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1.
Health Policy Plan ; 2022 Oct 12.
Article in English | MEDLINE | ID: covidwho-2243716

ABSTRACT

COVID-19 demanded urgent responses by all countries, with wide variations in the scope and sustainability of those responses. Scholarship on resilience has increasingly emphasized relational considerations such as norms and power and how they influence health systems' responses to evolving challenges. In this study, we explored what influenced countries' national pandemic responses over time considering a country's capacity to test for COVID-19. To identify countries for inclusion, we used daily reports of COVID-19 cases and testing from 184 countries between January 21st, 2020 to December 31st, 2020. Countries reporting test data consistently and for at least 105 days were included, yielding a sample of 52 countries. We then sampled five countries representing different geographies, income levels, and governance structures (Belgium, Ethiopia, India, Israel, Peru) and conducted semi-structured key informant interviews with stakeholders working in, or deeply familiar, with national responses. Across these five countries, we found that existing health systems capacities and political leadership determined how responses unfolded, while emergency plans or pandemic preparedness documents were not fit-for-purpose. While all five countries were successful at reducing COVID-19 infections at a specific moment in the pandemic, political economy factors complicated the ability to sustain responses, with all countries experiencing larger waves of the virus in 2021 or 2022. Our findings emphasize the continued importance of foundational public health and health systems capacities, bolstered by clear leadership and multisectoral coordination functions. Even in settings with high-level political leadership and a strong multisectoral response, informants wished they-and their country's health system-were more prepared to address the pandemic and maintain an effective response over time. Our findings challenge emergency preparedness as the dominant frame in pandemic preparedness and call for a continued emphasis on health systems strengthening to respond to future health shocks-and a pandemic moving to endemic status.

2.
Patient Education and Counseling ; 105(1):257-259, 2022.
Article in English | APA PsycInfo | ID: covidwho-1627070

ABSTRACT

Overall, the 2021 EACH Summer School for early-career researchers was a masterclass - not only in research but also in holding a successful online event. Although there were some concerns beforehand about downsides of online events, the Summer School managed to connect, teach, and inspire its participants in ways they did not anticipate. Shaping a comfortable atmosphere and having a varying program that included both formal and social activities was key. From wider accessibility came breadth of experience and perspective. From interactive icebreakers and informal chats came a supportive research network. Despite screens, we created a successful work environment and shared tips and tools for academic strategy, survival, and support. The 2021 Summer School was an illustration of just how much can be achieved despite restrictions. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

3.
BMJ Glob Health ; 6(6)2021 06.
Article in English | MEDLINE | ID: covidwho-1276951

ABSTRACT

BACKGROUND: Integrated health service delivery (IHSD) is a promising approach to improve health system resilience. However, there is a lack of evidence specific to the low/lower-middle-income country (L-LMIC) health systems on how IHSD is used during disease outbreaks. This scoping review aimed to synthesise the emerging evidence on IHSD approaches adopted in L-LMIC during the COVID-19 pandemic and systematically collate their operational features. METHODS: A systematic scoping review of peer-reviewed literature, published in English between 1 December 2019 and 12 June 2020, from seven electronic databases was conducted to explore the evidence of IHSD implemented in L-LMICs during the COVID-19 pandemic. Data were systematically charted, and key features of IHSD systems were presented according to the postulated research questions of the review. RESULTS: The literature search retrieved 1487 published articles from which 18 articles met the inclusion criteria and included in this review. Service delivery, health workforce, medicine and technologies were the three most frequently integrated health system building blocks during the COVID-19 pandemic. While responding to COVID-19, the L-LMICs principally implemented the IHSD system via systematic horizontal integration, led by specific policy measures. The government's stewardship, along with the decentralised decision-making capacity of local institutions and multisectoral collaboration, was the critical facilitator for IHSD. Simultaneously, fragmented service delivery structures, fragile supply chain, inadequate diagnostic capacity and insufficient workforce were key barriers towards integration. CONCLUSION: A wide array of context-specific IHSD approaches were operationalised in L-LMICs during the early phase of the COVID-19 pandemic. Emerging recommendations emphasise the importance of coordination and integration across building blocks and levels of the health system, supported by a responsive governance structure and stakeholder engagement strategies. Future reviews can revisit this emerging evidence base at subsequent phases of COVID-19 response and recovery in L-LMICs to understand how the approaches highlighted here evolve.


Subject(s)
COVID-19 , Developing Countries , Health Services , Humans , Pandemics , SARS-CoV-2
4.
BMJ Open ; 11(5): e042872, 2021 05 03.
Article in English | MEDLINE | ID: covidwho-1214973

ABSTRACT

INTRODUCTION: The importance of integrated, people-centred health systems has been recognised as a central component of Universal Health Coverage. Integration has also been highlighted as a critical element for building resilient health systems that can withstand the shock of health emergencies. However, there is a dearth of research and systematic synthesis of evidence on the synergistic relationship between integrated health services and pandemic preparedness, response, and recovery in low-income and lower-middle-income countries (LMICs). Thus, the authors are organising a scoping review aiming to explore the application of integrated health service delivery approaches during the emerging COVID-19 pandemic in LMICs. METHODS AND ANALYSIS: This scoping review adheres to the six steps for scoping reviews from Arksey and O'Malley. Peer-reviewed scientific literature will be systematically assembled using a standardised and replicable search strategy from seven electronic databases, including PubMed, Embase, Scopus, Web of Science, CINAHL Plus, the WHO's Global Research Database on COVID-19 and LitCovid. Initially, the title and abstract of the collected literature, published in English from December 2019 to June 2020, will be screened for inclusion which will be followed by a full-text review by two independent reviewers. Data will be charted using a data extraction form and reported in narrative format with accompanying data matrix. ETHICS AND DISSEMINATION: No ethical approval is required for the review. The study will be conducted from June 2020 to May 2021. Results from this scoping review will provide a snapshot of the evidence currently being generated related to integrated health service delivery in response to the COVID-19 pandemic in LMICs. The findings will be developed into reports and a peer-reviewed article and will assist policy-makers in making pragmatic and evidence-based decisions for current and future pandemic responses.


Subject(s)
COVID-19 , Developing Countries , Health Services , Humans , Pandemics , Research Design , Review Literature as Topic , SARS-CoV-2
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