PDF(Pubmed)
Abstract：
BACKGROUND: Public health emergencies of international concern (PHEICs) as the COVID-19 pandemic and others that have occurred since the early 2000s put enormous pressure on health and care systems. This is being a context for protests by health and care workers (HCWs) because of additional workload, working conditions and effects on mental and physical health. In this paper, we intended to analyze the demands of HCWs associated with industrial actions, protests, strikes and lockouts (IAPSLs) which occurred during COVID-19 pandemic and other PHEICs; to identify the impact of these grievances; and describe the relevant interventions to address these IAPSLs.
METHODS: We included studies published between January 2000 and March 2022 in PubMed, Embase, Scopus, BVS/LILACS, WHO\'s COVID-19 Research Database, ILO, OECD, HSRM, and Google Scholar for grey literature. Eligibility criteria were HCWs as participants, IAPSLs as phenomenon of interest occurring in the context of COVID-19 and other PHEICs. GRADE CERQual was used to assess risk of bias and confidence of evidence.
RESULTS: 1656 records were retrieved, and 91 were selected for full-text screening. We included 18 publications. A system-wide approach, rather than a limited approach to institutions on strike, makes it possible to understand the full impact of the strike on health and care services. PHEICs tend to aggravate already adverse working conditions of HCWs, acting as drivers for HCWs strikes, leading to staff shortages, and financial issues, both in the North and in the Global South, particularly evident in Asia and Africa. In addition, issues related to deficiencies in leadership and governance in heath sector and lack of medical products and technologies (e.g., lack of personal protective equipment) were the main drivers of strikes, each contributing 25% of the total drivers identified.
CONCLUSIONS: It is necessary to focus on the preparedness of health and care systems to respond adequately to PHEICs, and this includes being prepared for HCWs\' IAPSLs, talked much in the context of COVID-19 pandemic. Evidence to assist policymakers in defining strategies to respond adequately to the health and care needs of the population during IAPSLs is crucial. The main impact of strikes is on the disruption of health care services\' provision. Gender inequality being a major issue among HCWs, a proper understanding of the full impact of the strike on health and care services will only be possible if gender lens is combined with a systemic approach, rather than gender-undifferentiated approaches limited to the institutions on strike.
METHODS: We included studies published between January 2000 and March 2022 in PubMed, Embase, Scopus, BVS/LILACS, WHO\'s COVID-19 Research Database, ILO, OECD, HSRM, and Google Scholar for grey literature. Eligibility criteria were HCWs as participants, IAPSLs as phenomenon of interest occurring in the context of COVID-19 and other PHEICs. GRADE CERQual was used to assess risk of bias and confidence of evidence.
RESULTS: 1656 records were retrieved, and 91 were selected for full-text screening. We included 18 publications. A system-wide approach, rather than a limited approach to institutions on strike, makes it possible to understand the full impact of the strike on health and care services. PHEICs tend to aggravate already adverse working conditions of HCWs, acting as drivers for HCWs strikes, leading to staff shortages, and financial issues, both in the North and in the Global South, particularly evident in Asia and Africa. In addition, issues related to deficiencies in leadership and governance in heath sector and lack of medical products and technologies (e.g., lack of personal protective equipment) were the main drivers of strikes, each contributing 25% of the total drivers identified.
CONCLUSIONS: It is necessary to focus on the preparedness of health and care systems to respond adequately to PHEICs, and this includes being prepared for HCWs\' IAPSLs, talked much in the context of COVID-19 pandemic. Evidence to assist policymakers in defining strategies to respond adequately to the health and care needs of the population during IAPSLs is crucial. The main impact of strikes is on the disruption of health care services\' provision. Gender inequality being a major issue among HCWs, a proper understanding of the full impact of the strike on health and care services will only be possible if gender lens is combined with a systemic approach, rather than gender-undifferentiated approaches limited to the institutions on strike.
摘要：
背景：国际关注的突发公共卫生事件（PHEIC），如COVID-19大流行以及自2000年代初以来发生的其他事件，给医疗保健系统带来了巨大压力。由于额外的工作量，这是卫生和护理人员（HCW）抗议的背景，工作条件和对身心健康的影响。在本文中,我们打算分析与工业行动相关的HCWs的需求，抗议,在COVID-19大流行和其他PHEIC期间发生的罢工和停工(IAPSL)；确定这些不满的影响；并描述解决这些IAPSL的相关干预措施。
方法：我们纳入了2000年1月至2022年3月在PubMed上发表的研究，Embase,Scopus,BVS/LILACS,世界卫生组织的COVID-19研究数据库，ILO,OECD,HSRM,和谷歌灰色文学学者。合格标准是HCWs作为参与者，IAPSL是在COVID-19和其他PHEIC的背景下发生的感兴趣的现象。GRADECERQual用于评估偏倚风险和证据可信度。
结果：检索了1656条记录，并选择91人进行全文筛选。我们包括18种出版物。全系统的方法，而不是对罢工机构采取有限的方法，使人们有可能了解罢工对医疗保健服务的全部影响。PHEIC倾向于加剧已经不利的HCWs的工作条件，充当HCWs罢工的司机，导致人员短缺，和财务问题，在北方和全球南方，在亚洲和非洲尤其明显。此外,与卫生部门领导和治理不足以及医疗产品和技术缺乏相关的问题(例如，缺乏个人防护设备)是罢工的主要驱动因素，每个人占确定的总司机的25%。
结论：有必要将重点放在卫生保健系统的准备工作上，以充分应对PHEIC，这包括为HCWs\'IAPSL做准备，在COVID-19大流行的背景下谈了很多。在IAPSL期间，协助决策者制定充分应对人口健康和护理需求的战略的证据至关重要。罢工的主要影响是对医疗保健服务供应的中断。性别不平等是HCWs中的一个主要问题，只有将性别视角与系统方法相结合，才能正确理解罢工对医疗保健服务的全面影响，而不是仅限于罢工机构的无性别区分方法。
方法：我们纳入了2000年1月至2022年3月在PubMed上发表的研究，Embase,Scopus,BVS/LILACS,世界卫生组织的COVID-19研究数据库，ILO,OECD,HSRM,和谷歌灰色文学学者。合格标准是HCWs作为参与者，IAPSL是在COVID-19和其他PHEIC的背景下发生的感兴趣的现象。GRADECERQual用于评估偏倚风险和证据可信度。
结果：检索了1656条记录，并选择91人进行全文筛选。我们包括18种出版物。全系统的方法，而不是对罢工机构采取有限的方法，使人们有可能了解罢工对医疗保健服务的全部影响。PHEIC倾向于加剧已经不利的HCWs的工作条件，充当HCWs罢工的司机，导致人员短缺，和财务问题，在北方和全球南方，在亚洲和非洲尤其明显。此外,与卫生部门领导和治理不足以及医疗产品和技术缺乏相关的问题(例如，缺乏个人防护设备)是罢工的主要驱动因素，每个人占确定的总司机的25%。
结论：有必要将重点放在卫生保健系统的准备工作上，以充分应对PHEIC，这包括为HCWs\'IAPSL做准备，在COVID-19大流行的背景下谈了很多。在IAPSL期间，协助决策者制定充分应对人口健康和护理需求的战略的证据至关重要。罢工的主要影响是对医疗保健服务供应的中断。性别不平等是HCWs中的一个主要问题，只有将性别视角与系统方法相结合，才能正确理解罢工对医疗保健服务的全面影响，而不是仅限于罢工机构的无性别区分方法。
