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Heltveit-Olsen SR, Lunde L, Brænd AM, Spehar I, Høye S, Skoglund I, Sundvall PD, Fossum GH, Straand J, Risør MB. Local management of the COVID-19 pandemic in Norway: a longitudinal interview study of municipality chief medical officers. Scand J Prim Health Care 2024; 42:214-224. [PMID: 38214890 PMCID: PMC10851791 DOI: 10.1080/02813432.2023.2301562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/28/2023] [Indexed: 01/13/2024] Open
Abstract
OBJECTIVE To explore the experiences and views of Norwegian Municipality Chief Medical Officers (MCMOs) on preparedness, collaboration, and organization during the COVID-19 pandemic to gain insight into local crisis management of value for future pandemic responses. DESIGN Longitudinal qualitative interview study. We conducted semi-structured digital interviews with nine MCMOs working in different municipalities in Norway from September to December 2020. Five MCMOs were re-interviewed from January to April 2021. We used thematic analysis to analyze the data. RESULTS Through the analysis, three major themes were identified in the material; 1) The view of preparedness changed from being low-priority and dormant to the desire to strengthen preparedness as a permanent measure; 2) The nature of the pandemic forced a change in internal and external communication and collaboration for the MCMOs towards direct dialogue, teamwork and digital networking; 3) The pandemic changed the role and position of the MCMO within the municipal organization. Although most MCMOs were given a leading role in the municipal pandemic response, some MCMOs experienced that they were not positioned to fully exercise their intended role. In our material, de-authorization of the MCMO role seemed to coincide with the increasing size and organizational complexity of the municipality. CONCLUSIONS The Norwegian pandemic response and outcome have been regarded as successful internationally. Although the MCMOs managed to implement flexible and quick responses facilitated by teamwork, dialogue, and joint sensemaking, they also identified several challenges and shortcomings of the Norwegian pandemic preparedness requiring organizational and financial changes to sustain future health system resilience.
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Affiliation(s)
- Silje Rebekka Heltveit-Olsen
- Department of General Practice, The Antibiotic Centre for Primary Care, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Lene Lunde
- Department of Public Health Science, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Anja Maria Brænd
- Department of General Practice, The Antibiotic Centre for Primary Care, Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of General Practice, General Practice Research Unit (AFE), Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Ivan Spehar
- Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway
- Institute of Psychology, Oslo New University College, Oslo, Norway
| | - Sigurd Høye
- Department of General Practice, The Antibiotic Centre for Primary Care, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Ingmarie Skoglund
- General Practice/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Research, Education, Development and Innovation, Primary Health Care, Region Västra Götaland, Sweden
| | - Pär-Daniel Sundvall
- General Practice/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Research, Education, Development and Innovation, Primary Health Care, Region Västra Götaland, Sweden
| | - Guro Haugen Fossum
- Department of General Practice, The Antibiotic Centre for Primary Care, Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of General Practice, General Practice Research Unit (AFE), Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Jørund Straand
- Department of General Practice, General Practice Research Unit (AFE), Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Mette Bech Risør
- Department of Public Health, The Research Unit for General Practice, University of Copenhagen, Copenhagen, Denmark
- The General Practice Research Unit, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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