International cooperation for nursing human resource development in Lao PDR: Investing in nursing leadership.

Strengthening nursing leadership in health systems has been identified as a priority for achieving Universal Health Coverage (UHC). We aimed to analyse the characteristics of Japanese technical assistance projects for nursing human resource development in Lao People's Democratic Republic (Lao PDR) and suggest directions for future assistance. An upgrading program, as part of human resource development, was initiated in the 1990s; it has contributed to the development of nursing leaders. Moreover, technical assistance from development partners has had synergistic effects by consistently promoting the involvement of nursing leaders in administration, education, and clinical practice to establish a functional regulatory system. In resource-limited settings, the application of both edge-pulling (leadership development) and bottom-up (quality improvement of the mass population) strategies are required. From a long-term perspective, development partners should continue to invest in increasing the number and quality of nursing leaders by upgrading the courses and leadership training programs, starting from the younger generation.

Lessons learned from practices during the initial response to COVID-19 on the cruise ship Diamond Princess.

The battle against coronavirus disease 2019 (COVID-19) still continues three years after the onset of the pandemic, but there are concerns about the next emerging infectious disease. This study reports the practices during the initial response to COVID-19 on the cruise ship Diamond Princess and lessons learned from a nursing perspective. During these practices, one of the authors dealt with a sample collection team from the Self-Defense Forces and collaborated with the Disaster Medical Assistance Team (DMAT), Disaster Psychiatric Assistance Team (DPAT), and other teams. They mentioned the passengers' state and the distress and fatigue of the personnel assisting them. This revealed the specifics of emerging infectious diseases and their commonalities, regardless of the disaster. Results identified three crucial points: i) predicting the impact of lifestyle changes on health due to isolation and implementing preventive measures, ii) protecting individual human rights and dignity even in health emergencies, and iii) support for personnel providing assistance.

Comparison of the clinical competency of nurses trained in competency-based and object-based approaches in the Democratic Republic of the Congo: A cross-sectional study.

In the Democratic Republic of the Congo (DRC), the object-based approach (OBA) still remains mainstream in the basic nursing education program, despite the intention of the Ministry of Public Health to expand the competency-based approach (CBA) nationwide. This study aimed to compare the clinical competency of nurses trained with CBA and OBA. A cross-sectional, mixed study was conducted. We developed a self-assessment questionnaire consisting of an individual demographic information, a clinical competency assessment scale and the General Self-efficacy Scale. Nurses trained with CBA or OBA and currently working in health facilities with two to five years of clinical experience were purposively selected from ten cities across nine provinces in the DRC. We also conducted key informant interviews with the clinical supervisors at health facilities. In a comparison of 160 nurses trained with CBA and 153 with OBA, 3 competency domains ("establishing professional communication", "making decisions about health problems", and "performing nursing interventions") of the 5 domains required for nurses had significantly higher scores in the CBA group. The key informant interviews supported these results while revealing various issues in the basic nursing education program. The results support the strategic direction of the Ministry of Public Health in the DRC to expand CBA. Collaboration among education institutions, health facilities, and administrative bodies is crucial for clinical nurses to fully engage their competencies for the population. Other low- and middle-income countries with scarce resources can refer to the developed and implemented competency assessment method applied in this study.

How Hospitals Overcame Disruptions in the Early Stages of the COVID-19 Pandemic: A Case Study from Tokyo, Japan.

The COVID-19 pandemic has caused serious disruptions to health systems across the world. While the pandemic has not ended, it is important to better understand the resilience of health systems by looking at the response to COVID-19 by hospitals and hospital staff. Part of a multi-country study, this study looks at the first and second waves of the pandemic in Japan and examines disruptions experienced by hospitals because of COVID-19 and the processes through which they overcame those disruptions. A holistic multiple case study design was employed, and two public hospitals were selected for the study. A total of 57 interviews were undertaken with purposively selected participants. A thematic approach was used in the analysis. The study found that in the early stages of the pandemic, faced with a previously unknown infectious disease, to facilitate the delivery of care to COVID-19 patients while also providing limited non-COVID-19 health care services, the case study hospitals undertook absorptive, adaptive, and transformative actions in the areas of hospital governance, human resources, nosocomial infection control, space and infrastructure management, and management of supplies. The process of overcoming the disruptions caused by the pandemic was complex, and the solution to one issue often caused other problems. To inform preparations for future health shocks and promote resilience, it is imperative to further investigate both organizational and broader health system factors that build absorptive, adaptive, and transformative capacity in hospitals.

How should support for hospital staff during health shocks be improved? A discussion from Japan's experience during the COVID-19 pandemic.

Human resources for health are at the center of healthcare service delivery and play an important role in ensuring the resilience of health systems. Utilizing the results from a case study examining hospital resilience during COVID-19, this article draws on the experience of individual hospital staff during the first and second waves of the pandemic, briefly describes government responses to support human resources for health during the early stages of the pandemic, and argues the importance of constructive discussions about strategies to create an enabling work environment for healthcare providers, both clinical and non-clinical, during future health shocks.

