Strengthening Post-Ebola Health Systems: From Response to Resilience in Guinea, Liberia, and Sierra Leone

Govindaraj, Ramesh; Herbst, Christopher H.; Ajumobi, Oluwayemisi Busola; Rockmore, Christophe; Idrissi, Moulay Driss Zine Eddine El; Workie, Netsanet Walelign; Clark, Jocalyn

doi:10.1596/978-1-4648-1109-8

Cited by 7 publications

(10 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[16][17][18][19][20] Nonetheless, with all the investments provided by development partners following the EVD outbreak to strengthen Guinea's health system and make it more resilient, one would have expected a better preparedness level than what we observed. 8,11,12 To understand these findings, realistically evaluating the current aid strategies along with contexts of governance and coordination mechanisms and defining a new health system-strengthening approach are needed. 21 Second, despite these low levels of preparedness, disparities between the public and private health sectors and between Conakry (the epicentre of the pandemic at the time of the survey) and the countryside were observed.…”

Section: Discussionmentioning

confidence: 99%

“…7 In countries such as Guinea, which experienced the worst-ever Ebola Virus Disease (EVD) outbreak in 2014-2016, development partners such as the World Bank implemented health system-strengthening programmes. 8 These initiatives are aimed at increasing local capacities for outbreak preparedness and response through improving human resources for health, infrastructures, finances, and governance pillars of the health system. [8][9][10] Moreover, it stimulated regional and international collaboration for outbreak surveillance, infor-Acknowledgements: We thank all our study sites' managers for their kind collaboration and for facilitating the data collection, as well as study participants for accepting to respond to our questionnaire.…”

Section: Introductionmentioning

confidence: 99%

“…8 These initiatives are aimed at increasing local capacities for outbreak preparedness and response through improving human resources for health, infrastructures, finances, and governance pillars of the health system. [8][9][10] Moreover, it stimulated regional and international collaboration for outbreak surveillance, infor-Acknowledgements: We thank all our study sites' managers for their kind collaboration and for facilitating the data collection, as well as study participants for accepting to respond to our questionnaire. We are also grateful to the data collectors for their involvement during the data collection process.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A rapid assessment of health system preparedness and response to the COVID-19 pandemic in Guinea

Délamou

Sow²,

Fofana³

et al. 2022

J. Public Health Afr.

View full text Add to dashboard Cite

Epidemic-prone diseases have high adverse impacts and pose important threats to global health security. This study aimed to assess levels of health facility preparedness and response to the COVID-19 pandemic in Guinea. This was a cross-sectional study in public and private health facilities/services across 13 Guinean health districts. Managers and healthcare workers (HCWs) from departments in each facility/service were interviewed. Descriptive statistics and comparisons were presented using Pearson’s Chi-Squared Test or Fischer exact test. Totally, 197 managers and 1020 HCWs participated in the study. Guidance documents and dedicated spaces for management/isolation of suspected COVID-19 cases were available only in 29% and 26% of facilities, respectively. Capacities to collect (9%) and safely transport (14%) samples were low. Intensive care units (5%), dedicated patient beds (3%), oxygenators (2%), and respirators (0.6%) were almost lacking. While 36% of facilities/services had received infection prevention and control supplies, only 20% had supplies sufficient for 30 days. Moreover, only 9% of HCWs had received formal training on COVID-19. The main sources of information for HCWs were the media (90%) and the internet (58%). Only 30% of HCWs had received personal protective equipment, more in the public sector (p<0.001) and in Conakry (p=0.022). This study showed low levels of preparedness of health facilities/services in Guinea and highlighted a lack of confidence among HCWs who felt unsafe at their workplace. Better governance to improve and maintain the capacity of the Guinean health system to respond to current and future epidemics is needed.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A rapid assessment of health system preparedness and response to the COVID-19 pandemic in Guinea

Délamou

Sow²,

Fofana³

et al. 2022

J. Public Health Afr.

View full text Add to dashboard Cite

show abstract

“…These efforts have been met with some success. In 2006, there were about 700 nurses and midwives in Liberia (Varpilah et al, 2011); as of 2018, there were 2445 nurses, 158 physicians and 952 midwives (Govindaraj et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

