1
|
Diallo AM, Ridde V. Climate change and resilience of the Senegalese health system in the face of the floods in Keur Massar. Int J Health Plann Manage 2024. [PMID: 39152531 DOI: 10.1002/hpm.3846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 04/06/2024] [Accepted: 08/06/2024] [Indexed: 08/19/2024] Open
Abstract
This article is based on the observation that the affected populations perceive existing community-based adaptation strategies to the health effects of floods differently. We explore the resilience of the local health system to climate change (CC) in Keur Massar (Senegal) using a monographic approach based on a qualitative survey of flooded households, health professionals, hygiene agents, community health actors, administrative and local authorities, agents from the Ministries of Health and Environment, and experts from the ecological and meteorological monitoring centre (n = 72). The effects of CC on health are modulated by financial, organisational, social and cultural factors. The effects of CC on health are modulated by traditionally praised by self-centred health governance, which is often based on standardisation of problems and thus not sufficiently attuned to local contexts, especially the climate vulnerability index (CVI) of households and health structures. Despite the existence of programs to combat the consequences of CC, the notorious lack of exhaustive mapping of areas with a high CVI hinders the effective management of the health of the affected populations. A typology of forms of mobility in the context of flooding-ground floor to the upper floor, borrowing a room, renting a flat, seasonal residence-reveals inequalities in access to care as well as specific health needs management of vector-borne diseases, discontinuity of maternal, newborn and child health care, and psychosocial assistance. The article outlines how a health territorialisation based on surveillance and response mechanisms can be co-constructed and made sustainable in areas with a high CVI. Integrating this approach into national health policies allows for equity in health systems efficiently and sustainably.
Collapse
Affiliation(s)
- Abdoulaye Moussa Diallo
- UMR 196, CEPED, The French National Research Institute for Sustainable (IRD), Université Paris Cité, Paris, France
- Département de sociologie, Université Cheikh Anta Diop, Dakar, Senegal
| | - Valery Ridde
- UMR 196, CEPED, The French National Research Institute for Sustainable (IRD), Université Paris Cité, Paris, France
- Institut de Santé et Développement (ISED), Université Cheikh Anta Diop, Dakar, Senegal
| |
Collapse
|
2
|
Carbonara N, Pellegrino R, De Luca C. Resilience of hospitals in an age of disruptions: a systematic literature review on resources and capabilities. Health Syst (Basingstoke) 2024; 13:192-228. [PMID: 39175496 PMCID: PMC11338213 DOI: 10.1080/20476965.2024.2365144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 06/02/2024] [Indexed: 08/24/2024] Open
Abstract
Hospitals play a critical role in ensuring continuous and effective healthcare delivery, especially during crises. However, the COVID-19 pandemic exposed vulnerabilities in hospital systems, prompting a need to enhance resilience-the ability to withstand, absorb, respond to, recover from, and learn from disasters. A systematic literature review, grounded in the resource-based view, identified organizational characteristics, in terms of resources and capabilities, and their synergistic effects that bolster hospital resilience. The results demonstrate that digital technologies impact on anticipation and adaptation abilities, organizational capabilities to reorganize roles, tasks, and spaces enhance adaptability, and Inter-organizational collaborations increase the responsiveness of the hospitals. The study provides substantial theoretical and practical contributions. It expands knowledge of hospital resilience in light of recent disruptive events and promotes integration capabilities as determinants for the majority of resilience dimensions. All organisational and inter-organisational collaboration, cooperation, and coordination are deemed crucial for hospital resilience.
