Background
Climate change is expected to place increasing demands on Australian health services in the coming decades, with intensifying heatwaves, bushfires, floods, and compounding climate disasters. The implications for service demand and the workforce are multifaceted. Health system planning that relies on historical activity patterns and reactive adaptation may no longer capture the scale or complexity of future risk.

Aim
To review the literature on the impact of past extreme events on hospital utilisation and projections of future demand, to inform health service planning with consideration of compounding extreme events, health workforce needs, and strategies for health system resilience.

Methods
Database searches (PubMed, Scopus, CINAHL, Google Scholar, and citations) were conducted to February 2026. Reflecting stakeholder liaison and the current state of knowledge, multiple evidence types were searched, including quantitative and qualitative primary studies, synthesis reviews, and grey literature.

Key Findings
Extreme events impose context-dependent and growing demands on health services, with Australian studies projecting increases in emergency department presentations and hospital admissions under multiple climate scenarios. The health workforce faces acute and long-term logistical, psychological, and safety challenges. Vulnerable populations are particularly at risk, and rural and remote communities already experiencing inequitable access to services and
workforce shortages face further climate-related staff attrition. Compound events amplify health system impacts beyond single events yet remain understudied.

Policy Implications
Reliance on historical activity patterns and reactive adaptation is inadequate for the scale of projected risk. Health system resilience requires a shift toward vulnerability assessments, stress-testing of infrastructure and workforce capacity, organisational planning including staff training in disaster preparedness, and targeted support for vulnerable populations.

Learning Objectives

1, Describe the range of health system impacts associated with extreme weather events in the Australian context.

2, Identify key workforce vulnerabilities amplified by climate-related disasters.

3, Articulate priority actions for building climate-resilient health systems.

Background

Nigeria ranks highest for cervical cancer burden in Sub-Saharan Africa, with 13,700 new cases and 7,100 deaths annually. Addressing this burden requires Nigeria to achieve the WHO 90-70-90 targets for vaccination, screening, and treatment, which depend critically on health workforce capacity. However, information on workforce availability, distribution, and engagement in Nigeria from a cervical cancer service-delivery perspective is limited. This study assessed these domains to provide relevant evidence that can inform workforce interventions.

Methods

This study utilised a convergent parallel mixed methods design. Data from five regulatory and professional bodies and the Nigeria Health Workforce Profile (2022-2026) were used to examine relevant workforce stock, licensure gaps, and workforce density benchmarked against recommended thresholds. The qualitative strand involved nine key informant interviews with policymakers and top-level health workers, which were analysed using reflexive thematic analysis.

Results

Of the 635,503 registered health workers, only 64.5% were licensed, with physicians (36.8%) and nurses and midwives (46.3%) representing the highest proportion of unlicensed personnel. Substantial deficits were documented across all cadres. Physician, nurse, and midwife density was 11.26 per 10,000, representing only 25.3% of the SDG threshold. Specialist cadres, including oncologists, who are critical to cervical cancer treatment, constituted only 0.26% of the workforce. Six themes developed in the qualitative strand provide additional context: Despite progress in governance and vaccination, an unethical screening-treatment gap exists; health workers are disengaged, maldistributed, and depleted by brain drain due to the lack of an enabling work environment; and training capacity and access are limited.

Conclusion

Nigeria's health workforce is inadequate to achieve the 90-70-90 cervical cancer elimination targets. Closing this gap requires sustained investments in expanding training capacity, especially for specialists, equitable workforce distribution, and creating an enabling environment that prioritises welfare and infrastructure to attract and retain the cancer workforce in areas of greatest need.