“…Further, the majority of nurses, midwives and physicians practice in a rural setting (Govindaraj et al, 2018). Nevertheless, this proportion of healthcare workers (0.7 per 1000) is well below the WHO recommended 4.45 per 1000 people to achieve the Sustainable Development Goals (WHO, 2016) The development of a fit for purpose healthcare workforce has also been challenging.…”

Section: Introductionmentioning

confidence: 99%

The intellectual capital supporting nurse practice in a post‐emergency state: A case study

Ridge

Liebermann

Stimpfel

et al. 2022

Journal of Advanced Nursing

View full text Add to dashboard Cite

Aim To explore the resources supporting current nurse practice in the post‐emergency country of Liberia, using the nursing intellectual capital framework, as nurses work to meet the targets set by Government of Liberia's Essential Package of Health Services. Design Case study. Methods Data were collected in Liberia February–June 2019. Direct observation, semi‐structured interviews and photographs were used to investigate how nurse practice is supported. Field notes, transcripts and photographs were coded using both directed and conventional content analysis. Reports were then generated by code to triangulate the data. Results Thirty‐seven nurses at 12 health facilities participated. The intellectual capital supporting inpatient and outpatient nurse practice differs in important ways. Inpatient nurse practice is more likely to be supported by facility‐based protocols and trainings, whereas outpatient nurse practice is more likely to be supported by external protocols and trainings, often developed by the Liberian government or non‐governmental organizations. This can lead to uneven provision of inpatient protocols and trainings, often favouring private facilities. Similarly, inpatient nurses rely primarily on other nurses at their facilities for clinical support while outpatient nurses often have external professional relationships that provided them with clinical guidance. Conclusion Much has been accomplished to enable outpatient nurses to provide the primary‐ and secondary‐care target services in the Essential Package of Health Services. However, as the Liberian government and its partners continue to work towards providing certain tertiary care services, developing analogous protocols, trainings and clinical mentorship networks for inpatient nurses will likely be fruitful, and will decrease the burden on individual facilities. Impact Nurses are often expected to meet new service provision targets in post‐emergency states. Further research into how best to support nurses as they work to meet those targets has the potential to strengthen health systems.

show abstract

‘Tiny Iceland’ preparing for Ebola in a globalized world

Gunnlaugsson

Hauksdóttir

Bygbjerg

et al. 2019

Global Health Action

View full text Add to dashboard Cite

Background : The Ebola epidemic in West Africa caused global fear and stirred up worldwide preparedness activities in countries sharing borders with those affected, and in geographically far-away countries such as Iceland. Objective : To describe and analyse Ebola preparedness activities within the Icelandic healthcare system, and to explore the perspectives and experiences of managers and frontline health workers. Methods : A qualitative case study, based on semi-structured interviews with 21 staff members in the national Ebola Treatment Team, Emergency Room at Landspitali University Hospital, and managers of the response team. Results : Contextual factors such as culture and demography influenced preparedness, and contributed to the positive state of mind of participants, and ingenuity in using available resources for preparedness. While participants believed they were ready to take on the task of Ebola, they also had doubts about the chances of Ebola ever reaching Iceland. Yet, factors such as fear of Ebola and the perceived stigma associated with caring for a potentially infected Ebola patient, influenced the preparation process and resulted in plans for specific precautions by staff to secure the safety of their families. There were also concerns about the teamwork and lack of commitment by some during training. Being a ‘tiny’ nation was seen as both an asset and a weakness in the preparation process. Honest information sharing and scenario-based training contributed to increased confidence amongst participants in the response plans. Conclusions : Communication and training were important for preparedness of health staff in Iceland, in order to receive, admit, and treat a patient suspected of having Ebola, while doubts prevailed on staff capacity to properly do so. For optimal preparedness, likely scenarios for future global security health threats need to be repeatedly enacted, and areas plagued by poverty and fragile healthcare systems require global support.

show abstract

Strengthening Post-Ebola Health Systems: From Response to Resilience in Guinea, Liberia, and Sierra Leone

Cited by 7 publications

References 4 publications

A rapid assessment of health system preparedness and response to the COVID-19 pandemic in Guinea

A rapid assessment of health system preparedness and response to the COVID-19 pandemic in Guinea

The intellectual capital supporting nurse practice in a post‐emergency state: A case study

‘Tiny Iceland’ preparing for Ebola in a globalized world

Contact Info

Product

Resources

About