Field Epidemiology and Public Health Research Priorities in the Eastern Mediterranean Region: Delphi Technique

Abstract

Research is essential for evidence-based decision making. This study aimed to identify research priorities in the areas of field epidemiology and public health in the Eastern Mediterranean Region (EMR) from the perspectives of public health professionals. A Delphi technique, using online survey, was employed to reach 168 public health professionals who have experience in the EMR countries. The study took place between November 2019 and January 2020. Consensus on the research priorities was reached after two-round online questionnaires. A list of top 10 field epidemiology and public health research priorities in the EMR was developed. Of those priorities, four fell under health in emergency, war and armed conflict, two under communicable diseases, two under immunization, one under digital health, and one under sexual, reproductive, and adolescent health. Availability, adequacy, and quality of health services in crisis settings were scored as a top priority (mean = 4.4, rank 1), followed by use of technology to improve the collection, documentation, and analysis of health data (mean = 4.28, rank 2), and capacity of countries in the region to respond to emergencies (mean = 4.25, rank 3). This study was conducted prior to COVID-19 pandemic and, thus, it did not capture COVID-19 research as a priority area. Nevertheless, identified priorities under communicable diseases including outbreak investigation of infectious diseases, epidemics and challenges related to communicable diseases in the EMR were still notable. In conclusion, the field epidemiology and public health research priorities identified in this study through a systematic inclusive process could be useful to make informed decisions and gear the research efforts to improve the health of people in the EMR.

Preparedness of Eastern Mediterranean countries in view of monkeypox emergence during the COVID-19 pandemic: A call for action

“…Inadequate funds, poor infrastructure, a shortage of qualified and skilled human resources, political instability, and conflicts are some of the major causes that have weakened healthcare systems in some EMR countries, including Afghanistan, Iraq, Libya, Syria, Sudan, Somalia, Yemen and Lebanon. Identical issues also exist in Iran and Pakistan although they are minor [ 13 , 14 ]. It is challenging for Lebanon's healthcare system to manage a new catastrophe, as it is already struggling due to the recent COVID-19 pandemic, economic pressures, political unrest, a neglected refugee crisis, and an increasing number of healthcare professionals leaving the country.…”

“…In addition to these problems, the chemical explosion on August 4, 2020, at the Beirut port also added to these challenges, with the incident destroying nearby hospitals and related loss of healthcare resources [ 15 ]. The rest of the regional countries like Saudi Arabia, UAE, and Qatar may not have these concerns; however, the recent pandemic of COVID-19 has affected all these nations negatively and has strained their healthcare systems [ 13 , 14 ]. Furthermore, several concerns have also been observed during that period, including undesirable technical assistance, medical logistics, supplies management, limited human resource availability, and inadequate and weak public health interventions (e.g., contact tracing and epidemiological surveillance) [ 13 , 14 ].…”

“…The rest of the regional countries like Saudi Arabia, UAE, and Qatar may not have these concerns; however, the recent pandemic of COVID-19 has affected all these nations negatively and has strained their healthcare systems [ 13 , 14 ]. Furthermore, several concerns have also been observed during that period, including undesirable technical assistance, medical logistics, supplies management, limited human resource availability, and inadequate and weak public health interventions (e.g., contact tracing and epidemiological surveillance) [ 13 , 14 ]. All these can cause significant obstacles to preventing the spread of newly emerging diseases, such as the current MPX outbreak [ 13 , 14 ].…”

“…Furthermore, several concerns have also been observed during that period, including undesirable technical assistance, medical logistics, supplies management, limited human resource availability, and inadequate and weak public health interventions (e.g., contact tracing and epidemiological surveillance) [ 13 , 14 ]. All these can cause significant obstacles to preventing the spread of newly emerging diseases, such as the current MPX outbreak [ 13 , 14 ].…”