Challenge
Climate change increases pressure on health systems through extreme weather, disrupted supply chains and rising care demands. At the same time, healthcare contributes 5.5% of Australia’s carbon emissions, making decarbonisation essential to climate resilience. The National Health and Climate Strategy identifies the need for workforce development and integrating sustainability into routine quality improvement. Many clinicians lack practical tools to translate climate and sustainability goals into meaningful change within their practice.
Evidence
To address this capability gap, we developed and piloted a six week online course introducing the Sustainable Quality Improvement (SusQI) toolkit, developed by the UK Centre for Sustainable Healthcare, integrating environmental, social and financial sustainability into quality improvement. Using co design and constructive alignment, the course was adapted for Australia and delivered through 10 hours of structured learning. An Advisory Group representing health jurisdictions, trainees, climate experts and educators guided development. Participants from various clinical and organisational settings completed the pilot. Evaluation used post course surveys, facilitated discussions and team reflection. Participants reported increased understanding of healthcare’s climate impacts, greater confidence applying sustainability focused QI methods, and stronger motivation to lead climate positive initiatives. The practice oriented design was valued for turning climate concepts into actionable improvements.
Implications
The pilot, funded by a Commonwealth STP Project Support grant, demonstrates that SusQI provides a scalable, evidence based mechanism for embedding climate action into healthcare improvement. By equipping clinicians with practical tools to reduce emissions, minimise waste and strengthen system resilience, this approach supports transitioning to climate responsive, sustainable models of care. Building this capability across the workforce is essential for preparing Australia’s health system for a rapidly changing climate.
Objectives
1. Describe the climate related challenges facing healthcare systems
2. Summarise how the SusQI toolkit supports climate action within clinical practice.
3. Identify practical examples of how clinicians can contribute to low carbon, climate resilient healthcare

Background: Drowning is the leading cause of injury-related death among children under 10 in Bangladesh. Most caregivers already know drowning is dangerous — yet children continue to die. This reveals a deeper problem: awareness alone does not translate into consistent preventive action at the household level.
Objectives: To assess caregiver knowledge, attitudes, and practices related to childhood drowning, and to identify barriers that prevent awareness from becoming safer behaviour.
Methods: A nationally representative cross-sectional mixed-methods study was conducted across 45 upazilas in 16 districts, covering 133,387 households. Structured interviews were completed with 13,324 caregivers. Twenty-four focus group discussions explored supervision behaviours, attitudes toward survival swimming, and responses to drowning incidents. Quantitative and qualitative findings were triangulated to identify where and why prevention breaks down.
Results: Although 93% of caregivers recognised drowning as preventable, fewer than half (49.7%) identified limiting children's access to water hazards as a key strategy, and only 39% reported consistent supervision near water. Support for survival swimming was high (79%), but participation was limited by financial constraints and gender norms. Harmful traditional resuscitation practices were widely reported, with low awareness of CPR. These findings confirm a persistent gap between knowledge and practice.
Conclusions: Awareness campaigns alone cannot reduce child drowning deaths in Bangladesh. Prevention must be embedded within existing systems — national child health programmes, early childhood development services, and community health worker networks. Key priorities include structured caregiver training, equitable access to survival swimming, and standardised first aid education. Without this systemic approach, the gap between knowing and doing will continue to cost children their lives.

Background
The education sector is rapidly adapting to the implications of Generative AI (GenAI) However, staff and student perspectives are rarely examined together, despite both shaping how emerging technologies are adopted in practice.

Methods
We analysed two groups within a large Australian health faculty: a mixed-methods staff survey (n=96 educators) and open-ended survey responses from Master of Public Health students across two cohorts (2025, n=40; 2026, n=44) on how the program could better support appropriate GenAI use. Quantitative data were summarised descriptively; qualitative data underwent thematic analysis.

Results
Educators and students independently identified shared priorities. Both highlighted the value of consistent cross-subject guidance and reliable approaches to academic integrity, with current detection tools a common source of friction for educators managing integrity processes and students concerned about wrongful detection. Both groups pointed to authentic assessment redesign as a constructive way forward, and several students praised assignments asking them to critique GenAI outputs. Educators and students differed in a few areas of emphasis. Students more often favoured GenAI integration, framing it as workforce preparation. Overall, 73% of surveyed educators intended to use GenAI in their education but only 10% (9 of 86) felt sufficiently resourced to implement it. Educators navigated low self-efficacy for a range of GenAI skills (median confidence 15 to 39 out of 100). The specific types of GenAI skills that students demanded mapped directly to the specific types of GenAI skills that staff requested as professional development. A thoughtful minority in both groups questioned GenAI use on ethical grounds.

Conclusions
These findings constitute a needs analysis that pinpoints where educator capability development will have most effect and confirms strong student demand as a driver. Aligning willing educators with ready learners is achievable through coherent guidance, fair integrity processes, authentic assessment, and targeted faculty development.

