A cross-sectional survey of COVID-19 preparedness in governmental hospitals of North-West Ethiopia

Evaluating the performance of selected military hospitals in Tehran in response to Covid-19 pandemic: A cross-sectional study

Background and Aims

The rapid spread of coronavirus disease 2019 (Covid-19) led the need to admit a large number of infected people to hospitals in a short period of time, turning them into one of the most important responsive organizations. This study aims to evaluate the performance of selected military hospitals because they carried out a military operation in Tehran in response to the recent pandemic.

Methods

This is a descriptive-analytical study. The statistical population of this study consisted of military hospitals responding to Covid-19 pandemic in Tehran. A checklist to evaluate the performance of hospitals in response to Covid-19 pandemic (six areas, 23 sub-areas and 152 items) was used as a data collection tool in this study. This tool had six domains, including risk management and planning, coordination and communication, infection prevention and control, diagnosis and treatment, education and training, and resource management.

Results

The overall performance of selected hospitals was 63%, which indicated a good performance. The domain of coordination and communication obtained the lowest score.

Conclusion

The investigated hospitals had good performance because they had a desirable access to resources. Periodic self-assessment and accreditation is recommended to improve the performance of these hospitals.

Improving the quality of COVID-19 care in Sierra Leone: A modified Delphi process and serial nationwide assessments of quality of COVID-19 care in Sierra Leone

INTRODUCTION

Improving the quality of care that patients receive is paramount to improving patient outcomes and engendering trust during infectious disease outbreaks. Whilst Quality Improvement (QI) is well established to drive improvement in routine care and in health systems, there are fewer reports of its use during infectious disease outbreaks.

METHODS

A modified Delphi process was undertaken to create a standardized assessment tool for the quality of COVID-19 care in Sierra Leone. Four rounds of assessment were undertaken between July 2020 and July 2021. To assess change across the four assessment periods compared to baseline we used a mixed effects model and report coefficients and p values.

RESULTS

During the Delphi process, 12/14 participants selected the domains to be assessed within the tool. The final 50 questions included 13 outcome questions, 17 process questions and 20 input questions. A total of 94 assessments were undertaken over four assessment periods at 27 facilities. An increase of 8.75 (p = <0.01) in total score was seen in round 2, 10.67 (p = <0.01) in round 3 and 2.17 (p = 0.43) in round 4 compared to baseline. Mean cumulative scores for COVID-19 Treatment Centres were higher than Hospital Isolation Units (p<0.02) at all four timepoints. Significant improvements were reported in coordination, diagnostics, staffing, infection prevention and control (IPC), nutrition, and vulnerable populations domains, but not in the oxygen, care processes, infrastructure and drugs domains.

CONCLUSION

We demonstrate the feasibility of creating a quality of care assessment tool and conducting sequential nationwide assessments during an infectious disease outbreak. We report significant improvements in quality-of-care scores in round 2 and round 3 compared to baseline, however, these improvements were not sustained. We recommend the use of QI and the creation of standardised assessment tools to improve quality of care during outbreak responses.

Hospital disaster preparedness in sub-Saharan Africa: a systematic review of English literature

BACKGROUND

Disasters are increasing worldwide, with Sub-Saharan Africa (SSA) being one of the most prone regions. Hospitals play a key role in disasters. This study provides a systematic review of the evidence on disaster preparedness by hospitals in SSA countries based on English literature.

METHODS

A systematic literature review was conducted of articles published between January 2012 and July 2022. We searched PubMed, Elsevier, Science Direct, Google Scholar, the WHO depository library and CDC sites for English language publications. The key inclusion criteria were: publications should have been published in the above period, deal with hospital disaster preparedness in SSA, the full paper should have been available, and studies should have presented a comparison between hospitals and/or a single hospital.

RESULTS

Results indicate improvements in disaster preparedness over time. However, health systems in SSA are generally considered vulnerable, and they find it difficult to adapt to changing health conditions. Inadequately skilled healthcare professionals, underfunding, poor knowledge, the absence of governance and leadership, lack of transparency and bureaucracy are the main preparedness barriers. Some countries are in an infancy stage of their health system development, while others are among the least developed health system in the world. Finally, a major barrier to disaster preparedness in SSA countries is the inability to collaborate in disaster response.

CONCLUSIONS

Hospital disaster preparedness is vulnerable in SSA countries. Thus, improvement of hospital disaster preparedness is highly needed.

