| 1. |
- Alga, A, et al.
(författare)
-
Hope for the Best, Prepare for the Worst-An Assessment of Flood Preparedness at Primary Health Care Facilities in Central Vietnam
- 2018
-
Ingår i: International journal of environmental research and public health. - : MDPI AG. - 1660-4601. ; 15:12
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Floods affect over 85 million people every year and are one of the deadliest types of natural disasters. The health effects of floods are partly due to a loss of access to health care. This loss can be limited with proper flood preparedness. Flood preparedness is especially needed at the primary health care (PHC) level. Flood preparedness assessments can be used to identify vulnerable facilities and help target efforts. The existing research on PHC flood preparedness is limited. We aimed to assess the flood preparedness of PHC facilities in a flood-prone province in central Vietnam. Methods: Based on flood experience, the PHC facilities in the province were grouped as “severe” (n = 23) or “non-severe” (n = 129). Assessments were conducted during monsoon season at five facilities from each group, using a pre-tested, semi-structured questionnaire. Data were checked against official records when possible. Results: Nine of the ten facilities had a flood plan and four received regular flood preparedness training. Six facilities reported insufficient preparedness support. Half of the facilities had additional funding available for flood preparedness, or in case of a flood. Flood preparedness training had been received by 21/28 (75%) of the staff at the facilities with severe flood experience, versus 15/25 (52%) of the staff at the non-severe experience facilities. Conclusions: Our results suggest that the assessed PHC facilities were not sufficiently prepared for the expected floods during monsoon season. PHC flood preparedness assessments could be used to identify vulnerable facilities and populations in flood-prone areas. More research is needed to further develop and test the validity and reliability of the questionnaire.
|
|
| 2. |
- Fridell, M, et al.
(författare)
-
Health System Resilience: What Are We Talking About? A Scoping Review Mapping Characteristics and Keywords
- 2020
-
Ingår i: International journal of health policy and management. - : Maad Rayan Publishing Company. - 2322-5939. ; 9:1, s. 6-16
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Health systems are based on 6 functions that need to work together at all times to effectively deliver safe and quality health services. These functions are vulnerable to shocks and changes; if a health system is unable to withstand the pressure from a shock, it may cease to function or collapse. The concept of resilience has been introduced with the goal of strengthening health systems to avoid disruption or collapse. The concept is new within health systems research, and no common description exists to describe its meaning. The aim of this study is to summarize and characterize the existing descriptions of health system resilience to improve understanding of the concept. Methods and Analysis: A scoping review was undertaken to identify the descriptions and characteristics of health system resilience. Four databases and gray literature were searched using the keywords "health system" and "resilience" for published documents that included descriptions, frameworks or characteristics of health system resilience. Additional documents were identified from reference lists. Four expert consultations were conducted to gain a broader perspective. Descriptions were analysed by studying the frequency of key terms and were characterized by using the World Health Organization (WHO) health system framework. The scoping review identified eleven sources with descriptions and 24 sources that presented characteristics of health system resilience. Frequently used terms that were identified in the literature were shock, adapt, maintain, absorb and respond. Change and learning were also identified when combining the findings from the descriptions, characteristics and expert consultations. Leadership and governance were recognized as the most important building block for creating health system resilience. Discussion: No single description of health system resilience was used consistently. A variation was observed on how resilience is described and to what depth it was explained in the existing literature. The descriptions of health system resilience primarily focus on major shocks. Adjustments to long-term changes and the element of learning should be considered for a better understating of health system resilience.
|
|
| 3. |
- Green, HK, et al.
(författare)
-
Challenges with Disaster Mortality Data and Measuring Progress Towards the Implementation of the Sendai Framework
- 2019
-
Ingår i: INTERNATIONAL JOURNAL OF DISASTER RISK SCIENCE. - : Springer Science and Business Media LLC. - 2095-0055 .- 2192-6395. ; 10:4, s. 449-461
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Disasters exact a heavy toll globally. However, the degree to which we can accurately quantify their impact, in particular mortality, remains challenging. It is critical to ensure that disaster data reliably reflects the scale, type, and distribution of disaster impacts given the role of data in: (1) risk assessments; (2) developing disaster risk management programs; (3) determining the resources for response to emergencies; (4) the types of action undertaken in planning for prevention and preparedness; and (5) identifying research gaps. The Sendai Framework for Disaster Risk Reduction 2015–2030s seven global disaster-impact reduction targets represent the first international attempt to systematically measure the effectiveness of disaster-impact reduction as a means of better informing policy with evidence. Target A of the Sendai Framework aims to “substantially reduce global disaster mortality by 2030, aiming to lower the average per 100,000 global mortality rate in the decade 2020–2030 compared to the period 2005–2015.” This article provides an overview of the complexities associated with defining, reporting, and interpreting disaster mortality data used for gauging success in meeting Target A, acknowledging different challenges for different types of hazard events and subsequent disasters. It concludes with suggestions of how to address these challenges to inform the public health utility of monitoring through the Sendai Framework.
|
|
| 4. |
- Grimm, PY, et al.
(författare)
-
Civic Duty: A Booster for Resilience?