Collapse
Affiliation(s)
- Nunzia Carbonara
- Department of Mechanics Mathematics and Management, Polytechnic University of Bari, Bari, Italy
| | - Roberta Pellegrino
- Department of Mechanics Mathematics and Management, Polytechnic University of Bari, Bari, Italy
| | - Cristina De Luca
- Department of Mechanics Mathematics and Management, Polytechnic University of Bari, Bari, Italy
| |
Collapse
|
3
|
Saragosa M, Goraya F, Serrano F, Nowrouzi-Kia B, Guilcher S, Abdul Aziz Y, Gohar B. From Crisis to Opportunity: A Qualitative Study on Rehabilitation Therapists' Experiences and Post-Pandemic Perspectives. Healthcare (Basel) 2024; 12:1050. [PMID: 38786460 PMCID: PMC11120773 DOI: 10.3390/healthcare12101050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/03/2024] [Accepted: 05/06/2024] [Indexed: 05/25/2024] Open
Abstract
Rehabilitation therapists (RTs) have developed substantial mental health problems since the pandemic. Our study aimed to understand the experience of COVID-19 on occupational therapists and physiotherapists practicing in Canada, how the pandemic may have affected care delivery, and to identify new learnings articulated by RTs. A qualitative descriptive study design guided data collection through one-on-one interviews, dyadic interviews, and focus groups. We recruited active RTs across Canada, advertising on professional practice networks and social media platforms and using snowball sampling. Forty-nine RTs representing seven Canadian provinces participated. The four overarching themes developed using thematic analysis were (1) navigating uncertainty along with ever-changing practices, policies, and attitudes, (2) morphing roles within a constrained system, (3) witnessing patients suffering and experiencing moral distress, and (4) recognizing the personal toll of the pandemic on self and others, as well as lessons learned. Our study demonstrated that many RTs suffered moral distress, poor mental health, and some from challenging financial situations, especially those in the private sector. They also expressed a resilient attitude in response to these stressors. Implications in the future include identifying promising communication strategies that could act as protective factors, addressing workforce constraints and diminishing resources through innovative models of care.
Collapse
Affiliation(s)
- Marianne Saragosa
- Department of Population Medicine, University of Guelph, Guelph, ON N1G 2W1, Canada; (F.G.); (F.S.); (B.G.)
| | - Farwa Goraya
- Department of Population Medicine, University of Guelph, Guelph, ON N1G 2W1, Canada; (F.G.); (F.S.); (B.G.)
| | - Frances Serrano
- Department of Population Medicine, University of Guelph, Guelph, ON N1G 2W1, Canada; (F.G.); (F.S.); (B.G.)
- Department of Psychology, University of Guelph, Guelph, ON N1G 2W1, Canada
- Department of Psychology, Laurentian University, Sudbury, ON P3E 2C6, Canada
| | - Behdin Nowrouzi-Kia
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, ON M5G 1V7, Canada;
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
- Centre for Research in Occupational Safety & Health, Laurentian University, Sudbury, ON P3E 2C6, Canada
| | - Sara Guilcher
- Department of Physical Therapy, University of Toronto, Toronto, ON M5G 1V7, Canada;
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON M5S 3M2, Canada;
| | - Yasmin Abdul Aziz
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON M5S 3M2, Canada;
| | - Basem Gohar
- Department of Population Medicine, University of Guelph, Guelph, ON N1G 2W1, Canada; (F.G.); (F.S.); (B.G.)
- Centre for Research in Occupational Safety & Health, Laurentian University, Sudbury, ON P3E 2C6, Canada
| |
Collapse
|
4
|
Ferrante P. The First Two Years of COVID-19 Hospitalization Characteristics and Costs: Results from the National Discharge Registry. Healthcare (Basel) 2024; 12:958. [PMID: 38786370 PMCID: PMC11121639 DOI: 10.3390/healthcare12100958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 05/02/2024] [Accepted: 05/06/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has emerged as the primary global health challenge of the new millennium. Understanding its impact on health systems and learning from these experiences are crucial for improving system resilience against future health crises. This paper examines hospitalizations related to COVID-19 in Italy from 2020 to 2021, with a specific focus on the costs associated with these admissions. DESIGN AND METHODS This is a retrospective, population-based study of Italian hospitalizations of patients diagnosed with COVID-19 during the 2020-2021 period, using data extracted from the National Hospital Discharge Registry. The outcome variables considered include hospital admissions, costs, and length of stay. RESULTS In Italy, hospitalizations for COVID-19 totaled 357,354 in 2020 and 399,043 in 2021, with the transfer rate being three times higher than that of other patients. Hospitalizations were predominantly concentrated in the northern regions, especially during the first year. Mortality rates increased with age, while hospitalization rates peaked in the youngest and oldest age groups. The financial impact of COVID-19 hospitalizations was approximately €3.1 billion in 2020 and €3.6 billion in 2021. The cost per admission was around €8000 for standard care and €24,000 for intensive therapy in both years. CONCLUSION Conducting a cost-benefit analysis of implementing a protective pad around the entire health system, which leverages networks of family doctors and nurses connected in real-time, could be an important step in strengthening health system resilience.
