COVID-19 and beyond: how lessons and evidence from implementation research can benefit health systems’ response and preparedness for COVID-19 and future epidemics

Abstract

Early in the COVID-19 pandemic—and based on limited data on the novel coronavirus—it was projected that African countries will be ravaged and the health systems overwhelmed. Fortunately, Africa has so far defied these dire predictions. Many factors account for the less dramatic outcome, in particular the local know-how gained through dealing with previous epidemics, such as Ebola, and the early and coordinated political and public health response, applying a combination of containment and mitigation measures. However, these same measures, exacerbated by existing inequalities, have had negative impacts on vulnerable populations, notably women and children. Furthermore, the observed deterioration of access to and provision of essential health services will likely continue and worsen in countries experiencing future waves of COVID-19 and lacking access to vaccines. The impact of the pandemic on health systems may be one of Africa’s main COVID-19 challenges and women and children its greatest victims. In this article, we argue that just as learning from previous epidemics and coordinated preparation informed Africa’s response to COVID-19, knowledge, innovations and resources from recent implementation research can be leveraged to mitigate the pandemic’s effects and inform recovery efforts. As an example, we present the proven model and multifaceted approach of the Innovating for Maternal and Child Health in Africa Initiative and describe how such a model could be readily applied to building the robust and equitable systems needed to tackle future stresses and shocks, such as epidemics, on health systems while maintaining essential routine services.

Changing Admission Patterns in Pediatric Emergency Departments during the COVID-19 Pandemic in Italy Were Due to Reductions in Inappropriate Accesses

“…COVID-19 (coronavirus disease 2019) probably started in Wuhan, China at the end of 2019, spreading globally over the following months. Despite the roll-out of vaccination programs and improved therapy, the disease continues to incur significant healthcare and societal burdens worldwide [1]. After so-called "Patient 1" was admitted to the intensive care unit of his local hospital due to a deteriorating clinical condition from SARS-CoV-2/COVID-19 infection, Italy has been among the most severely affected countries worldwide both in terms of numbers of infected people and deaths.…”

Lessons learnt while designing and conducting a longitudinal study from the first Italian COVID-19 pandemic wave up to 3 years

“…In addition, how to identify community-relevant research questions during pandemics [ 12 ] as well as the consequences for doctoral/resident students who were unable to continue their studies [ 13 – 15 ] have been analysed. Previous outbreaks have been a useful resource for addressing the current one [ 16 ], which has been characterized by an urgent need to generate knowledge and immediately disseminate it to mitigate and control the pandemic and its devastating effects [ 17 ]. In this context, the aim of this contribution is to summarize the lessons learnt by a multidisciplinary research group that designed and conducted a longitudinal study starting in March 2020, which included patients affected by the first wave of COVID-19.…”

Healthcare workers’ experiences with COVID-19-related prevention and control measures in Tanzania

“…Shortages of health care workers (HCWs) are common in low-income countries, and the available HCW often face challenging working conditions and limited resources [1][2][3]. The ability of a health system to withstand adverse events, such as a pandemic, depends largely on the availability and preparedness of HCWs [4][5][6]. However, many countries struggle to have enough HCWs in all health facilities to meet existing and emerging health needs [3,[7][8][9][10][11].…”

“…Several studies have shown that the pandemic has placed a heavy burden on HCWs [13,16], with factors such as institutional decisions, organisational support and government responses influencing their experiences [17][18][19]. A country's ability to manage health and other competing priorities during a pandemic depends largely on the responsiveness of the health system and its ability to rapidly develop and implement strategies that can be implemented and supported by HCWs [5,[20][21][22][23]. The effectiveness of interventions therefore depends not only on the timely adoption of evidence-based interventions, but also on how these interventions are implemented and perceived by frontline workers [24].…”