A health promotion approach to emergency management: effective community engagement strategies from five cases

Enhancing vaccination uptake through community engagement: evidence from China

With growing recognition of the importance of community engagement in addressing public health challenges, its role in promoting healthy behaviors and preventing infectious diseases has gained attention. However, vaccination coverage remains a significant concern in many developing countries. While previous studies have linked community engagement to positive health outcomes, there is a gap in understanding its influence on individual vaccination choices, particularly in the context of developing countries. Utilizing data from the 2021 Chinese General Social Survey (CGSS), this study examines the impact of community engagement on COVID-19 and flu vaccination uptake among 7281 individuals. Community engagement, measured by community vaccination notifications, serves as the key independent variable. The study employs Ordinary Least Squares (OLS) regression and Propensity Score Matching (PSM) methods to analyze the relationship between community engagement and vaccination behavior. The analysis reveals a positive association between community engagement and vaccination rates. Specifically, individuals receiving notifications were more likely to get the COVID-19 vaccine compared to non-recipients (vaccination rates: 100% vs. 53.3%), and flu vaccination rates were also significantly higher among those notified (2.7% vs. 1.9%). Mechanism analysis suggests that individuals receiving community notifications are more aware of the benefits of vaccination, leading to higher vaccination rates among this group. This study underscores the effectiveness of community engagement strategies in promoting positive vaccination behavior among individuals in China. By enhancing awareness and trust in immunization, community engagement initiatives play a crucial role in shaping health behaviors and improving vaccination uptake. These findings emphasize the importance of integrating community engagement approaches into public health interventions to address vaccination challenges.

Climate crisis risks to elderly health: strategies for effective promotion and response

The climate crisis significantly impacts the health and well-being of older adults, both directly and indirectly. This issue is of growing concern in Canada due to the country's rapidly accelerating warming trend and expanding elderly population. This article serves a threefold purpose: (i) outlining the impacts of the climate crisis on older adults, (ii) providing a descriptive review of existing policies with a specific focus on the Canadian context, and (iii) promoting actionable recommendations. Our review reveals the application of current strategies, including early warning systems, enhanced infrastructure, sustainable urban planning, healthcare access, social support systems, and community engagement, in enhancing resilience and reducing health consequences among older adults. Within the Canadian context, we then emphasize the importance of establishing robust risk metrics and evaluation methods to prepare for and manage the impacts of the climate crisis efficiently. We underscore the value of vulnerability mapping, utilizing geographic information to identify regions where older adults are most at risk. This allows for targeted interventions and resource allocation. We recommend employing a root cause analysis approach to tailor risk response strategies, along with a focus on promoting awareness, readiness, physician training, and fostering collaboration and benchmarking. These suggestions aim to enhance disaster risk management for the well-being and resilience of older adults in the face of the climate crisis.

Roles of health system leadership under emergency in drought-affected districts in northeast Uganda: a mixed-method study

OBJECTIVE

Health system leadership plays a critical role in sustaining healthcare delivery during emergencies. Thus, we aimed to assess the contribution of health system leadership in sustaining healthcare delivery under emergency conditions based on adaptive leadership theoretical framework.

DESIGN

We employed a concurrent mixed-methods study approach to assess health system leadership roles during emergency. This involved a quantitative survey administered to 150 health facilities managers/service focal persons selected via multistage sampling method from 15 districts, and qualitative interviews with 48 key informants who purposively selected.

PARTICIPANTS

We interviewed health facility managers, services focal persons, district health officers and residential district commissioners. We also reviewed weekly emergency situation reports and other relevant documents related to the emergency response. We used structured questionnaire, observation checklist and semistructured questionnaire to collect data. We employed descriptive statistics to analyse quantitative data and thematic analysis for qualitative data.

MAIN OUTCOME

Health system leadership contributions in sustaining healthcare delivery during emergencies.

RESULTS

Health system leadership was effective in leading emergency response and ensuring the continuity of health service during emergencies. Community engagement, partners coordination and intersectoral collaboration were effectively used in the emergency response and ensuring continuity of healthcare delivery. Deployment of experienced personnel and essential medical and non-medical supplies played a critical role in the continuity of health service. Availability of incidence management teams across health system significantly contributed to health system leadership. Participation of village health teams in community engagement and information communication helped in the success of health system leadership under emergency.

CONCLUSION

Adaptive health system leadership played a crucial role in managing health services delivery under emergency conditions. Effective partnership coordination and collaboration across sectors, frequent information communication, building local actor capacity and implementing scheduled supportive supervisions emerged as key strategies for sustaining health services during emergencies.

Doing public health differently: How can public health departments engage with local communities through social media interventions?

Objectives

This paper evaluates a collaborative intervention between public health professionals and local social media administrators, in which the social media site Facebook was used with a view to strengthening engagement with and, dissemination of, core messages and building trust and resilience within local communities during the COVID-19 pandemic.

Study design

A qualitative design was used, exploring the research question: how does collaboration between public health professionals and local social network group administrators create community engagement during a global crisis?

Methods

Fourteen semi-structured interviews were conducted with public health staff and online group administrators. Data was analysed using framework analysis.

Results

Collaboration between public health professionals and local group administrators created both opportunities and challenges. Local group administrators had wide reach and trust within the local community, but message credibility was enhanced through local authority involvement. Such collaborations contain inherent tensions due to perceived risks to social capital and independence but can be successful if receiving strong risk-tolerant support from the local authority. Findings are discussed in the context of Bourdieu's theory of social capital to examine how public health information can be delivered by trusted social media actors in communication tailored to the local community.

