Public Health Crisis: The Need for Primary Prevention in Failed and Fragile States

Quinn, John M.; Stoeva, Preslava; Zeleny, Tomas; Nanda, Toozy; Tomanová, A.; Bencko, Vladimír

doi:10.21101/cejph.a4671

Cited by 12 publications

(11 citation statements)

References 25 publications

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“…Strengthening and building resilient health systems in fragile states is important for global health security agendas since serious disease outbreaks might affect the whole world [5]. Investment of high-income countries in health infrastructure and research capacity building in fragile countries is believed to strengthen global health security [6,7] and limit and decrease international violence and terrorism [8,9]. Fragile States Index (FSI) is a tool developed to measure fragility based on 12 indicators that measure cohesion, economic, social, and political vulnerability of any country [10].…”

Section: Resultsmentioning

confidence: 99%

Health-related publications on fragile states in the alert zone: a bibliometric analysis

Sweileh¹

2020

Preprint

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Background Vulnerable and fragile settings is global health challenge. Assessing health research activity can help identify neglected health domains in fragile settings. The objective of the current study was to assess and describe health research activity on fragile states in the alert zone. Method A bibliometric method was applied using SciVerse Scopus. Research articles published on fragile states in the alert zone were retrieved and analyzed. The Fragile State Index (FSI) score was used for selection of states in the alert zone. The analysis was limited to one year; 2018. Results The search query found 2299 research articles giving an average of 2 research articles per one million people per year in the selected fragile states. The number of research articles per one million population was not significantly correlated (p=0.053; r= - 0.349) with FSI scores. However, it was significantly correlated with the extent of international research collaboration (P<0.01, r=065). Research on communicable diseases was the largest research domain (763 articles; 33.2%) followed by maternal/women’s health (430 articles; 18.7%), non-communicable diseases (291 articles; 12.7%), health system/policy (271 articles; 11.8%) and psychosocial and mental health (89; 3.9%). The top ten cited articles were mainly on infectious diseases, particularly on malaria and Lassa fever. Of all the retrieved documents, 727 (31.6%) research articles appeared in national/regional journals while the remaining appeared in international journals. The World Health organization was the most active funding organization for research on fragile states. Top ten active institutions were mainly based in fragile states with the lowest FSI score, specifically Ethiopia, Uganda, Nigeria, and Pakistan. Conclusion Research on fragile states was relatively low. Research on mental health and health system/policy should be encouraged. Collaboration and funding might help academic institutions in fragile states to make health problems in these countries more visible

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Section: Resultsmentioning

confidence: 99%

Health-related publications on fragile states in the alert zone: a bibliometric analysis

Sweileh¹

2020

Preprint

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“…If the survival of individuals is not safeguarded, the survival of social structures and institutions loses its significance. Contextualizing the security of individuals and groups in relation to and within state security is an area of security analysis that needs further attention in a changing landscape of political conflict—examples include the health security of populations in the context of civil war, failed or fragile states, [ 111–113 ] or the provision of health‐services in territories held by nonstate groups, e.g., rebels, guerrilla groups, ISIS; or the security of women and girl refugees fleeing conflict. [ 114,115 ] Empirical evidence needs to be brought to bear on understandings of security politics in general and health security in particular.…”

