Designing Interventions to Strengthen Resilience Among HIV Healthcare Providers for Pregnant/Postpartum Women in Southwestern Kenya During Service Disruption: The REACH Study (Resilience Amid Challenges in Healthcare)

Service disruptions, such as those experienced during the COVID-19 pandemic, have led to significant physical and mental health challenges for healthcare providers supporting pregnant and postpartum women (PPW) globally. These disruptions intensified the emotional and psychological burden on frontline workers. This study explores the perspectives of healthcare workers (HW) in southwestern Kenya to inform the design of interventions aimed at building resilience, developing coping strategies, and enhancing support mechanisms during times of crisis.

We conducted four focus group discussions (FGDs), two with clinical HW (ClinHW) and two with lay HW (LHWs), involving a total of 29 participants working at two public clinics in Kisumu County, Kenya. In addition, we carried out 10 key informant interviews (KIIs) with purposively selected stakeholders from the health and governance sectors during October–November 2023. Eligible participants were aged 18 years or older, employed at HIV/antenatal clinics or in county health management, and had at least three years of work experience. All FGDs and KIIs were conducted in English. A team of four trained study staff conducted rapid thematic analysis to identify emerging patterns and themes, framed around the integrated Quality-of-Life Models.

Participants expressed an urgent need for interventions aimed at building resilience and enhancing mental health preparedness of HWs during times of crisis. They described how COVID-19 related service disruptions negatively impacted their psychological and emotional well-being. When asked about potential interventions, participants envisioned programs for HWs focused on stress management, work-life balance, emergency preparedness, and stigma reduction around use of mental health services. Suggested strategies included mindfulness therapy, talk therapy, and positive thinking to promote emotional resilience. One-on-one delivery of supportive sessions for HWs, preferably at the workplace, was the most favored and viewed as the most feasible format.

HW suggest that interventions focused on building resilience and strengthening emergency preparedness can improve mental health outcomes for both healthcare providers and the pregnant and postpartum women living with HIV they serve during future societal crises. Additionally, such programs may offer lasting benefits by equipping providers with practical coping and stress management strategies to address everyday burnout and emotional strain in healthcare settings.