Impacts of industrial actions, protests, strikes and lockouts by health and care workers during COVID-19 and other pandemic contexts: living systematic review
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Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisboa, Portugal
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Zakir Husain Centre for Educational Studies, Jawaharlal Nehru University, Delhi, India
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Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
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Instituto Nacional de Câncer, Ministério da Saúde, Rio de Janeiro, Brazil
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Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa (UNL) , Lisboa, Portugal
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Health Workforce Department, World Health Organization, Geneva, Switzerland
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Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro - UERJ, Rio de Janeiro, Brazil
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Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa - UNL, Lisbon, Portugal
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A1720
ABSTRACT
Background and Objective: Public health emergencies of international concern (PHEIC) like COVID-19 pandemic and others that have occurred since the early 2000s put enormous pressure on health and care systems and are a fertile ground for protests by health and care workers (HCWs). We aimed to (i) identify the impact of the COVID-19 pandemic and other PHEICs on the industrial actions, protests, strikes and lockouts (IAPSLs); (ii) analyze the demands of HCWs associated with these IAPSLs; (iii) identify and describe the relevant interventions to address these grievances. Methods: Living systematic review of 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. 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. Results: The searches retrieved 1656 records, of which 91 were selected for full-text screening. We included 18 publications for data extraction. A system-wide approach, rather than a limited approach to institutions on strike, will allow understanding the full impact of strikes on health and care services. PHEICs tend to aggravate already adverse working conditions (e.g., lack of PPE and financial issues), acting as drivers for HCWs strikes both in the North and Global South, particularly evident in Asia and Africa based on literature. Conclusions: Evidence to assist policy-makers in defining strategies to respond adequately to the healthcare needs of the population during IASPLs is crucial. Adequate responses will minimize additional economic burden for the poorest families who cannot afford private health care when IAPSLs compromise access to public health care. There is a lack of information on relevant interventions to resolve these IAPSLs, justifying periodic updates to capture emergent literature, helping to fill knowledge gaps.
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