Section: Dimensions Of Health Securitymentioning

confidence: 99%

Dimensions of Health Security—A Conceptual Analysis

Stoeva

2020

Global Challenges

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COVID-19 pandemic is a stark example of health security politics, despite the pandemic not being currently labeled as a health security concern in political discourse. With high levels of morbidity and mortality globally and a highly contagious pathogen this pandemic is a prime and unprecedented example of a global health security threat. Analyses of the politics and practicalities of confronting health-related threats, of policy options and institutional approaches, however, hinge on the way these challenges are constructed and on the way the dimensions of the concept of health security are charted. In 2015 Horton and Das noted that there was no simple definition of health security. [5] Indeed, there has been little consensus among analysts over the meaning and parameters of health security. [16-19] These disagreements, Aldis argues, have effects beyond analytical debates, as they hinder communications and collaboration on global health initiatives, creating confusion and mistrust among stakeholders. [18] They also inhibit comparative evaluation, critique of existing analysis, or the possibility of consistent policy recommendations. Conceptual analyses of the two constitutive parts of health security illustrate the difficulties of coming up with a simple definition and the inherent tensions and contestations in such debates. Given these difficulties, it is argued here that a framework for conceptual analysis of "health security," instead of a fixed definition, would provide valuable space to evaluate the key features of existing analysis, the explicit and implicit assumptions about the nature and parameters of health security politics underpinning current policy responses, as well as possible alternative conceptualizations and ways of thinking about health security. Health security politics is a burgeoning and contested field of analysis and practice with the potential to affect security thinking beyond its own parameters. This article aims to contribute to debates both about the scope and meaning of health security and about the scope and meaning of security more broadly. To achieve this, it first presents a brief review of the scope and focus of contemporary conceptual debates of health security; second, it applies Baldwin's [20] framework for the concept of security to demonstrate how conservative the current definition of health security is; and thirdly, it proposes an alternative framing with a view to demonstrate the benefits of thinking about health security in broader more inclusive ways, which has the potential to improve global responses to current and future health-related challenges. Discussions of the politics and practicalities of confronting health security challenges-from infectious disease outbreaks to antimicrobial resistance and the silent epidemic of noncommunicable diseases-hinge on the conceptualization of health security. There is no consensus among analysts about the specific parameters of health security. This inhibits comparative evaluation and critique, and affects the consistency of a...

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“…Building a strong health system in any country requires strong leadership and governance, good information on health challenges facing the nation, health financing to reduce inequalities and ensure universal health coverage, human resources and health workforce, availability of sound quality essential medicines and technologies used in diagnostic procedures, and finally, the availability of primary healthcare system capable of providing cost-effective and close health service delivery [ 20 ]. Investment of high-income countries in health infrastructure and research capacity building in fragile states is believed to strengthen the national health system, global health security [ 21 , 22 ], and limit international violence and terrorism [ 15 , 23 ]. International engagement in health research in fragile states will provide detailed information on health challenges and health situation in the country.…”

Section: Introductionmentioning

confidence: 99%

“…At the health level, people living in fragile states suffer from poverty, malnutrition, violence, high child and maternal mortality, psychological trauma, poor health systems with inadequate staff and medication, poor infrastructure, and high risk of infectious diseases [14,15]. Strengthening and building resilient health systems in fragile states is important for global health security agendas since serious disease outbreaks in fragile states might affect the whole world [16].…”

mentioning

confidence: 99%

Health-related publications on people living in fragile states in the alert zone: a bibliometric analysis

Sweileh

2020

Int J Ment Health Syst

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Background: Fragile states pose a global challenge. Assessing health research activity on people living in these states can help identify neglected health domains in fragile settings. The objective of the current study was to assess and describe health research activity on people living in fragile states in the alert zone. Method: A bibliometric method was applied using SciVerse Scopus. Research articles published on people in fragile states in the alert zone were retrieved and analyzed. The Fragile State Index (FSI) score was used for selection of states in the alert zone. The analysis was limited to 1 year; 2018. Results: The search query found 2299 research articles giving an average of 2 research articles per one million population per year in the selected fragile states. The number of research articles per one million population was not significantly correlated (p = 0.053; r = − 0.349) with FSI scores. However, it was significantly correlated with the extent of international research collaboration (p < 0.01, r = 065). Research on communicable diseases was the largest research domain (763 articles; 33.2%) followed by maternal/women's health (430 articles; 18.7%), non-communicable diseases (291 articles; 12.7%), health system/policy (271 articles; 11.8%) and psychosocial and mental health (89; 3.9%). There were three research themes in the research domain of infectious diseases: HIV/AIDS; water-borne infectious diseases; and miscellaneous infectious diseases such as tuberculosis and malaria. The top ten cited articles were mainly on infectious diseases, particularly on malaria and Lassa fever. Of all the retrieved documents, 727 (31.6%) research articles appeared in national/regional journals while the remaining appeared in international journals. The World Health organization was the most active funding organization for research on fragile states. Top ten active institutions were mainly based in fragile states with the lowest FSI score, specifically Ethiopia, Uganda, Nigeria, and Pakistan. Conclusion: Research on fragile states was relatively low. Research on mental health and health system/policy should be encouraged. Collaboration and funding might help academic institutions in fragile states to make health problems in these countries more visible.

show abstract

Public Health Crisis: The Need for Primary Prevention in Failed and Fragile States

Cited by 12 publications

References 25 publications

Health-related publications on fragile states in the alert zone: a bibliometric analysis

Health-related publications on fragile states in the alert zone: a bibliometric analysis

Dimensions of Health Security—A Conceptual Analysis

Health-related publications on people living in fragile states in the alert zone: a bibliometric analysis

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