A Review of COVID-19 Response Challenges in Ethiopia

BACKGROUND

The COVID-19 pandemic has positioned fragile healthcare systems in low-income countries under pressure, leading to critical gaps in service delivery. The pandemic response demands the healthcare system to be resilient and continue provision of healthcare services. This review is aimed at describing the healthcare response challenges during the pandemic in Ethiopia.

METHODOLOGY

Eligible studies dealing with challenges of the healthcare system in response to the COVID-19 pandemic in Ethiopia were included. The six World Health Organization (WHO) healthcare system building blocks were used to categorize healthcare challenges. PubMed ProQuest, databases were searched, and results were summarized using systematic review synthesis.

RESULTS

Financial constraints led to a shortage of mechanical ventilators. Furthermore, the pandemic hindered the capacity to avail full packages of personal protective equipment in health facilities and intensive care capacity. The pandemic also affected the delivery of maternal, child and new-born services, prevention, and treatment of childhood illness, including immunization services.

CONCLUSIONS

The COVID-19 pandemic posed various challenges to the performance of the healthcare system in Ethiopia. It is recommended that policy makers and stakeholders enhance pandemic preparedness and strengthen response capacity by considering the six WHO healthcare system building blocks.

Using a national level cross-sectional study to develop a Hospital Preparedness Index (HOSPI) for Covid-19 management: A case study from India

Background

We developed a composite index–hospital preparedness index (HOSPI)–to gauge preparedness of hospitals in India to deal with COVID-19 pandemic.

Methods

We developed and validated a comprehensive survey questionnaire containing 63 questions, out of which 16 critical items were identified and classified under 5 domains: staff preparedness, effects of COVID-19, protective gears, infrastructure, and future planning. Hospitals empaneled under Ayushman Bharat Yojana (ABY) were invited to the survey. The responses were analyzed using weighted negative log likelihood scores for the options. The preparedness of hospitals was ranked after averaging the scores state-wise and district-wise in select states. HOSPI scores for states were classified using K-means clustering.

Findings

Out of 20,202 hospitals empaneled in ABY included in the study, a total of 954 hospitals responded to the questionnaire by July 2020. Domains 1, 2, and 4 contributed the most to the index. The overall preparedness was identified as the best in Goa, and 12 states/ UTs had scores above the national average score. Among the states which experienced high COVID-19 cases during the first pandemic wave, we identified a cluster of states with high HOSPI scores indicating better preparedness (Maharashtra, Tamil Nadu, Karnataka, Uttar Pradesh and Andhra Pradesh), and a cluster with low HOSPI scores indicating poor preparedness (Chhattisgarh, Delhi, Uttarakhand).

Interpretation

Using this index, it is possible to identify areas for targeted improvement of hospital and staff preparedness to deal with the COVID-19 crisis.

Assessing the dynamic impacts of non-pharmaceutical and pharmaceutical intervention measures on the containment results against COVID-19 in Ethiopia

The rapid spread of COVID-19 in Ethiopia was attributed to joint effects of multiple factors such as low adherence to face mask-wearing, failure to comply with social distancing measures, many people attending religious worship activities and holiday events, extensive protests, country election rallies during the pandemic, and the war between the federal government and Tigray Region. This study built a system dynamics model to capture COVID-19 characteristics, major social events, stringencies of containment measures, and vaccination dynamics. This system dynamics model served as a framework for understanding the issues and gaps in the containment measures against COVID-19 in the past period (16 scenarios) and the spread dynamics of the infectious disease over the next year under a combination of different interventions (264 scenarios). In the counterfactual analysis, we found that keeping high mask-wearing adherence since the outbreak of COVID-19 in Ethiopia could have significantly reduced the infection under the condition of low vaccination level or unavailability of the vaccine supply. Reducing or canceling major social events could achieve a better outcome than imposing constraints on people's routine life activities. The trend analysis found that increasing mask-wearing adherence and enforcing more stringent social distancing were two major measures that can significantly reduce possible infections. Higher mask-wearing adherence had more significant impacts than enforcing social distancing measures in our settings. As the vaccination rate increases, reduced efficacy could cause more infections than shortened immunological periods. Offsetting effects of multiple interventions (strengthening one or more interventions while loosening others) could be applied when the levels or stringencies of one or more interventions need to be adjusted for catering to particular needs (e.g., less stringent social distancing measures to reboot the economy or cushion insufficient resources in some areas).

Preparedness of Public Hospitals for the Coronavirus (COVID-19) Pandemic in Lahore District, Pakistan

Background

Pakistan reported more than a million cases during the coronavirus disease 2019 (COVID-19) pandemic, shuffling the already resource-constrained health system that is known for its high vulnerability and lack of adaption.