Conclusions

Social media provides new channels of communication for delivery of public health messages, enabling new ways of working which create long-term engagement and community building. Although the intervention was developed quickly in response to the COVID-19 pandemic, participants felt it could be mobilised to address a wider range of issues.

Enhancing community health system resilience: lessons learnt during the COVID-19 pandemic in Uganda through the qualitative inquiry of the COVID Task Force

Objective

This study aimed to explore the elements of a resilient community health system during the COVID-19 pandemic and discuss whether the frameworks described in previous studies can be applied to real-world situations with those who implemented the Community Engagement Strategy, a strategy to make health systems work in their communities during health crises in Uganda.

Methods

Focus group discussions (22 participants in total) were conducted with COVID Task Force members in four districts in Uganda in March 2022. These districts implemented a Community Engagement Strategy to ensure that health systems in their communities continued to function during health scares, and have been evaluated to ensure that the strategies have been implemented.

Results

A thematic analysis was applied. From the results some factors which can enhance the resiliency of community health systems were identified: including health "knowledge," "communication," "governance," and "resources" health. The most important elements changed depending on the phase of the outbreak. VHTs are the key players in the transition from knowledge-and resource-oriented initiatives to communication and governance by community residents.

Conclusion

COVID-19, a new infectious disease, provides lessons for a resilient community health system. First, the health system should be flexible enough to be able to change the elements on which it is focused, and second, VHTs play an important role in the flexibility of the health system. This suggests that it is time to assess whether VHTs are still able to continue their activities after the pandemic is over, and whether the environment, including financial and non-financial support, has improved.

What made primary health care resilient against COVID-19? A mixed-methods positive deviance study in Nigeria

INTRODUCTION

The SARS-CoV-2 (COVID-19) pandemic overwhelmed some primary health care (PHC) systems, while others adapted and recovered. In Nigeria, large, within-state variations existed in the ability to maintain PHC service volumes. Identifying characteristics of high-performing local government areas (LGAs) can improve understanding of subnational health systems resilience.

METHODS

Employing a sequential explanatory mixed-methods design, we quantitatively identified 'positive deviant' LGAs based on their speed of recovery of outpatient and antenatal care services to prepandemic levels using service volume data from Nigeria's health management information system and matched them to comparators with similar baseline characteristics and slower recoveries. 70 semistructured interviews were conducted with LGA officials, facility officers and community leaders in sampled LGAs to analyse comparisons based on Kruk's resilience framework.

RESULTS

A total of 57 LGAs were identified as positive deviants out of 490 eligible LGAs that experienced a temporary decrease in PHC-level outpatient and antenatal care service volumes. Positive deviants had an average of 8.6% higher outpatient service volume than expected, and comparators had 27.1% lower outpatient volume than expected after the initial disruption to services. Informants in 12 positive deviants described health systems that were more integrated, aware and self-regulating than comparator LGAs. Positive deviants were more likely to employ demand-side adaptations, whereas comparators primarily focused on supply-side adaptations. Barriers included long-standing financing and PHC workforce gaps.

CONCLUSION

Sufficient flexible financing, adequate PHC staffing and local leadership enabled health systems to recover service volumes during COVID-19. Resilient PHC requires simultaneous attention to bottom-up and top-down capabilities connected by strong leadership.

Innovate emergency governance mechanism of urban communities in response to major public health events: A qualitative study from multiple principals in Guangzhou, China

Since the end of 2019, the sudden outbreak of COVID-19 has challenged the emergency governance systems of various countries. As the cornerstone of national governance, China's community emergency governance mainly adopts top-down organizational mobilization and rapid response, which is typical abnormal governance. In responding to major public health events, China's national system has developed certain advantages in some respects. However, the current pandemic is still serious in many places, and new mutant strains are constantly appearing. Some drawbacks of such system and mechanism are gradually emerging. In the process of preventing and controlling the pandemic, China's urban communities have continuously improved the joint mechanism, and played the role of multiple principals in collaborative and co-governance. The current work of pandemic prevention and control has entered a period of normalization. What is the collaborative mechanism of multiple principals (Subdistrict headquarter, Community committee, Owners' committee, Community hospital, Local police station, Property management company, etc.) in urban communities participating in emergencies and how to seek ways to further improve the mechanism? Therefore, taking the community practice and actions in Guangzhou, China as an example, the present study employed a qualitative design, proposed to better community emergency governance mechanisms from the aspects of preparedness, response, communication and recovery, so as to provide a reference for other grassroots organizations.

Egg-derived porous plasma modified clay composite for wastewater remediation

Clays are often envisaged as an alternative to activated carbon for wastewater pollutant adsorption. However, conclusive results have only been obtained for clays heavily chemically modified. In this study, a greener approach is proposed to improve the retention capacity of clays. It consists in mixing clay (C) with eggshell (ES) and calcine, and then exposing to gliding arc plasma (ESC-800/PL). The resulting materials were characterized by nitrogen physisorption, FTIR, XRD, TGA/DTG, and point of zero charge analyses. The preparation gives porous platelet agglomerates resulting from the kaolinite-metakaolinite transition, thereby increasing their internal specific surface area and capacity to retain pollutants. This granular distribution is kept stable by partial pozzolanic reactions avoiding deagglomeration. The specific surface area and total pore volume increased respectively from 14 m² g^-1 and 0.049 cm³ g^-1 to 89 m² g^-1 and 0.061 cm³ g^-1 leading to an enhanced removal efficiency of Fast Green and Orange G dyes from polluted water. The maximum adsorption capacity occurred at 298 K attaining values of 32.34 and 14.78 mg g^-1 for OG and FG, respectively. The pH plays a crucial role in the maximum sorption of dyes, and the experimental data were successfully adjusted to pseudo-first-order kinetic and Liu isotherm model.