COVID-19 in humanitarian settings and lessons learned from past epidemics

Lau, Ling San; Samari, Goleen; Moresky, Rachel T; Casey, Sara E.; Kachur, S. Patrick; Roberts, Leslie; Zärd, Monette

doi:10.1038/s41591-020-0851-2

Cited by 175 publications

(167 citation statements)

References 12 publications

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“…Overcrowding and inadequate water and sanitation in underserved settlements are barriers to basic infection prevention measures. [47][48][49][50] Displaced women's and newborns' access to MNH services is suboptimal, and they experienced poor outcomes before the pandemicinduced disruptions of essential care. [51][52][53][54] Efforts should ensure that displaced populations are protected, with adequate access to testing, treatment and quality MNH care to halt anticipated exacerbations of negative health outcomes.…”

Section: Bmj Global Healthmentioning

confidence: 99%

Voices from the frontline: findings from a thematic analysis of a rapid online global survey of maternal and newborn health professionals facing the COVID-19 pandemic

et al. 2020

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IntroductionThe COVID-19 pandemic has substantially impacted maternity care provision worldwide. Studies based on modelling estimated large indirect effects of the pandemic on services and health outcomes. The objective of this study was to prospectively document experiences of frontline maternal and newborn healthcare providers.MethodsWe conducted a global, cross-sectional study of maternal and newborn health professionals via an online survey disseminated through professional networks and social media in 12 languages. Information was collected between 24 March and 10 April 2020 on respondents’ background, preparedness for and response to COVID-19 and their experience during the pandemic. An optional module sought information on adaptations to 17 care processes. Descriptive statistics and qualitative thematic analysis were used to analyse responses, disaggregating by low-income and middle-income countries (LMICs) and high-income countries (HICs).ResultsWe analysed responses from 714 maternal and newborn health professionals. Only one-third received training on COVID-19 from their health facility and nearly all searched for information themselves. Half of respondents in LMICs received updated guidelines for care provision compared with 82% in HICs. Overall, 47% of participants in LMICs and 69% in HICs felt mostly or completely knowledgeable in how to care for COVID-19 maternity patients. Facility-level responses to COVID-19 (signage, screening, testing and isolation rooms) were more common in HICs than LMICs. Globally, 90% of respondents reported somewhat or substantially higher levels of stress. There was a widespread perception of reduced use of routine maternity care services, and of modification in care processes, some of which were not evidence-based practices.ConclusionsSubstantial knowledge gaps exist in guidance on management of maternity cases with or without COVID-19. Formal information-sharing channels for providers must be established and mental health support provided. Surveys of maternity care providers can help track the situation, capture innovations and support rapid development of effective responses.

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Section: Bmj Global Healthmentioning

confidence: 99%

Voices from the frontline: findings from a thematic analysis of a rapid online global survey of maternal and newborn health professionals facing the COVID-19 pandemic

et al. 2020

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“…Living conditions in these under-served settlements, such as overcrowding and lack of adequate water and sanitation, make the implementation of basic infection prevention and control measures nearly impossible. [50][51][52][53] Displaced women and their newborns face sub-optimal access to ANC, skilled attendance at birth, PNC, and vaccination, and subsequently experienced poor health outcomes even prior to the pandemic-induced disruptions of essential services. [54][55][56][57] Global and local efforts must be established to ensure that displaced populations have access to appropriate infection prevention measures, testing and treatment, and to quality maternal and newborn services to halt anticipated exacerbations of negative health outcomes.…”

Section: Responsementioning

confidence: 99%

“…[54][55][56][57] Global and local efforts must be established to ensure that displaced populations have access to appropriate infection prevention measures, testing and treatment, and to quality maternal and newborn services to halt anticipated exacerbations of negative health outcomes. 29,52 Personal Experiences. Consistently with experiences from previous infectious disease outbreaks and emergencies, healthcare workers providing essential services to women and newborns during this pandemic experience increased levels of stress and anxiety.…”

