Experiences on the frontline: Qualitative accounts of South African healthcare workers during the COVID-19 pandemic.

Background: The COVID-19 pandemic significantly impacted people's mental health significantly. Frontline healthcare workers (HCWs) were arguably most affected, particularly in low-to-middle-income countries like South Africa. Understanding their experiences is important to inform interventions for social and psychological support for future pandemics. Aim: This study explored the experiences of frontline HCWs in South Africa during the COVID-19 pandemic. Setting: The sample included HCWs from various professions and health sectors who worked with COVID-19 patients across South Africa. Methods: An exploratory descriptive qualitative design was used. Semi-structured interviews were conducted with 11 frontline HCWs recruited via purposive sampling. Data were analysed using principles of inductive thematic analysis. Results: Four major themes were identified in the data: (1) Working during COVID-19 was an emotional rollercoaster; (2) Working during COVID-19 was physically and mentally exhausting; (3) Participants held negative attitudes towards the Department of Health; and (4) COVID-19 had a transformative impact on the daily life of HCWs. Conclusion: HCWs' experiences were diverse and marked by contradictions. Limited psychological support and resources aggravated experiences. However, a positive narrative of hope and gratitude also resonated with participants. Qualitative methodologies provided depth and insights into the diverse realities of frontline HCWs. Contribution: This study provides significant insights into the experiences of a diverse group of frontline South African HCWs during COVID-19. It demonstrates a shift in the definition of a 'frontline' HCW and highlights the need for greater psychological support and individualised public health interventions during future pandemics.