ABSTRACT
Background The COVID-19 syndemic reveals social and health inequalities, putting marginalized groups such as migrants at greater risk. Yet health systems fail to routinely monitor the health of migrants, refugees, and internally displaced persons. Our systematic review provides an up-to-date synthesis of the empirical evidence on COVID-19 infection risk, transmission, outcome of disease and risk of severe course of disease among migrant populations. It further aims to compile extant evidence on COVID-19 vaccination coverage among these groups, and on the effects of pandemic control measures on their health. Methods Following PRISMA guidelines, we registered a review protocol, searched 14 scientific databases and 4 pre-print servers using the WHO database of global literature on COVID-19, and hand-searched relevant websites for grey literature. The search period covers the time from 12/2019 to 11/30/2021. Articles in English, German and Spanish and all study designs were included. Results A total of 6966 references were identified for title and screening. 518 records were screened in full-text, out of which 204 articles were included so far (conflict solving at full-text stage and data extraction are ongoing). Our review presents a broad landscape of different study designs, migrant populations and COVID-19 outcomes. Based on previous work, we expect to find a higher risk of infection in migrants and their disproportionate share among COVID-19 cases, and consolidate the (mental) health impacts of pandemic control measures. Our preliminary findings indicate a vast knowledge gap on vaccination coverage among migrant groups. Conclusions Two years into the syndemic, this review summarizes the global empirical evidence on the impact of the COVID-19 syndemic on migrant populations. With health systems often lacking related data, the review provides an important evidence base for the consideration of migrants in future pandemic preparedness policies. Key messages • The systematic review provides an up-to-date synthesis of the empirical evidence on COVID-19 among diverse migrant populations globally. • Knowledge on vaccination coverage in migrants remains patchy.
ABSTRACT
For decades, the public health service in Germany (PHS) experienced shortages of young professionals and challenges in recruiting qualified personnel. To sustainably counteract this challenge, it is necessary to understand the reasons of the perceived low attractiveness of PHS as a potential employer among students and young professionals. Two cross-sectional online surveys were conducted to assess the attitudes of medical, public health, and health science students towards the PHS as a potential employer. Wave 1, conducted from 2019-12 to 2020-04, focused on factors associated with high and with low interest in working for the PHS. Wave 2 was conducted from 2020-06 to 2020-09 to capture changes that may have resulted from the newfound attention of the PHS during the SARS-CoV-2 pandemic. Participants in both waves were asked about opportunities to increase the attractiveness of the PHS, which were analyzed using qualitative content analysis. In total 3040 students participated. Low interest in the PHS was associated with limited knowledge about public health, primary interest in clinical medicine, and a negative image of the public service. The qualitative analysis indicated as major obstacles: low visibility of and low awareness about the PHS, a perception of hierarchical and bureaucratic workplaces, and perceptions of repetitive occupations, among others. The participants suggested: improving awareness about the PHS in the population, including PHS in curriculum, and reducing entry barriers for non-medical students. The results of the largest survey of students on the attractiveness of the ÖGD in Germany provide valuable insights for ongoing reform processes. In addition to approaches to increase external visibility, existing processes and procedures within the ÖGD should be considered. Key messages • To counteract the shortage of skilled workers, the PHS must become more attractive to young professionals. This requires both, greater external visibility and modernization of internal structures. • Successful inclusion of the perspective of young professionals in the current modernization processes introduces opportunities to increase the attractiveness of the PHS in the long-term.
ABSTRACT
Einleitung The Public Health Service in Germany (PHS, German: ÖGD) has been suffering from a significant shortage of young professionals for decades. An issue likely to intensify in the coming years due to demographic processes. This applies not only, but especially, to the municipal level. The reasons for the perceived low attractiveness of the PHS as a potential employer have been widely discussed, but so far, no empirical data is available. Therefore, the German Network of Young Professionals in Public Health (German: NOEG), has set up a study to analyze the attractiveness of the PHS as a potential employer for young professionals. Methoden We conducted two cross-sectional surveys to assess the requirements and expectations of students in PHSrelevant fields of study with regard to their future employers. The first survey (wave 1) was conducted from December 2019 to April 2020 and focused on wishes and expectations of medical, public health, and health science students regarding their prospective jobs and employers. It was postulated that the various roles and activities of the public health workforce within the PHS are of interest to many students but are not considered as potential fields of employment for a variety of reasons. The second survey (wave 2) was conducted from June to September 2020 to be able to address any changes that may have resulted from the newfound attention on the PHS during the coronavirus crisis, to identify changes in the evaluation of the PHS as a potential employer form a young professional perspective. Ergebnisse In the wave 1, 2456 students participated, with an additional 584 taking part in wave 2. Medical students were less likely to report interest in working for the PHS in comparison with public health students and students of other health sciences. The vast majority of those medical students that considered the PHS as a potential employer reported their main interest as working in primary health care. Public health students and other students have experienced barriers when seeking jobs in the PHS. The respondees reported on a number of domains contributing to a low attractiveness of the PHS as an employer, such as the PHS being perceived as antiquated, inefficient and slow, the occupations consisting of too much braucracy, and limited career opportunities. Suggestions for improvement included a stronger occupational focus on prevention, health promotion and public health impact, modernization and digitalization, as well as providing attractive job offers for candidates without a professional training in medicine. Schlussfolgerung The results of this largest survey regarding the attractivenss of the German PHS among students provide valuable insights for the reform of the German PHS. We synthesized a number of suggestions for reform, among others regarding training and education, occupation in the PHS, adminstrative processes, and career opportunities.