Understanding the structure of a country’s health service providers for defence health engagement

Bricknell, Martin; Hinrichs, Saba; Ismail, Sharif; Sullivan, Richard

doi:10.1136/bmjmilitary-2020-001502

Cited by 8 publications

(7 citation statements)

References 12 publications

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“…Putting aside issues of COVID-19, the role of military health systems in contributing to population health and the domestic health policy tends to be poorly understood. 15 It is often viewed as a distinct entity from the civilian health system, though the armed forces and wider security services could play a greater role in global health and national public health. 16 17 The ALMANAC Military Medical Corps Worldwide collates some data on military health systems; however, the depth and quality of the information is insufficient for international comparisons.…”

Section: Introductionmentioning

confidence: 99%

Civil–military cooperation in the early response to the COVID-19 pandemic in six European countries

Gad¹,

Kazibwe

Quirk

et al. 2021

BMJ Mil Health

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BackgroundThe COVID-19 pandemic has presented many countries with significant health system and economic challenges. The role of civil–military cooperation in a health crisis of the magnitude presented by COVID-19 remains virtually unexplored. This review aims to detect and identify typologies, if any, of associations between security or military systems and the national response measures during the COVID-19, as adopted by six European countries during the early phase of the outbreak (January to March 2020).MethodsWe designed a structured qualitative literature review (qualitative evidence synthesis), primarily targeting open-source grey literature using a customised Google web search. Our target countries were UK, France, Spain, Italy, Belgium and Sweden. We employed a ‘best fit’ framework synthesis approach in qualitative analysis of the result records.ResultsA total of 277 result records were included in our qualitative synthesis, with an overall search relevance yield of 46%. We identified 19 distinct descriptive categories of civil–military cooperation extending across seven analytical themes. Most prominent themes included how military support was incorporated in the national COVID-19 response, including support to national health systems, military repatriation and evacuation, and support to wider public systems.ConclusionFindings of this review show the significance of military systems in supporting an expansive response during the COVID-19 pandemic, and our proposed methodological approach for capturing military health data in a reproducible manner and providing a comparative view on common types of interventions provided by civil–military cooperation to inform lessons from the use of military capacities during current COVID-19 outbreak.

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Section: Introductionmentioning

confidence: 99%

Civil–military cooperation in the early response to the COVID-19 pandemic in six European countries

Gad¹,

Kazibwe

Quirk

et al. 2021

BMJ Mil Health

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“…Therefore, the military policy on admission to hospital for patients other than the designated PAR will need to consider the capabilities and capacities of the whole health system, including local private and public facilities and nongovernment organizations (eg, the Red Cross or Red Crescent). 7 This assessment might include plotting all medical facilities with contact details on a map.…”

Section: General Dutiesmentioning

confidence: 99%

How Should Access to Military Health Care Facilities Be Controlled in Conflict?

Bricknell

Whetham

Sullivan

et al. 2022

AMA Journal of Ethics

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This commentary on a case analysis examines the principles that govern decisions about which patients might be admitted to an international military hospital during humanitarian or combat operations. It explores the balance between duties under the Geneva Conventions and other international humanitarian laws, the requirement to be able to provide medical support to the military mission, and the obligation of clinicians to coordinate with other health care practitioners (local civilian, local military, and nongovernment organizations). Finally, this commentary considers the practical aspects of implementing these arrangements.The American Medical Association designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit™ available through the AMA Ed Hub TM . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

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“…Two previous papers in this journal have highlighted the importance of understanding the relationships between the various providers of healthcare within a country, including the security sector and the armed forces, in order to inform Defence Health Engagement activities. 1 2 Military medical personnel need to understand how their health system interfaces with their country’s wider health system and, if deployed overseas, the relationship between civil and military systems in the host nation. This requires a framework for the comparison of health systems, several of which already exist for the civilian context.…”

Section: Introductionmentioning

confidence: 99%

Framework for the evaluation of military health systems

et al. 2021

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The organisation of a military health system (MHS) differs from the civilian system due to the role of the armed forces, the unique nature of the supported population and their occupational health requirements. A previously published review of the Military Medical Corps Worldwide Almanac demonstrated the value of a standardised framework for evaluation and comparison of MHSs. This paper proposes such a framework which highlights the unique features of MHSs not covered by health services research of national health systems. These include: national context and summary; organisational structure; firm base facilities, healthcare beneficiaries and medical research; operational capabilities, overseas deployments, collaborations and alliances; personnel including recruitment, training and education; and history and culture. This common framework can help facilitate international collaboration between military medical services including capability development, training exercises and mutual support during military operations. It can also inform national contributions to future editions of the Almanac.

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Understanding the structure of a country’s health service providers for defence health engagement

Cited by 8 publications

References 12 publications

Civil–military cooperation in the early response to the COVID-19 pandemic in six European countries

Civil–military cooperation in the early response to the COVID-19 pandemic in six European countries

How Should Access to Military Health Care Facilities Be Controlled in Conflict?

Framework for the evaluation of military health systems

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