Managing Scarcity: Innovation and Resilience During the COVID-19 Pandemic

The critical elements of the health system that could make for resilience in the World Health Organization African Region: a scoping review

Background

Unpredictable events, such as the outbreak of infectious diseases and humanitarian crises, are putting a strain on health care systems. As a result, African countries will need to prepare themselves with appropriate strategies to withstand such occurrences. Therefore, the purpose of this scoping review was to map available evidence about what type and what components of health systems are needed to help countries cope with health emergencies and to foster health system resilience in the WHO African Region.

Methods

A systematic search was performed independently in Scopus and PubMed electronic databases as well as grey literature. Studies were selected based on set eligibility criteria based on the Joanna Brigg's Institute (JBI) methodology for scoping reviews. The key findings were focused on health system resilience and were mapped based on the WHO's core health system components. Our data were tabulated, and a narrative synthesis was conducted.

Results

A total of 28 studies were included in this scoping review, mostly conducted in the WHO African Region and region of the Americas. Studies focused on a variety of strategies, such as the continuous delivery of essential services, the strengthening of the health workforce, including community health care workers, community engagement, the provision of protective mechanisms for the health workforce, and flexible leadership and governance measures.

Conclusion

Our findings suggest that strategies to improve health system resilience must include all areas of the healthcare delivery process, including primary care. A resilient health system should be ready for a crisis and have adaptable policies in place to offer adequate response at all levels, as well as post-recovery planning. Such health systems should also seek for continuous improvement. More research is needed to assess the efficacy of initiatives for improving health system resilience, particularly in vulnerable African health systems.

Global research hotspots and trends in the field of spine surgery during the COVID-19 pandemic: A bibliometric and visual analysis

Background

The Coronavirus disease-2019 (COVID-19) significantly affected the healthcare and research systems, including spine surgery, throughout the world. A bibliometric analysis allows graphical visualization of the development of an academic field and its frontiers. Since research concerning spine surgery during the COVID-19 pandemic is being constantly upgraded, we conducted a bibliometric analysis of this literature to investigate the current status, research hotspots, and trends in this field.

Methods

We searched the Web of Science database for literature published (from December 1, 2019, to March 24, 2022) using the terms “COVID-19” OR “2019-nCoV” OR “SARS-CoV-2” AND “spine surgery” OR “spinal surgery” OR “discectomy” OR “decompression” OR “laminectomy” OR “interbody fusion” OR “pedicle screws.” Detailed bibliometric and visual analysis of the number of publications, geographical distribution, institutions, journals, authors, and keywords was done using CiteSpace, VOSviewer, and R-Bibliometrix.

Results

Of the initially screened 173 articles, we included 84 relevant articles—62 original articles, 10 editorial materials, 8 reviews, and 4 others. The United States, China, Egypt, and Argentina were most actively publishing in the field of spine surgery and COVID-19. The AOSpine International community contributed 7 articles (24 citations). The Hospital for Special Surgery (13.1%) and Johns Hopkins University (13.1%) were institutions with the most publications. Using the Law of Bradford, we found that World Neurosurgery, Global Spine Journal, and European Spine Journal are the core journals in this field, with P. K. Louie being the most influential author. “Elective surgery,” “intensive care,” “telehealth,” “patient satisfaction,” and “follow-up” had the strongest citation bursts.

Conclusions

During the COVID-19 pandemic, spine surgeons were more concerned with surgical timing, care, treatment, and patient’s quality of life. Accordingly, research hotspots in spine surgery during the pandemic shifted from “early healthcare” to “virus management” and “experience and education.”