Objective

To find out the level of preparedness of public hospitals for the novel COVID-19 pandemic in Lahore district.

Methods

A descriptive cross-sectional study was conducted from April to July 2021 among all 18 public hospitals under Specialized Health Care and Medical Education (SHC&ME) in Lahore by administering World Health Organization (WHO) and SHC&ME modified and pre-tested interviewer based and observation checklist. The level of preparedness was assessed for 11 domains, and each domain was scored as a dichotomous variable (Yes and No). Hospital preparedness was labeled as ‘acceptable,’ ‘insufficient,’ and ‘unacceptable.’ Descriptive statistics were run by using SPSS version 26 (IBM Corp., Armonk, NY), and data are presented in the form of tables and bar graphs.

Results

Out of 18 hospitals, only three (17%) had an acceptable level of preparedness for COVID-19 (>70%). An unacceptable level of preparedness (<35%) was seen in one hospital (5%). Fourteen hospitals (78%) were insufficiently prepared (35-70%).

Conclusion

The study highlights the suboptimal preparedness in 83% of the public hospitals with a consistent pattern of deficiencies in surge capacity, logistics and resource management, essential services, including diagnostics, infection prevention, and control.

Preparedness, Identification and Care of COVID-19 Cases by Front Line Health Workers in Selected Health Facilities in Mbale District Uganda: A Cross-Sectional Study

Introduction:

The nature of work of Health care professionals exposes them to high risks of contracting COVID-19 and spreading it among themselves, to their patients and subsequently to the general community. Thus, it is essential that frontline health workers are equipped with both material and knowledge to enable them accurately suspect, detect, isolate, and manage COVID-19 cases. Findings have indicated a high prevalence of COVID-19 infections among front-line health workers. The Current Study assessed preparedness, identification, and care of COVID-19 Cases by frontline health workers in selected health facilities in Mbale District.

Methodology:

Across sectional survey was used to collect quantitative data using Google forms, An online platform for data collection. Data was collected from 189 frontline health workers in both government and private Health facilities in Mbale District between April and August 2020. Data was analysed using Statistical Package for the Social Sciences (SPSS) version 20.

Findings:

The study found that a good proportion of frontline health workers can identify cases by symptom and case definitions as probable case 113/189(59.8%), suspected case 60/189(36%) and confirmed case 22/189 (11.6%). There were generally low levels of preparedness in terms of initial service care being offered with the highest being 53/189(28.2%) and 50/189(26.4%) for facilities that had places for isolation and those with intravenous fluids respectively and the least was being able to offer oxygen and Intensive Care Services at 43/189(22.0%) and 20/189(10.3%) respectively.

Conclusion and recommendations:

There's a need to ensure a continuous supply of PPEs and IPC materials to health facilities. CPD programs are essential in equipping Health workers with up-to-date information on COVID-19 Case Management. Facilities should be supported to setup isolation facilities at all levels, both permanent and temporary. Provision of Face masks to health workers should be prioritised and hand washing facilities should be installed at every serving point.

Attitude and associated factors of COVID-19 vaccine acceptance among health professionals in Debre Tabor Comprehensive Specialized Hospital, North Central Ethiopia; 2021: cross-sectional study

Control of coronavirus disease through vaccination is not merely dependent on vaccine efficacy and safety. Professional and general public acceptance is vital for the successful control of the virus. This study aimed (1) to assess health professionals' attitude towards COVID-19 vaccine acceptance; (2) to identify factors associated with health professional's attitude towards COVID-19 vaccine acceptance. An Institutional based cross-sectional study was conducted on health professionals working at Debre Tabor Comprehensive Specialized Hospital. A structured questionnaire containing 16 items was used to assess the attitude of health professionals on vaccine acceptance. Bivariable and multivariable logistic analysis was done to identify factors associated with the attitude of health professionals. In this study, 42.3% [95% CI (36.7-47.6)] participants had positive attitude to COVID-19 vaccine acceptance. Age 30-39 years [AOR 2.23; (CI 1.23-4.04)] and ≥ 40 years [AOR 5.51; (CI 2.47-12.30)] of respondents have positive attitude than their counterparts. Also physicians [AOR 3.67; (CI 1.90-7.09)], pharmacists [AOR 4.27; (CI 1.39-13.09)] and laboratory professionals [AOR 4.56; (CI 1.34-15.39)] have higher attitude to COVID vaccine acceptance than nurses. In conclusion, the attitude level of health professionals on COVID-19 vaccine acceptance was poor. Age and profession were factors significantly associated with the attitude level of health professionals for COVID-19 vaccine acceptance.