] |
Nigeria |
In-patient COVID care and other essential services |
Medical students |
80.4% students surveyed had good knowledge of COVID-19 78.3% students felt at risk of infections, yet 93% of them expressed willingness to assist care provision. Parental disapproval and fear were cited by those unwilling to get involved. Male respondents were more willing to assist, in comparison to females
|
| Taylor, MK et al [42] |
Multi-country
(Singapore, Trinidad and Tobago, Iraq, India USA, Brazil and more) |
Testing, contact tracing, triaging, risk communication and in-patient COVID care |
Primary care physicians, medical students |
Primary care physicians tested and triaged COVID-19 patients Primary care physicians increased awareness about social distancing, symptoms and quarantining Primary care physicians helped treat cases in intensive care units Primary care physicians undertook nursing procedures Final year medical students were involved in in-patient care
|
| Eggleton, K et al [43] |
New Zealand |
Telephone triaging and nursing care |
Nurses and practice receptionists |
Receptionists were upskilled in telephone triaging and they determined whether patients needed General physician (GP) consultations or referrals Nurses and receptionist teams ran separate respiratory units to isolate patients with possible symptoms Routine clinical tasks of COVID-19 were shifted onto nurses TS increased workloads for nurses and receptionists, but freed GPs to attend more patients TS improved system efficiency and outputs
|
| Yoshioka-Maeda, K et al[44] |
Japan |
Telephone consultations |
Office support staff (non-healthcare staff) |
Telephone consultations included queries on prevention measures and patient flow pathways; which did not need PHN involvement Telephone consultations can be shifted onto low-level staff and office workers through training, creation of script-based manuals and monitoring
|
| Yoshioka-Maeda, K [45] |
Japan |
Telephone consultations, information management, resource management |
Office support staff and external company (non-healthcare staff) |
PHN developed a response manual for telephone consultations on COVID-19 and trained teams of office support staff to handle routine queries of local residents PHN created a web-based system to host patient information management and shifted clerical work to office support staff PHN shifted personal protective equipment management to external inventory management companies, increasing available nursing time and allocative efficiency
|
| Helmi, M et al[46] |
Indonesia |
Intensive care services |
General practitioners and medical students |
ICUs reported inadequate availability of equipment, service support on call specialists and ineffective TS, leadership and communication among hospital staff Shifting services from specialists to general practitioners and students needs to be supplemented with training on roles, rights, communication and management skills
|
| Sono-Setati, ME et al [47] |
South Africa |
Clinical auditing and resource management |
Hospital staff (not specific) |
Sub-standard management of COVID-19 cases, medical records and resources and staff anxiety, confusion and stress was reported Hospitals should expand roles of HRH to include TS to address staff shortages and burnouts Clinical audits should be conducted and reviewed routinely
|
| Köppen, J et al[48] |
Germany |
Emergency procedures for infection control |
Emergency paramedics |
Although federal infection control law authorised TS, TS and skill-mixing was not mentioned in state policies directly Only Saxony-Anhalt specified the law and provided information supplementing the federal law Emergency paramedics were allowed to perform certain medical tasks provided they had competencies relevant to standard operating procedures and treatment pathways Medical directors of services needed to enlist tasks shifted and ensure adequate documentation
|
| Faria de Moura Villela, E et al [49] |
Brazil |
In-patient COVID care and emergency medical services |
Physicians, nurses and hospital staff |
TS of services was seen in COVID wards (39.1%), intensive care units (11.6%) and emergency departments (15.9%) Shifts in roles and corresponding salary cuts coincided with reporting of anxiety and depression in HRH
|
|
Mental health screening and therapeutic interventions
|
| Ortega, AC et al [50] |
Mexico |
Psychosocial support, psychological first aid, grief management and palliative mental health services |
Primary care physicians, community healthcare workers and non-clinical office staff |
Non-profit Compañeros En Salud trained non-specialist providers on stress, anxiety and depression screening, identifying nonverbal cues, referral systems, psychological first aid and self-care strategies and provided them with pocket field guides for reference HRH were trained in contact tracing and their home-visit questionnaires had questions on patient mood, anxiety and suicidal thoughts Alongside psychological support, they provided mental healthcare for patients who were grieving and patients in need of palliative mental healthcare due to COVID-19
|
| Mukhsam, MH et al [51] |
Malaysia |
Psychosocial support |
Medical students |
400 international medical students were tested and quarantined upon return to the University from China Disinfection and decontamination team performed cleaning upon positive case contact Quarantine team isolated cases under investigations Mobile medical and promotion team led surveillance and health education Students were grouped in tens on online messaging platforms and were supervised by local mandarin-speaking peers, one in each group Supervisors provided psychosocial support and health education Supervisors ensured students filled home-monitoring questionnaires
|
|
HIV consultation, testing, counselling and treatment services
|
| Omam, LA et al [52] |
Cameroon |
Counselling, testing, patient follow ups, Antiretroviral therapy (ART) initiation and refilling |
Primary care physicians, nurses and non-clinical staff |
Primary care-based differentiated service delivery of ART to internally displaced people during COVID-19 was achieved via mobile clinics In 7 months, 14,623 persons were sensitised and 1,979 were tested, from which 122 tested positive and 33 placed on ART 28 loss-to-follow up patents were relinked to treatment and 209 consultations were conducted Mobile clinics were resource-effective in improving access of HIV services in conflict regions, but the model needs economic evaluation
|
| Pry, J.M. et al [53] |
Zambia |
ART initiation and refilling, community mobilisation |
CHWs |
Health ministry COVID-19 mitigation guidelines for HIV recommended dispensing 6 multi-month ART to patients and using TS to communicate and mobilise patients to collect ART refills early Adjusted prevalence ratio (4.63; 95% CI 4.45 to 4.82) of early returns to collect ART improved significantly post guideline implementation Weekly receipt of 6 multi-month dispensation increased from 47.9% before to 73.4% post guideline implementation Proportion of late visits fell from 18.8% to 15.1% post guideline implementation
|
| Abraham, SA et al [54] |
Ghana |
Prescribing and dispensing ART |
Nurses |
Placing nurses at pharmacies and TS prescribing and dispensing of ART onto them reduced patient clustering and expedited service delivery during COVID-19 pandemic Staff rosters and roles were changed to complement TS
|
|
Others: Sexual and reproductive health; Nutrition; Rheumatoid diseases
|
| Jacobi, L et al [55] |
USA |
Provision of contraceptives and dispensing medicines |
CHWs |
Informants reported that the pandemic has ‘primed’ stakeholders for TS and sharing services to and with community health workers at primary care level TS and sharing provision of contraceptives and dispensing medicines a ‘necessity’ in times of COVID-19 in conflict affected regions
|
| Davis, C. et al [56] |
Singapore |
Behaviour contracts for nutrition |
General physicians and nurses |
In-patient services of a tertiary hospital underwent reorganisation of HRH, limiting teams to one physician, nutritionist and speciality nurse Behaviour contracts for patients and caregivers, charted by psychologists ordinarily, were being drawn up by physicians and nurses during COVID-19
|
| Kuhlmann, E et al [57] |
Germany |
Care for rheumatoid arthritis and other inflammatory musculoskeletal disorders |
General practitioners, rheumatology specialist assistants and other medical assistants |
67% rheumatologists delegated tasks to rheumatology specialist assistants and other medical assistants Rheumatologists perceived TS to rheumatology specialist assistants (87%) and GPs (33%) as an efficient approach to address rheumatologist shortages 81% found cooperation with medical assistants and nurses as good or very good, while cooperation with GPs scored significantly lower
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