- 2021
-
Ingår i: International journal of public health. - : Frontiers Media SA. - 1661-8564. ; 66, s. 1604064-
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
|
|
| 5. |
|
|
| 6. |
|
|
| 7. |
- Saulnier, DD, et al.
(författare)
-
A health systems resilience research agenda: moving from concept to practice
- 2021
-
Ingår i: BMJ global health. - : BMJ. - 2059-7908. ; 6:8
-
Tidskriftsartikel (refereegranskat)abstract
- Health system resilience, known as the ability for health systems to absorb, adapt or transform to maintain essential functions when stressed or shocked, has quickly gained popularity following shocks like COVID-19. The concept is relatively new in health policy and systems research and the existing research remains mostly theoretical. Research to date has viewed resilience as an outcome that can be measured through performance outcomes, as an ability of complex adaptive systems that is derived from dynamic behaviour and interactions, or as both. However, there is little congruence on the theory and the existing frameworks have not been widely used, which as diluted the research applications for health system resilience. A global group of health system researchers were convened in March 2021 to discuss and identify priorities for health system resilience research and implementation based on lessons from COVID-19 and other health emergencies. Five research priority areas were identified: (1) measuring and managing systems dynamic performance, (2) the linkages between societal resilience and health system resilience, (3) the effect of governance on the capacity for resilience, (4) creating legitimacy and (5) the influence of the private sector on health system resilience. A key to filling these research gaps will be longitudinal and comparative case studies that use cocreation and coproduction approaches that go beyond researchers to include policy-makers, practitioners and the public.
|
|
| 8. |
|
|
| 9. |
|
|
| 10. |
- Saulnier, DD, et al.
(författare)
-
Staying afloat: community perspectives on health system resilience in the management of pregnancy and childbirth care during floods in Cambodia
- 2020
-
Ingår i: BMJ global health. - : BMJ. - 2059-7908. ; 5:4
-
Tidskriftsartikel (refereegranskat)abstract
- Resilient health systems have the capacity to continue providing health services to meet the community’s diverse health needs following floods. This capacity is related to how the community manages its own health needs and the community and health system’s joined capacities for resilience. Yet little is known about how community participation influences health systems resilience. The purpose of this study was to understand how community management of pregnancy and childbirth care during floods is contributing to the system’s capacity to absorb, adapt or transform as viewed through a framework on health systems resilience.MethodsEight focus group discussions and 17 semi-structured interviews were conducted with community members and leaders who experienced pregnancy or childbirth during recent flooding in rural Cambodia. The data were analysed by thematic analysis and discussed in relation to the resilience framework.ResultsThe theme ‘Responsible for the status quo’ reflected the community’s responsibility to find ways to manage pregnancy and childbirth care, when neither the expectations of the health system nor the available benefits changed during floods. The theme was informed by notions on: i) developmental changes, the unpredictable nature of floods and limited support for managing care, ii) how information promoted by the public health system led to a limited decision-making space for pregnancy and childbirth care, iii) a desire for security during floods that outweighed mistrust in the public health system and iv) the limits to the coping strategies that the community prepared in case of flooding.ConclusionsThe community mainly employed absorptive strategies to manage their care during floods, relieving the burden on the health system, yet restricted support and decision-making may risk their capacity. Further involvement in decision-making for care could help improve the health system’s resilience by creating room for the community to adapt and transform when experiencing floods.
|
|
| 11. |
|
|
| 12. |
- Saulnier, DD, et al.
(författare)
-
'We have a plan for that': a qualitative study of health system resilience through the perspective of health workers managing antenatal and childbirth services during floods in Cambodia
- 2022
-
Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 12:1, s. e054145-
-
Tidskriftsartikel (refereegranskat)abstract
- Health system resilience can increase a system’s ability to deal with shocks like floods. Studying health systems that currently exhibit the capacity for resilience when shocked could enhance our understanding about what generates and influences resilience. This study aimed to generate empirical knowledge on health system resilience by exploring how public antenatal and childbirth health services in Cambodia have absorbed, adapted or transformed in response to seasonal and occasional floods.DesignA qualitative study using semi-structured interviews and thematic analysis and informed by the Dimensions of Resilience Governance framework.SettingPublic sector healthcare facilities and health departments in two districts exposed to flooding.ParticipantsTwenty-three public sector health professionals with experience providing or managing antenatal and birth services during recent flooding.ResultsThe theme ‘Collaboration across the system creates adaptability in the response’ reflects how collaboration and social relationships among providers, staff and the community have delineated boundaries for actions and decisions for services during floods. Floods were perceived as having a modest impact on health services. Knowing the boundaries on decision-making and having preparation and response plans let staff prepare and respond in a flexible yet stable way. The theme was derived from ideas of (1) seasonal floods as a minor strain on the system compared with persistent, system-wide organisational stresses the system already experiences, (2) the ability of the health services to adjust and adapt flood plans, (3) a shared purpose and working process during floods, (4) engagement at the local level to fulfil a professional duty to the community, and (5) creating relationships between health system levels and the community to enable flood response.ConclusionThe capacity to absorb and adapt to floods was seen among the public sector services. Strategies that enhance stability and flexibility may foster the capacity for health system resilience.
|
|
