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As we review health governance during the COVID-19 pandemic, we have an opportunity to reflect on these processes and ensure that future challenges might be managed in a more collaborative and whole of system response. This 'Perspective' reviews COVID-19 responses in Australia, reflects on a number of potential solutions that have been developed by organisations over the past two decades and proffers a governance framework for a Communicable Disease and Pandemic Management Authority that might assist health responses to future challenges. What is known about the topic? Responses to the COVID-19 pandemic were at best disorganised with multiple failures at almost every level. Reflecting on these responses is essential if we are to perform better in future health and societal crises, which will inevitably occur. What does this paper add? This paper summarises a number of organisational 'structures' and discussion documents that have been developed over the past decades which might be useful starting points for development of a structure(s) that would leave Australia in a better position when the next 'wave' hits. What are the implications for practitioners? Good governance is fundamental to how we do business and the complexities of the health and welfare system(s) only compound these challenges. [ABSTRACT FROM AUTHOR]

This paper draws from a review of the global literature on school leadership during the first 30 months of the pandemic (2020-2022), when educational leaders were faced with complexity on an unprecedented scale. COVID-19 challenged school leadership, providing opportunities to reflect on: leadership practice within and beyond school contexts; building relationships with wider communities and external stakeholders; established bureaucratic systems and ways of working (Author et al. under review). School leaders' reliance on organisational stability, hierarchy and standardised practice was also challenged: reflective practice was needed, whilst responding to complex and demanding situations. Increased teacher autonomy and agency was encouraged and embraced, with 'profound collaboration borne out of necessity and urgency' (p. 393), highlighting the fluid practice of leadership rather than the role specificities of a leader. As school systems return to the business of in-person schooling and further away from the shock of the pandemic, the article renews calls to learn from experience and innovation. Three aspects are discussed, for supporting the development of school leadership/leaders capable of navigating complexity: school leadership; informal professional learning; formal professional learning. Our analysis provides insights into advancing professional learning approaches: accounting for complexity; enhancing teaching and learning; strengthening educator empowerment. [ABSTRACT FROM AUTHOR]

India with a population of 1.3 billion has a unique health care system in its different states. Mental health care varies widely across the country and this became even more apparent after the COVID-19 pandemic set in. This paper examines the various strategies in response to COVID-19 adopted by the Government of India, the health departments of the individual states, and other private players such as on-government organizations and the civil society. The cessation of many services including outpatient and inpatient care and the scarcity of medicines were serious impacts of COVID-19. The prolonged lockdown in many parts of the country impeded access to mental health care services since public transport was unavailable. This led to many relapses in persons with serious mental disorders. The emergence of new cases of psychosis and an increase in suicides were also seen. Tele consultations came to the fore and many helplines were started offering counseling and guidance regarding the availability of mental health care facilities. While these helped the urban dwellers, those in remote and rural areas were unable to use these services effectively. Many mental health wards were used for COVID-19 patients and mental health professionals were deployed for COVID-19 related duty. The severely mentally ill, the homeless mentally ill, and the elderly were especially vulnerable. Based on our experience with COVID-19, we urge a strong call for action, in terms of strengthening the primary care facilities and increasing the manpower resources to deliver mental health care. [ABSTRACT FROM AUTHOR]

Background: Even though trust is placed at the central point in ensuring proper functioning of the health systems, studies remain scant on how it affects both the implementation and uptake of COVID-19 response measures in low- and middle-income countries such as Tanzania. This study, therefore, explored the role of trust in the implementation and uptake of recommended COVID-19 response measures including vaccines from the perspective of health professionals in Tanzania. Methods: This cross-sectional qualitative study was implemented in four of Tanzania's thirty-one regions. Qualitative data was collected through 26 in-depth interviews held with regional and district disease outbreak response teams, district cold chain co-ordinators and health facility in-charges. In addition, five focus group discussions and seven group interviews were conducted with healthcare workers from the lower-level health facilities. Thematic analysis was conducted and applied the trust constructs. Results: Interpersonal trust and health system trust emerged as two major themes in the study. Interpersonal trust was reported to stem from lack of transparency that instigated fear, worries, and confusion regarding the implementation and uptake of the recommended response measures. The distrust was mainly between health professionals in health facilities and those assigned to isolation centres as well as between patients and community members. On the other hand, the health system trust was shaped by mixed feelings regarding COVID-19 vaccine national decisions, and conflicting messages from national officials, politicians and religious leaders on COVID-19 responses, safety, and effectiveness of the vaccines. Questions surrounding the short duration of clinical trials, indeterminate post-vaccination protection duration, impotence-linked beliefs, freemasonry notion and unclear vaccinated cards information are other reported contributory factors to mistrust in the health system. However, after a comprehensive health education and experience in COVID-19 vaccination administration most professionals affirmed the effectiveness of the vaccines in limiting infections and its severe consequences. Conclusion: Participants indicated limited trust at both interpersonal and health system levels aggravated by lack of transparency, unclear and conflicting messages on COVID-19 infections and response measures. Enforced transparency on pandemics alongside standardised messages from the reliable sources is crucial in enhancing trust in implementation and uptake of the recommended response measures. [ABSTRACT FROM AUTHOR]

As the world goes through the fourth wave and the continued emergence of new COVID‐19 variants, the general and work‐related risks of healthcare professionals are expected to rise. This has the capacity to adversely affect productivity and efficiency in the healthcare delivery system, particularly in this era of global shortage of trained healthcare professionals. We aimed to develop and validate a new instrument known as the COVID‐19 Responses Impact Questionnaire (COVRiQ) to evaluate the impact of the pandemic on the healthcare professionals managing the COVID‐19 pandemic. This methodological study involved three steps: the formulation of the COVRiQ draft, content and face validation, and construct validity. A total of 61 questions were drafted with 3‐point Likert scale answers. From the list, 39 were rated valid by a panel of experts and subsequently tested on 301 participants. The results were analyzed and validated using exploratory factor analysis on SPSS. Components were extracted and questions with low factor loading were removed. The internal consistency was measured with Cronbach's alpha. Following analysis, three components were extracted and named as behavioral, social, and economic impacts. In general, 29 items were deleted leaving 32 out of 61 questions retained as the final validated COVRiQ. Internal consistency showed high reliability with Cronbach's alpha of 0.91. Participants scored a total cumulative mean of 118.74 marks. A subanalysis by occupation showed that medical assistants scored the lowest in the group with a score of 22.3% whereas medical specialists scored the highest at 77.7%. Higher score indicates higher impact of COVID‐19 responses among healthcare professionals. The new COVRiQ consisting of 32 items demonstrated to be user friendly with good psychometric properties and valid for assessing the impacts of COVID‐19 responses among healthcare professionals. [ABSTRACT FROM AUTHOR]