Collapse
Affiliation(s)
- Pierpaolo Ferrante
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian National Workers' Compensation Authority (INAIL), Via Stefano Gradi 55, 00143 Rome, Italy
| |
Collapse
|
5
|
Muhsen K, Cohen D, Glatman-Freedman A, Husseini S, Perlman S, McNeil C. Review of Israel's action and response during the COVID-19 pandemic and tabletop exercise for the evaluation of readiness and resilience-lessons learned 2020-2021. Front Public Health 2024; 11:1308267. [PMID: 38328537 PMCID: PMC10847317 DOI: 10.3389/fpubh.2023.1308267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 12/28/2023] [Indexed: 02/09/2024] Open
Abstract
Background Reevaluating response plans is essential to ensuring consistent readiness and resilience to the COVID-19 pandemic. The "During Action Review" and Tabletop (DART) methodology provides a retrospective and prospective assessment to inform the adaptive response. Israel introduced COVID-19 vaccinations in December 2020 and was the first country to implement booster vaccination to address waning immunity and surges caused by new variants. We assessed Israel's readiness and resilience related to COVID-19 response while capturing the pre-vaccination and vaccination periods. Methods A DART analysis was conducted between December 2020 and August 2021 among experts involved in the management of the COVID-19 pandemic in Israel. During the retrospective stage, a role-based questionnaire and discussions were undertaken in a participant-led review of the response, focusing on epidemiology and surveillance, risk communication, and vaccines. The prospective stage included tabletop exercises to evaluate short to long-term simulated scenarios. Results Participants emphasized the pivotal role of Israel globally by sharing experiences with the pandemic, and vaccination. Perceived strengths included multi-sectoral collaboration between the Ministry of Health, healthcare providers, academia, military, and others, stretching capacities, expanding laboratory workload, and establishing/maintaining surveillance. The vaccine prioritization plan and strong infrastructure, including computerized databases, enabled real-life assessment of vaccine uptake and impact. Challenges included the need to change case definitions early on and insufficient staffing. Quarantine of patients and contacts was particularly challenging among underprivileged communities. Risk communication approaches need to focus more on creating norms in behavior. Trust issues and limited cooperation were noted, especially among ethnic and religious minorities. To ensure readiness and resiliency, participants recommended establishing a nationally deployed system for bringing in and acting upon feedback from the field, especially concerning risk communication and vaccines. Conclusion Our study appraised strengths and weaknesses of the COVID-19 pandemic response in Israel and led to concrete recommendations for adjusting responses and future similar events. An efficient response comprised multi-sectoral collaboration, policy design, infrastructure, care delivery, and mitigation measures, including vaccines, while risk communication, trust issues, and limited cooperation with minority groups were perceived as areas for action and intervention.
Collapse
Affiliation(s)
- Khitam Muhsen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Middle East Consortium on Infectious Disease Surveillance, Jerusalem, Israel
| | - Dani Cohen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Middle East Consortium on Infectious Disease Surveillance, Jerusalem, Israel
| | - Aharona Glatman-Freedman
- Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel
| | - Sari Husseini
- Middle East Consortium on Infectious Disease Surveillance, Jerusalem, Israel
| | - Saritte Perlman
- Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | |
Collapse
|