Table 4 Outcomes, described for the implementation of the policy and management interventions and quality of evidence

Decent working conditions

Protection of HCWs against infection

Training on use of PPE, instructed to practice social distance and hotels with only designated for medical staff

943 health professionals from Guangzhou that were sent to assist Wuhan to combat COVID-19, tested negative for all four reverse transcription polymerase chain reaction (RT-PCR) performed on days 1, 2, 7, and 14. The local healthcare workers in Wuhan and Jingzhou, 2.5% (113 out of 4495) and 0.32% (10 out of 3091) had RT-PCR confirmed COVID-19, respectively. The seropositivity for SARS-CoV-2 antibodies (IgG, IgM, or both IgG/IgM positive) was 3.4% (53/1571) in local healthcare workers from Wuhan with Level 2/3 PPE working in isolation areas and 5.4% (126/2336) in healthcare staff with Level 1 PPE working in non-isolation medical areas, respectively [30]

Intensification of COVID-19 epidemiological surveillance, distance learning seminars (continuous education), communication, feedback to the Heads of the long-term care facility (LTCF), harmonization of Standard operating procedures and intensification of audits to the LTCF, promotion of volunteerism and active participation of medical students, and task force activation on confirmed case identification and cluster events

The results indicated a statistically significant decrease in COVID-19 cases between the first and second decade of December 2020 for Cyprus LTCF. During the interventional period, a significant decrease of 47% in COVID-19 cases was observed in the LTCFs (reduction of the prevalence from 2.83% to 1.5%). The results indicated a statistically significant decrease in COVID-19 cases (χ2 = 19.42, p < .001) between the first and second decade of December 2020 for Cyprus LTCF Total (from 138/4878; 2.83% 95%CI [2.40% − 3.33%] to 71/4740; 1.5% 95%CI [1.19% − 1.89%]), as well as a significant decrease (χ2 = 19.29, p < .001) for Cyprus LTCF Residents (from 107/ 2928; 3.65% 95%CI [3.03% − 4.40%] to 49/2817; 1.74% 95%CI [1.31% − 2.30%]) but a non-statistically significant difference (χ2 = 1.41, p = .24) for Cyprus LTCF Staff (from 31/1950; 1.59% 95%CI [1.11% − 2.26%] to 22/1923; 1.14% 95%CI [0.75% − 1.74%]) [45]

Low

Decent working conditions

Improved knowledge

Training of biosecurity measures for nurses exposed to SARS-CoV-2 in emergency sectors

An educational intervention (10 modules—318 h) with 80 nurses (26 technicians, and 54 graduates), duration of 5 weeks. Before intervention both groups had insufficient knowledge regarding COVID-19, after intervention the level of knowledge of COVID-19, standards of biosafety increased in both groups. The educational intervention was effective with statistical significance in the level of knowledge of the group licensed regarding the technician. The level of knowledge of COVID-19 rose after the intervention (69,23% group I, 74.07% group II), while the knowledge on principles and standards of biosafety increased in both groups (88.46% and 100%). The knowledge about precautions standards rose in 65.38% technical group and 92.59% graduates’ group. Group I (26 technicians) and group II (54 graduates)[32]

Low

Building Competences Through Education and Training

Improved knowledge

Nationwide electronic learning (e-Learning) intervention was implemented across 25 states of Nigeria, using a tutorial app with 7 training modules, consisting of video, audio and text-based learning materials, available in English and then translated to three major languages: Hausa, Igbo and Yoruba

A total of 1051 health workers from 25 states across Nigeria undertook the e-learning on the InStrat COVID-19 training app. Of these, 627 (57%) completed both the pre- and post-tests in addition to completing the training modules. Overall, there were statistically significant differences between pre- and post-tests knowledge scores (54 increasing to 74). There were also differences in the subcategories of sex, region, and cadre. There were higher post-test scores in males compared with females, younger versus older and southern compared with northern Nigeria. A total of 65 (50%) of the participants reported that the app increased their understanding of COVID-19, while 69 (53%) stated that they had applied the knowledge and skills learnt at work. Overall, the functionality and usability of the app were satisfactory [28]

