Global health security: where is the data to inform health system strengthening?

Abimbola, Seye; Topp, Stephanie M.; Palagyi, Anna; Marais, Ben J.; Negin, Joel

doi:10.1136/bmjgh-2017-000481

Cited by 11 publications

(16 citation statements)

References 12 publications

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“…A 2018 revision of the IHR selfassessment annual reporting tool (Kluge et al, 2018) takes a worthwhile step towards acknowledging the vital importance of strong resilient health systems for the implementation of the IHR, along with a need to integrate core capacities with essential public health functions. Further work engaging governments of LMICs is necessary to not only ensure identification of relevant preparedness capacities, but that national health system data applicable to capacity indicators are available, accessible and complete (Abimbola et al, 2017b). Developing human and institutional resources to ensure that civil servants and policy-makers are able to collect and interpret this information, and act on assessment outcomes, is also crucial.…”

Section: Discussionmentioning

confidence: 99%

“…Recent efforts to categorise health system resilience in light of the Ebola epidemic have highlighted the centrality of both hardware and software components noting the need for health systems to be aware, diverse, self-regulating, integrated and adaptive (Kruk, Myers, Varpilah, & Dahn, 2015). However, given that in order to be resilient a health system must first be strong (and not vice versa), it is important to link the resilience required to respond to an EID outbreak to a need to strengthen health systems more broadly (Abimbola & Topp, 2018;Abimbola, Topp, Palagyi, Marais, & Negin, 2017b). To inform such strengthening efforts, we must identify those features of a strongor preparedhealth system that would confer resilience.…”

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confidence: 99%

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Health system preparedness for emerging infectious diseases: A synthesis of the literature

Palagyi

Marais

Abimbola

et al. 2019

Global Public Health

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This review reflects on what the literature to date has taught us about how health systems of low-and middle-income countries (LMICs) respond to emerging infectious disease (EID) outbreaks. These findings are then applied to propose a conceptual framework characterising an EID prepared health system. A narrative synthesis approach was adopted to explore the key elements of LMIC health systems during an EID outbreak. Overarching themes ('core health system constructs') and sub-themes ('elements') relevant to EID preparedness were extracted from 49 peerreviewed articles. The resulting conceptual framework recognised six core constructs: four focused on material resources and structures (i.e. system 'hardware'), including (i) Surveillance, (ii) Infrastructure and medical supplies, (iii) Workforce, and (iv) Communication mechanisms; and two focused on human and institutional relationships, values and norms (i.e. system 'software'), including (i) Governance, and (ii) Trust. The article reinforces the interconnectedness of the traditional health system building blocks to EID detection, prevention and response, and highlights the critical role of system 'software' (i.e. governance and trust) in enabling LMIC health systems to achieve and maintain EID preparedness. The review provides recommendations for refining a set of indicators for an 'optimised' health system EID preparedness tool to aid health system strengthening efforts. ARTICLE HISTORY

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Health system preparedness for emerging infectious diseases: A synthesis of the literature

Palagyi

Marais

Abimbola

et al. 2019

Global Public Health

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“…We urge advocates of health system strengthening to deliberately promote resilience as adaptation with robustness ; with health system strengthening as a precondition for resilience—not the other way around. 24 …”

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confidence: 99%

Adaptation with robustness: the case for clarity on the use of ‘resilience’ in health systems and global health

Abimbola

Topp

2018

BMJ Glob Health

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“…Of concern, there is currently also no consolidated measure or database to help assess and compare countries’ health system capacity (beyond infrastructure). 29 , 30 Together with our findings, these gaps in knowledge highlight a growing imperative to strengthen both our understanding of and investment in equity-promoting health systems. 31 …”

Section: Discussionmentioning

confidence: 56%

Health inequality in the tropics and its costs: a Sustainable Development Goals alert

Callander

Topp

2020

International Health

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Background It is known that health impacts economic performance. This article aims to assess the current state of health inequality in the tropics, defined as the countries located between the Tropic of Cancer and the Tropic of Capricorn, and estimate the impact of this inequality on gross domestic product (GDP). Methods We constructed a series of concentration indices showing between-country inequalities in disability-adjusted life years (DALYs), taken from the Global Burden of Disease Study. We then utilized a non-linear least squares model to estimate the influence of health on GDP and counterfactual analysis to assess the GDP for each country had there been no between-country inequality. Results The poorest 25% of the tropical population had 68% of the all-cause DALYs burden in 2015; 82% of the communicable, maternal, neonatal and nutritional DALYs burden; 55% of the non-communicable disease DALYs burden and 61% of the injury DALYs burden. An increase in the all-cause DALYs rate of 1/1000 resulted in a 0.05% decrease in GDP. If there were no inequality between countries in all-cause DALY rates, most high-income countries would see a modest increase in GDP, with low- and middle-income countries estimated to see larger increases. Conclusions There are large and growing inequalities in health in the tropics and this has significant economic cost for lower-income countries.

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Global health security: where is the data to inform health system strengthening?

Cited by 11 publications

References 12 publications

Health system preparedness for emerging infectious diseases: A synthesis of the literature

Health system preparedness for emerging infectious diseases: A synthesis of the literature

Adaptation with robustness: the case for clarity on the use of ‘resilience’ in health systems and global health

Health inequality in the tropics and its costs: a Sustainable Development Goals alert

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