International technical cooperation to low- and middle-income countries during the COVID-19 pandemic.

This paper reports on the current status of international technical cooperation, reflecting the views of the Bureau of International Health Cooperation of the National Center for Global Health and Medicine (NCGM) during the COVID-19 pandemic. To appropriately respond to the pandemic, the need for assistance to low- and middle-income countries has increased. Since 2020, there has been a shift from on-site to online international technical cooperation to avoid human contact. While online solutions increased the number of participants in international conferences and training, business travel costs and time were reduced. However, it became necessary to consider not only effective labor-management practices to enable participation in meetings held in different time zones but also quicker ways to develop online training materials, which took a long time. In the future, a hybrid format combining offline and online international technical cooperation will become mainstream.

Reporting on the implementation to set up a "care and isolation facility" for mild COVID-19 cases in Tokyo.

The increasing number of COVID-19 cases has placed pressure on medical facilities. Against this backdrop, the Tokyo Metropolitan Government established a facility for mild and asymptomatic COVID-19 cases by using existing hotels. These kinds of facilities were established in several countries, and represented a spectrum from hotel-like to hospital-like care. In this article, we focused on implementation and related strategies for establishing such a facility in Tokyo as implementation research, while ensuring patient and staff safety. This facility had three functions: care, isolation, and buffering. For the implementation strategy, we used several strategies from the Expert Recommendations for Implementing Change (ERIC) to implement functions similar to an ordinary hospital, but using fewer inputs. This experience can be applied to other resource-limited settings such as that in less developed countries.

Learning from public health and hospital resilience to the SARS-CoV-2 pandemic: protocol for a multiple case study (Brazil, Canada, China, France, Japan, and Mali).

BACKGROUND: All prevention efforts currently being implemented for COVID-19 are aimed at reducing the burden on strained health systems and human resources. There has been little research conducted to understand how SARS-CoV-2 has affected health care systems and professionals in terms of their work. Finding effective ways to share the knowledge and insight between countries, including lessons learned, is paramount to the international containment and management of the COVID-19 pandemic. The aim of this project is to compare the pandemic response to COVID-19 in Brazil, Canada, China, France, Japan, and Mali. This comparison will be used to identify strengths and weaknesses in the response, including challenges for health professionals and health systems. METHODS: We will use a multiple case study approach with multiple levels of nested analysis. We have chosen these countries as they represent different continents and different stages of the pandemic. We will focus on several major hospitals and two public health interventions (contact tracing and testing). It will employ a multidisciplinary research approach that will use qualitative data through observations, document analysis, and interviews, as well as quantitative data based on disease surveillance data and other publicly available data. Given that the methodological approaches of the project will be largely qualitative, the ethical risks are minimal. For the quantitative component, the data being used will be made publicly available. DISCUSSION: We will deliver lessons learned based on a rigorous process and on strong evidence to enable operational-level insight for national and international stakeholders.

Can we apply lessons learned from Ebola experience in West Africa for COVID-19 in lower income countries?

The COVID-19 affects vulnerable groups disproportionally in a society where inequities are long-standing issue. Weak health system, especially the shortage and maldistribution of capable health workforce will be the main challenge in lower income countries to fight against the COVID-19. Applying the lesson learned and success from the Ebola outbreak in West Africa is important. International collaboration with already well functioned local mechanisms, such as the Network of Managers of Health Workforce in Francophone Africa is the key to provide prompt support. This approach contributes not only to the short-term COVID-19 control but also long-term strengthening of the sustainable and resilient health system in the lower income countries.

The Role of a Network of Human Resources for Health Managers in Supporting Leadership for Health Systems Strengthening in Francophone African Countries.

This article presents the Vision Tokyo 2010 Network, a unique model of peer learning and information sharing among human resources for health (HRH) managers in Francophone African countries. It describes the network's origins, achievements, and factors underlying its success. The network's origins lie in an overseas training program in Tokyo between 2010 and 2014. Participants included directors and heads of HRH management departments at federal and provincial levels across nine Francophone African countries: Benin, Burkina Faso, Burundi, the Democratic Republic of Congo, Côte d'Ivoire, Niger, Mali, Senegal, and Togo. The network itself was established in 2012 based on the common strategic vision (Vision Tokyo 2010) developed during the training program, with an objective of tackling major problems to improve the performance of human resource development systems in the health systems of participants' countries. Some of the main outcomes of the network, demonstrated during the Ebola outbreak include: improved use of human resource information systems in Senegal established as a result of peer learning within the network and technical cooperation between the Democratic Republic of Congo and Côte d'Ivoire to develop standard operational procedures and to train health workers in the management of Ebola. Having a common strategic vision and contextualized framework-African house of solidarity-as a symbol for HRH system development, strong ownership by core members, participatory processes, a positive peer learning environment, and coaching-style support by partners were key elements of success in this initiative. The biggest challenge for this network thus far has been financial sustainability. However, steps are being taken to demonstrate the cost-effectiveness of networks such as these in order to garner further support from partners to invest in networked approaches rather than siloed, country-specific programs.