A 5-week online training program for healthcare professionals on prevention and control of SARS-CoV-2 infection. The objective knowledge assessment was carried out using a total of 110 test questions, with four response options. The participants had to pass each test with at least 80% correct answers

Of the 880 healthcare professionals pre-enrolled on the course, 766 (87.1%) started the training. From these, 705 (92.0%) success fully passed assessments and completed the pre-and surveys (represents 29.12% of the total number of healthcare professionals in Tenerife). The pre-training median total score of perceived knowledge score was 40 (29–53) points, which the post training total score was 53 (39–60) points, confirming significance in this difference (p < 0.001, Wilcoxon’s Z: –22.407). The results of this study suggest a high level of self-perceived knowledge acquired in all areas assessed and related to the prevention and control of SARS-CoV-2 infection in healthcare professionals who completed the training program [35]

Low

Improving HCWs availability

Health workforce availability

MINSA (Ministry of Health) and regional government facility staffing per subsector from additional temporary hiring of health personnel hires, the additional contract workers were utilised in Rapid Response Teams

Increase in MINSA and regional government facility staffing per subsector. In response to COVID‐19 there was an additional contract in 10,44%, a total of 26,120 additional contracts, with 4640 medical, 6467 nurses,1272 midwifes, 8325 technical assistants and others [63]

Very Low

Rationalizing HCWF

Protection and personal well-being (burnout)

Nationwide cross-sectional survey was design to understand the impact of COVID-19 pandemic on junior and middle grade doctors working for National Health System in the United Kingdom

Out of 1564 (survey questionnaire) respondent 61.6% of doctors were redeployed outside their primary specialty. The major redeployments were from other specialties to intensive therapy unit (ITU)/critical care units (CCU) (41.8%). This was secondary to expansion in critical care capacity across all hospitals particularly in tertiary care hospitals. The majority of deployments were from medicine and allied specialties (54.4%); 63.3% of respondents spend more than 8 weeks in redeployed specialty with majority of doctors from medicine followed by anesthesiology. In general, anesthesiology and medicine and allied were more significantly affected specialties by this mass redeployment. When burnout was gauged using single questions with the highest factor loading on the EE and DP, 85.25% (n = 1333) and 64.7% (n = 1012) responded positively, suggesting very high impact of COVID-19 on doctors’ well-being [31]

Low

Impact on clinical work (working conditions)

Nationwide cross-sectional survey was design to understand the impact of COVID-19 pandemic on junior and middle grade doctors working for National Health System in the United Kingdom

Majority of doctors had an impact of COVID-19 on their clinical practices irrespective of the fact if they stayed in their primary specialty or redeployment elsewhere. This all happened due to unfamiliar surroundings, increased work demand, nature of COVID-19 disease causing sudden deterioration of the patients, and rapid influx of patients to hospitals. This unprecedented work intensity required more support for junior and middle grade doctors, which unfortunately was not readily available that resulted in more adverse impact on physical and mental well-being of these doctors. Various areas for improvement were suggested. The major areas requiring immediate attention include proper leadership and clinical support (64.1%), pre redeployment planning and induction (48.5%), redeployment according to the skills and/or in familiar specialties (44.6%), and regular mental and physical well-being checks (37%) [31]

Low

Professional's satisfaction

National Health System Portugal. The hospital administrations and services, and the Ministry of Health, preferably recommended the teleconsultation activity, reserving face-to-face consultations for when teleconsultation was not clinically adequate or technically possible

A total of 2452 answers were obtained, and 2225 answers were considered for analysis. The answers of doctors who were not working in the National Health System in the first phase of the pandemic were excluded. Thus, around 7.2% of doctors who worked in the National Health System responded to the questionnaire. 50% refer that they are globally satisfied or very satisfied with teleconsultation, 16% are dissatisfied or very dissatisfied and 35% are indifferent [29]

Low