The Promoting Understanding of Leadership in Schools (PULS) Survey aims to inform policy- and decision-makers about the on-the-ground reality of, and the support needed by school leaders in low- and middle- income countries (LMICs). In 2020, we learned that school leaders’ top struggles were student well-being, finances, and online teaching. In 2021, one in two school leaders reported COVID-19 related loss of lives in their school communities. They identified student and teacher health and safety and student learning as key issues. This year’s survey followed up on these themes to understand how these challenges have persisted or changed over time. We analyzed data from 2,646 school leaders in 11 countries. We identified differences based on income levels of the countries, geographies, school types, and schooling levels. This report presents detailed findings, with a focus on the following topics: 1) Student re-enrollment after the pandemic; 2) Learning loss in schools; and 3) Mental health and wellbeing.