Background: The transition home after hospital discharge is a period of high vulnerability for older patients with heart failure (HF). Research shows that specialised cardiac nursing services can reduce rehospitalisations and emergency department visits. Despite the evidence highlighting the crucial role of cardiac nurses in enhancing transition of care (TOC) for patients with HF, there is limited understanding of their perspectives on these services.
Aim: To understand cardiac nurses' perspectives on TOC services for older patients with HF to inform improvements in patient care.
Methodology: Semi-structured interviews were conducted for the qualitative data. Purposive sampling was used to recruit cardiac nurses from the Victorian Heart Hospital, Austin Health and one of the regional hospitals. Face-to-face interviews were conducted, and recordings were transcribed for thematic analysis using NVivo.
Results: A total of 12 nurses participated in the interviews. Thematic analysis from the nurses' perspectives uncovered five key themes that significantly impact TOC services, including: System-level barriers and disparities; Equipping patients and nurses with effective management tools; Multidisciplinary collaboration and clear pathways; Proactive practices for early risk detection and monitoring; and Emotional and social dimensions of patient care.
Conclusion and Implications: Nurses identify five key areas essential for enhancing TOC and promoting patient safety. Cardiac nurses play a vital role by offering clinical management, patient education, and emotional support throughout care transitions. However, addressing resource limitations and bridging communication gaps is crucial for achieving optimal healthcare outcomes, especially in regional areas. Acknowledging the complexities involved in patient transitions, nurses emphasise the need for a coordinated and compassionate healthcare system that balances clinical outcomes with the overall patient experience. To foster improvements in care, investing in comprehensive nurse training, standardised communication practices, and streamlined protocols, particularly within regional healthcare frameworks, is highly beneficial.
Keywords: Nurses, Heart failure, Transition of care

The global spread of multidrug-resistant organisms (MDRO) has led to increased in-hospital mortality and reduced treatment options, making it an increasingly worrisome problem. According to statistics, in 2019, 1.27 million deaths were directly caused by bacterial resistance to antibiotics, and 4.95 million deaths were associated with bacterial resistance [1,2]. The ESKAPE group (Enterococcus faecium, Staphylococcus aureus, Klebsiella Pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter) is a group of bacteria very difficult to treat, due to their high capacity to acquire resistance to antibiotics and which are the main causes of nosocomial infections worldwide, posing a threat to global public health [3]. The acronym is sometimes extended to ESKAPEE to also include Escherichia coli [4].

Increasing antibiotic and antimicrobial resistance among strains in the hospital environment raises serious concerns about limited treatment options. As regional partnerships and collaborative ventures increase between militaries, it is important to have surveillance of MDRO is place for not just endemic but international strains that are introduce into community and hospitals.

Recent increasing priority alignment between regional militaries to co-operate in medical activities have led to combined research opportunities towards regional health security, including MDRO surveillance. The Australian Defence Force Malaria and Infectious Disease Institute has initiated a multi-sectoral international engagement with partner militaries in Papua New Guinea (PNG), Vietnam, Lao, Cambodia, Thailand and Philippines to train, skill exchange and conduct collaborative MDRO surveillance across local sectors using One Health paradigm.

This initiative has led to screening with over 400 samples collected per site including human, animal and environmental, using a shared protocol of clinical, epidemiological and lab techniques and questionnaires, to identify and isolate ESKAPE group bacteria, their resistance pattern, risk level and genomic profiles.

This collaboration has yielded novel MDRO information to inform health planning and policy in individual countries as well as across the region during joint activities. Common approaches in MDRO risk and awareness campaigns, hospital infection control and personal wound management has been explored and shared across nations through actioned projects. These projects involve (1) field and economical approaches to screen for MDROs in remote locations of PNG, as well as survey data identifying overuse and prescription of certain antibiotics and associated resistance developing in bacteria of that region; (2) skill exchange workshops as well environmental screening of local markets for source of transmission of MDROs in Vietnam, Philippines, Cambodia and Lao; (3) consent screening of human carriage, skin and soft tissue infections, as well as hospital infection control screening and policy in Australia, Philippines, Thailand and PNG.

The outcomes of these projects will be summarised with clear evidence that led to policy and practice change. Through given examples, it also illustrates the importance of working across locations and sectors to inform risk of infection through data and protocol sharing and harmonisation, and achieve collective risk mitigation.


