Psychological resilience, fragility and the health workforce: lessons on pandemic preparedness from Liberia and Sierra Leone

Health workers in fragile settings are constantly exposed to stressors that become exacerbated in times of crisis; the scarcity within which they operate is now increasingly globally acknowledged.

Many providers—whether based in facilities or communities—may still carry unresolved trauma from earlier shocks.

Health systems resilience may require fundamental changes in resources and other structural factors, but also key to this is facilitating health workers access to long-term psychological support to enable them to navigate psychological distress.

Psychological support during shocks should be available for all health workers early, consider needs across cadres (including close to community providers) and respond to cumulative and historic trauma as well as associated stigma.

Health system planners need to design context-specific responses that are informed by close to real-time data and systematic research focused on improving understanding of healthcare workers stresses and mental health needs.