Management of the health workforce in facing COVID-19: disinformation and absences in Brazil’s Public Policies

Abstract

The objective of this research was to analyse federal government interventions in crisis management and the consequences for health professionals. This is a documentary-type qualitative research. Brazilian Federal regulations referring to work and health education produced during the pandemic emergency of COVID-19, published from January 28 to June 2, 2020, were identified. Of the total of 845 documents, 62 were selected in accordance with the inclusion criteria and were then submitted to Thematic Content Analysis. The results and discussions were grouped into four categories:workforce management, workforce protection, workforce training and academic-workforce relationship. Absence of a federal coordinating actions and policies for desinformation were identified. This lacking mechanisms for coordination contributed decisively to the tragic epidemiological situation still underway, especially in terms of the exposure of health workers to the risk of contamination, revealed in the extremely high rates of professionals infected or killed by COVID-19 in Brazil and the failure to control the pandemic in the population.

Spatial and temporal fluctuations in COVID-19 fatality rates in Brazilian hospitals

“…Fourth, in characterizing hospital fatality rates in a broad Brazilian context, we are ignoring historical policy aspects that can be a source of heterogeneity. The standard of healthcare per unit staff member can be improved by federal coordinated actions and policies on training as well as unambiguous governmental medical policies to prevent disinformation 41 . These federal policies also extend to financing to ensure that the underlying structure of primary care and emergency services all present a standardized quality of care 42 .…”

Implementation of policy and management interventions to improve health and care workforce capacity to address the COVID-19 pandemic response: a systematic review

“…•Programs of training for use of PPE, biosafety measures and infection prevent control [30,39,42,43,46] • Establishment epidemiological monitoring and infection control, harmonization of standard operating procedures [41,45] • Policies to access to PPE [34,44] • Reassignment of HCWs at high risk [40,47] • Campaign to reduce harassment and violence against HCWs [48]…”

“…• Increase resources and budget reallocations to HCWs [52,62] • Financial incentives, such as salary adjustment, extra hours, special bonuses and others [42, 44, • Supervision assurance to reinforce skills acquired to provide care beyond usual professional skills [99] • Support from professional associations in training the HCWF [39] • Review of national guidelines and development of training according to current evidence [40,45,77] Optimizing roles • Expansion of scope of practice [42,59,70,81] • Shift in responsibilities and relocation to face shortage skills [54,78,80,99] • Availability of personnel for dedicated hotlines, apps and telemedicine [34,43] • Redistribution of tasks among HCWF to take advantage of scope of available skills [34, Fast track legislation and intersectoral collaborations to increase availability [47,52,55,73,86] Financial strategies to respond to COVID-19 such as allocation of nancial resources, recovery plan and adjustment to ensure availability of funds to pay for COVID-19 services [42,54,59,66,69,79,81,82] Improving HCWF information systems • Health information system to planning tools to rapidly assess workforce requirements such as monitoring reporting absence system [60]…”

COVID-19 mortality in Brazil, 2020-21: consequences of the pandemic inadequate management

“…Further, epidemic management was not in place at the national level, delegating social restrictions of physical contacts and other prevention measures to state and municipal governments [ 12 , 13 ]. The activities implemented by the Federal Government focused on minimizing COVID-19 severity, setting a strategy of disseminating fake news, and using medicines that were proven ineffective against COVID-19 [ 14 , 15 ].…”