‘We have a plan for that’: a qualitative study of health system resilience through the perspective of health workers managing antenatal and childbirth services during floods in Cambodia

Saulnier, Dell D; Thol, Dawin; Ir, Por; Hanson, Claudia; Schreeb, Johan von; Alvesson, Helle Mölsted

doi:10.1136/bmjopen-2021-054145

Cited by 13 publications

(7 citation statements)

References 29 publications

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“…The hospital with the plan saw no significant change in obstetrics admissions (OR: 1.05, 95% CI (0.81 to 1.36), p=0.713), while the hospital without the plan had a large decrease in obstetrics admissions (OR 0.38, 95% CI (0.26 to 0.56), p<0.01) following the typhoon. 37 The second excluded study, Saulnier et al, 38 had similar results. 38 This qualitative study, in which researchers interviewed staff at a hospital in Cambodia, revealed that flooding had little impact on access to MHS at the facility due to the comprehensive contingency plan in place.…”

Section: Discussionmentioning

confidence: 70%

Extreme weather events and maternal health in low-income and middle-income countries: a scoping review

Pappas,

Kovats,

Ranganathan

2024

BMJ Open

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BackgroundDespite global efforts to improve maternal health and healthcare, women throughout the world endure poor health during pregnancy. Extreme weather events (EWE) disrupt infrastructure and access to medical services, however little is known about their impact on the health of women during pregnancy in resource-poor settings.ObjectivesThis review aims to examine the current literature on the impact of EWE on maternal health to identify the pathways between EWE and maternal health in low-income and middle-income countries to identify gaps.Eligibility criteriaStudies were eligible for inclusion if they were published before 15 December 2022 and the population of the studies included pregnant and postpartum women (defined at up to 6 weeks postpartum) who were living in low-income and middle-income countries. The exposure of the included study must be related to EWE and the result to maternal health outcomes.Sources of evidenceWe searched the literature using five databases, Medline, Global Health, Embase, Web of Science and CINAHL in December 2022. We assessed the results using predetermined criteria that defined the scope of the population, exposures and outcomes. In total, 15 studies were included.Charting methodsWe identified studies that fit the criteria and extracted key themes. We extracted population demographics and sampling methodologies, assessed the quality of the studies and conducted a narrative synthesis to summarise the key findings.ResultsFifteen studies met the inclusion criteria. The quantitative studies (n=4) and qualitative (n=11) demonstrated an association between EWE and malnutrition, mental health, mortality and access to maternal health services.ConclusionEWE negatively impact maternal health through various mechanisms including access to services, stress and mortality. The results have demonstrated concerning effects, but there is also limited evidence surrounding these broad topics in low-resource settings. Research is necessary to determine the mechanisms by which EWE affect maternal health.PROSPERO registration numberCRD42022352915.

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Section: Discussionmentioning

confidence: 70%

Extreme weather events and maternal health in low-income and middle-income countries: a scoping review

Pappas,

Kovats,

Ranganathan

2024

BMJ Open

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“…It should then be possible to provide potential insights on the factors that promote resilience in healthcare systems exposed to extreme perturbations, that are key to policy makers and health care managers as part of risk and vulnerability analyses. 20,21 . Each FRAM function is in essence a mathematical equation describing the requirements to pass from its input stage to its output stage.…”

Section: Discussionmentioning

confidence: 99%

A Functional Resonance Analytical Methodology exploration of the essential functions of a paediatric major trauma centre responding to a mass casualty incident

MacKinnon,

Slater,

Jenner

et al. 2024

Preprint

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Background Functional Resonance Analytical Methodology (FRAM) is a systematic approach to model and explore how complex systems adapt to variations and to understand resilient properties in the face of perturbations. Mass Casualty Incidents are rare but can significantly stress healthcare systems. The aim of this study was to use FRAM to create a model of a paediatric trauma system during the initial response to the Manchester Arena Attack to provide resilience-based insights for the management of future Mass Casualty Incidents (MCI). Methods Qualitative interviews in the immediate aftermath of a terrorist bombing, were followed up with further in-depth probing of subject matter experts to create a validated and verified FRAM model. This model was compared with real incident data, then simplified for future studies. Results A Work As Imagined (WAI) model of how a paediatric emergency department provided resilient healthcare for MCI patients from reception and resuscitation to definitive care is presented. A simplified model focussing upon the pathway for the most severely injured patients that will facilitate the simulation of a myriad of potential emergency preparedness resilience response scenarios is also presented. Conclusions The systematic approach undertaken in this study has produced a model of a paediatric trauma system during the initial response to the Manchester Arena Attack, providing key insights on how a resilient performance was sustained. This modelling may provide an important step forward in the preparedness and planning for future MCIs.

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“…These interviews yielded valuable insights and perspectives from individuals directly engaged in these enterprises. The researchers employed a deductive qualitative technique to establish a connection between the categories derived from the scoping review and the insights obtained from interviews conducted with pertinent stakeholders (Saulnier et al, 2022).…”

Section: Methodsmentioning

confidence: 99%

Deciphering blue economy for SMEs in Malaysia: A dual approach through scoping review and stakeholder conversations

Saarani,

Alias,

Amran

et al. 2023

J. Infras. Policy. Dev.

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The expanding blue economy, marked by its focus on sustainable use of ocean resources, offers enormous opportunity for Small and Medium-sized Enterprises (SMEs). However, for SMEs to properly integrate and succeed in this economy, they must first have a thorough awareness of the sector’s challenges and prospects. This research used a scoping review and a qualitative study to identify the challenges and opportunities facing SMEs operating in the blue economy. The study discovered recurring themes and gaps in the existing literature by conducting an extensive examination of scholarly publications. The key challenges identified include complicated regulatory frameworks, restricted access to funding, infrastructure restrictions, talent deficiencies, government support, and market outreach. In-depth interviews with Malaysian SME leaders, industry stakeholders, and policymakers were conducted to decipher these findings. The results of interviews confirmed the relevance of the regulatory framework, infrastructure restrictions, talent deficit, and market access challenges in the Malaysian context. In particular, the study revealed emerging opportunities for Malaysian blue SMEs in sectors such as renewable energy, sustainable fisheries, marine biotechnology, and ecotourism. The study emphasizes the importance of an encouraging policy framework, knowledge-sharing platforms, and capacity building activities. It finishes by underlining the ability of SMEs to drive a sustainable and thriving blue economy, if challenges are systematically handled, and opportunities are appropriately capitalized.

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‘We have a plan for that’: a qualitative study of health system resilience through the perspective of health workers managing antenatal and childbirth services during floods in Cambodia

Cited by 13 publications

References 29 publications

Extreme weather events and maternal health in low-income and middle-income countries: a scoping review

Extreme weather events and maternal health in low-income and middle-income countries: a scoping review

A Functional Resonance Analytical Methodology exploration of the essential functions of a paediatric major trauma centre responding to a mass casualty incident

Deciphering blue economy for SMEs in Malaysia: A dual approach through scoping review and stakeholder conversations

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