Section: Responsementioning

confidence: 99%

Voices from the frontline: findings from a thematic analysis of a rapid online global survey of maternal and newborn health professionals facing the COVID-19 pandemic

Semaan

Audet

Huysmans

et al. 2020

Preprint

178

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ObjectiveTo prospectively document experiences of frontline maternal and newborn healthcare providers during the COVID-19 pandemic. DesignCross-sectional study via an online survey disseminated through professional networks and social media in 12 languages. We analysed responses using descriptive statistics and qualitative thematic analysis disaggregating by low-and middle-income countries (LMICs) and high-income countries (HICs).Setting 81 countries, between March 24 and April 10, 2020.Participants 714 maternal and newborn healthcare providers. Main outcome measuresPreparedness for and response to COVID-19, experiences of health workers providing care to women and newborns, and adaptations to 17 outpatient and inpatient care processes during the pandemic. ResultsOnly one third of respondents received training on COVID-19 from their health facility and nearly all searched for information themselves. Half of respondents in LMICs received updated guidelines for care provision compared with 82% in HICs. Overall, only 47% of participants in LMICs, and 69% in HICs felt mostly or completely knowledgeable in how to care for COVID-19 maternity patients. Facility-level responses to COVID-19 (signage, screening, testing, and isolation rooms) were more common in HICs than LMICs. Globally, 90% of respondents reported somewhat or substantially higher levels of stress. There was a widespread perception of reduced use of routine maternity care services, and of modification in care processes, some of which were not evidence-based. ConclusionsSubstantial knowledge gaps exist in guidance on management of maternity cases with or without COVID-19. Formal information sharing channels for providers must be established and mental health support provided. Surveys of maternity care providers can help track the situation, capture innovations, and support rapid development of effective responses. We would like to thank the study participants who took time to respond to this survey despite the difficult circumstances and increased workload. We acknowledge the Institutional

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“…A great deal could have been learned from the history of pandemics, both recent and in the distant past, a history that was largely overlooked by most countries (Griffin and Denholm, 2020; Lau et al, 2020). Anatomists should not fall into the same trap as politicians and policy makers, but take seriously both the educational and ethical lessons emerging from the Covid‐19 pandemic and re‐orientate their thinking as they envision the future of anatomy teaching.…”

Section: Resultsmentioning

confidence: 99%

Ethical Responses to the Covid‐19 Pandemic: Implications for the Ethos and Practice of Anatomy as a Health Science Discipline

Jones

2020

Anatomical Sciences Ed

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The move of much anatomy teaching online in response to the Covid‐19 pandemic has been successfully implemented within very short time frames. This has necessitated a high degree of dependence upon the use of digitized cadaveric resources, has entailed immense workload demands on staff, and has disrupted students' studies. These educational exigencies have been accompanied by ethical uncertainties for a discipline centered on study of the dead human body. An ethical framework for anatomy is suggested based on the principles of equal concern and respect, minimization of harm, fairness, and reciprocity, in which all staff and students are to be treated with respect and as moral equals. A series of ethical obligations are proposed as a means of maintaining the ethos of anatomy, coping with the suspension of body donation, providing adequate resources, and responding to increased dependence upon external providers. Good academic practice raises more general obligations stemming from the welfare of students, the increased workload of staff, and checking on online assessment and invigilation. As anatomists respond to the educational and ethical lessons prompted by this pandemic, they should plan for future disruptions to normal work patterns by adopting a sustainable and equitable course of action.

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COVID-19 in humanitarian settings and lessons learned from past epidemics

Cited by 175 publications

References 12 publications

Voices from the frontline: findings from a thematic analysis of a rapid online global survey of maternal and newborn health professionals facing the COVID-19 pandemic

Voices from the frontline: findings from a thematic analysis of a rapid online global survey of maternal and newborn health professionals facing the COVID-19 pandemic

Voices from the frontline: findings from a thematic analysis of a rapid online global survey of maternal and newborn health professionals facing the COVID-19 pandemic

Ethical Responses to the Covid‐19 Pandemic: Implications for the Ethos and Practice of Anatomy as a Health Science Discipline

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