Community engagement for COVID-19 prevention and control: a rapid evidence synthesis

Nutrition-sensitive lockdowns: conceptual framework and empirical insights from Africa during COVID-19

Motivation

Countries facing challenges of nutrition security confront a trade-off when dealing with pandemics such as COVID-19. Implementing lockdown measures, widely used worldwide, can help "flatten the curve" (of disease), but such measures may worsen nutrition security.

Purpose

We aim to identify and justify nutrition-sensitive lockdown measures to reduce trade-offs with nutrition security.

Methods and approach

We propose a conceptual framework which distinguishes eight lockdown measures and six pathways to nutrition security. To demonstrate the relevance of the pathways, we reviewed emerging literature on COVID-19 and nutrition security. We analysed the content of 1,188 newspaper articles on lockdown effects in five African countries - Benin, Ghana, Kenya, Uganda and Zambia.

Findings

Some lockdown measures, such as closing workplaces and restricting movement, potentially worsen nutrition far more than others - banning events and public gatherings have far lesser impacts on nutrition. This can be seen from the framework, literature, and is supported by the analysis of newspaper reports in the five countries.

Policy implications

It is better when possible to test and trace disease than to lockdown. But when lockdowns are needed, then first recourse should be to measures that have few nutritional consequences, such as banning public events. When more drastic measures are necessary, look to mitigate nutritional harm by, for example, exempting farm labour from restrictions on movement, by replacing school meals with take-home rations, and, above all, providing income support to households most affected and most vulnerable.

Towards a national strategy for the provision of spiritual care during major health disasters: A qualitative study

Background

Spirituality is beneficial to health. Evidence around the benefits of Spiritual care (SC) is advancing, and training is becoming part of healthcare professional development. As the COVID‐19 crisis showed, during major health disasters (MHDs), the demand for SC grows exponentially, while the burden of care and focus on preserving life often hamper its provision. Nonetheless, existing health emergency strategic frameworks lack preparedness for the provision of SC.

Aim

The aim of this study was to identify the components for a National Strategy (NS) for the provision of SC during MHDs.

Methods

Descriptive, cross‐sectional, qualitative phenomenological design based on individual, semi‐structured e‐interviews with nursing managers and National Health Service/volunteer chaplains based in England. Thematic analysis of 25 e‐interview data was performed based on a dialogic collaborative process.

Results and Discussion

Eleven themes were identified as components of the proposed NS. From these components, specific recommendations for practical actions are provided. An integrated framework approach and smart investments in resources, staff training and technologies should be led by the paradigm of culturally competent and compassionate care.

Conclusion

The need to have strategic frameworks, both national and local, that better equip a country healthcare sector to prevent, face, and recover from MHDs is paramount. Catering for the spiritual needs of the affected population should be a key aspect of any health emergency strategy to ensure the preservation of quality care.

Adequate provision of Spiritual care (SC) is more needed yet challenging during health disasters.

With the COVID‐19 crisis, SC strategic planning proved essential.

Collaboration, communities' inclusivity, and training are key strategic elements.

Governments investments should look at advanced technologies, and material and human resources.

Strategies associated with COVID-19 vaccine coverage among nursing home staff

Background

After the first of three COVID‐19 vaccination clinics in U.S. nursing homes (NHs), the median vaccination coverage of staff was 37.5%, indicating the need to identify strategies to increase staff coverage. We aimed at comparing the facility‐level activities, policies, incentives, and communication methods associated with higher staff COVID‐19 vaccination coverage.

Methods

Design. Case–control analysis.

Setting. Nationally stratified random sample of 1338 U.S. NHs participating in the Pharmacy Partnership for Long‐Term Care Program.

Participants. Nursing home leadership.

Measurement. During February 4–March 2, 2021, we surveyed NHs with low (<35%), medium (40%–60%), and high (>75%) staff vaccination coverage, to collect information on facility strategies used to encourage staff vaccination. Cases were respondents with medium and high vaccination coverage, whereas controls were respondents with low coverage. We used logistic regression modeling, adjusted for county and NH characteristics, to identify strategies associated with facility‐level vaccination coverage.

Results

We obtained responses from 413 of 1338 NHs (30.9%). Compared with facilities with lower staff vaccination coverage, facilities with medium or high coverage were more likely to have designated frontline staff champions (medium: adjusted odds ratio [aOR] 3.6, 95% CI 1.3–10.3; high: aOR 2.9, 95% CI 1.1–7.7) and set vaccination goals (medium: aOR 2.4, 95% 1.0–5.5; high: aOR 3.7, 95% CI 1.6–8.3). NHs with high vaccination coverage were more likely to have given vaccinated staff rewards such as T‐shirts compared with NHs with low coverage (aOR 3.8, 95% CI 1.3–11.0). Use of multiple strategies was associated with greater likelihood of facilities having medium or high vaccination coverage: For example, facilities that used ≥9 strategies were three times more likely to have high staff vaccination coverage than facilities using <6 strategies (aOR 3.3, 95% CI 1.2–8.9).

Conclusions

Use of designated champions, setting targets, and use of non‐monetary awards were associated with high NH staff COVID‐19 vaccination coverage.