References
1. Ma, J.; Song, X.; Li, M.; Yu, Z.; Cheng, W.; Yu, Z.; Zhang, W.; Zhang, Y.; Shen, A.; Sun, H.; et al. Global spread of carbapenem-resistant Enterobacteriaceae: Epidemiological features, resistance mechanisms, detection and therapy. Microbiol. Res. 2023, 266, 127249
2. Ranjbar, R.; Alam, M.; Antimicrobial Resistance Collaborators (2022). Global burden of bacterial antimicrobial resistance in 2019: A systematic analysis. Evid. Based Nurs. 2023, 27, 16.
3. Santajit, S.; Indrawattana, N. Mechanisms of Antimicrobial Resistance in ESKAPE Pathogens. BioMed. Res. Int. 2016, 2475067.
4. Mahmood, H.Y.; Jamshidi, S.; Sutton, J.M.; Rahman, K.M. Current Advances in Developing Inhibitors of Bacterial Multidrug Efflux Pumps. Curr. Med. Chem. 2016, 23, 1062–1081.

Introduction: From 2016 to 2025, Médecins Sans Frontières (MSF)-Operational Centre Amsterdam (OCA) collaborated with the Sierra Leone Ministry of Health (MOH) to implement a maternal and child health program in the Tonkolili district of Sierra Leone. The handover of the program to the MOH took place throughout 2024–2025. This study aimed to explore the perspectives of MSF and MOH staff during the 2024–2025 handover and a prior handover in 2007.

Methods: We conducted key-informant interviews with 60 purposively selected participants at the mid-point of the 2024–2025 handover. Participants included managerial staff from MSF and MOH, medical staff, District Health Management Team staff, and individuals who experienced the 2007 handover. The data were analysed thematically.

Results: The study included 25 (41.7%) female and 35 (58.3%) male participants. Participants reported that the 2007 handover was unstructured and ineffective, leading to declining service quality and health outcomes, unaffordable care, reduced health-seeking behaviour, unemployment among locally recruited MSF staff, limited medical supplies, and inadequate patient referrals. Similar changes were observed in the initial facility handed over in March 2024. The 2024–2025 handover was communicated early, executed in phases, involved task shifting, and was guided by a closure document. Participants recommended facility renovations; donation of medical supplies and equipment; mental health support for stressed staff; recruiting volunteers; continuous monitoring; involving other non-governmental organisations; supporting MOHs’ initiatives; sustained community and stakeholder engagement through committees; and incorporating lessons through post-handover evaluations.

Conclusions: The study—conducted during the handover—identified challenges and opportunities to improve the handover’s effectiveness and highlighted key activities for MSF and the MOH’s implementation. Our study demonstrated the utility and feasibility of integrating staff insights into health program handovers in Sierra Leone and similar contexts globally.

Background / Challenge:
Older people in residential aged care homes often experience mental health concerns that go unrecognised or unsupported. Workforce capability is variable, and education is often hard to access, poorly tailored, or difficult to integrate into practice. Eastern Melbourne Primary Health Network (EMPHN) identified a need to redesign capability building within its Healthy Ageing Service (HAS), delivered by St Vincent’s Hospital Melbourne (SVHM), to better support frontline staff.
Approach / Evidence:
EMPHN engaged the University of Melbourne to conduct a behavioural science-informed gap analysis of barriers and enablers to mental health care for older people across residential aged care and general practice. These findings informed a PHN-led co-design process involving general practitioners, aged care staff, and the SVHM HAS team. Five capability-building interventions were then prioritised and implemented through the HAS model.
Findings / Practice Insights:
Co-design produced a multi-modal suite of interventions, including clinician education (delivered through face-to-face sessions and webinars), short training videos and a poster resource for aged care workers, consumer and carer resources, and a communication toolkit to support coordination between services. Early implementation showed strong uptake of flexible digital formats, particularly webinars and videos. Face-to-face sessions were less attended but highly valued. Interventions requiring greater administrative effort, such as communication tools, were harder to implement, highlighting the importance of minimising workflow burden.
Implications and Learning Objectives:
This work shows how PHNs can lead commissioning for outcomes by embedding behavioural insights and co-design into service redesign. Participants will learn how to apply behavioural insights to capability building, use co-design to develop practice-relevant interventions, and design multi-modal approaches suited to service constraints.
Conclusion:
A co-designed, behaviourally informed approach offers a practical pathway to strengthening workforce capability and improving mental health care for older people.