Building resilient healthcare systems: physicians’ views on ways to mitigate the impact of the COVID-19 pandemic in the Dominican Republic and Nicaragua

Introduction Extensive research on the mental health impact of COVID-19 on healthcare workers suggests that this created a mental health crisis. However, limited research has been conducted on the unique challenges faced in regions with scarce healthcare resources, specifically, the Dominican Republic and Nicaragua.Theory This study used the Job Demands-Resources Model and Global Health Systems perspective to examine the pandemic’s impact on physicians’ mental health and implications for healthcare systems.Method Physicians were recruited via an online survey, including general practitioners and physicians from multiple specialties. We used qualitative methods to analyze narrative responses examining challenges faced during the COVID-19 pandemic, factors impacting their mental health, and recommendations to improve physicians’ mental health in any future pandemic. The sample of 154 physicians included 70% females, mean age of 30.5 years (SD = 6.23). We used thematic analysis to organize and report patterns in the data, extract meaningful statements, and formulate themes.Results Thematic analysis revealed significant emotional and psychological strain due to challenging work conditions, social isolation, and fear of infection. Themes focused on challenges included insufficient preventive measures and inadequate training tailored to COVID-19. Physicians recommended: increased workforce capacities; schedules allowing for greater rest; provision of mental health services, including group discussions; greater attention to preventive measures; and ensuring work breaks despite the extremely demanding clinical workload.Discussion Enhanced resourcing in countries with relatively low healthcare capacities is needed to strengthen preparedness for future infectious disease outbreaks, including efforts to improve the mental health of healthcare workers.