Macro level influences on strategic responses to the COVID-19 pandemic - an international survey and tool for national assessments.


Journal

Journal of global health
ISSN: 2047-2986
Titre abrégé: J Glob Health
Pays: Scotland
ID NLM: 101578780

Informations de publication

Date de publication:
01 Jul 2021
Historique:
entrez: 5 7 2021
pubmed: 6 7 2021
medline: 17 7 2021
Statut: epublish

Résumé

Variation in the approaches taken to contain the SARS-CoV-2 (COVID-19) pandemic at country level has been shaped by economic and political considerations, technical capacity, and assumptions about public behaviours. To address the limited application of learning from previous pandemics, this study aimed to analyse perceived facilitators and inhibitors during the pandemic and to inform the development of an assessment tool for pandemic response planning. A cross-sectional electronic survey of health and non-health care professionals (5 May - 5 June 2020) in six languages, with respondents recruited via email, social media and website posting. Participants were asked to score inhibitors (-10 to 0) or facilitators (0 to +10) impacting country response to COVID-19 from the following domains - Political, Economic, Sociological, Technological, Ecological, Legislative, and wider Industry (the PESTELI framework). Participants were then asked to explain their responses using free text. Descriptive and thematic analysis was followed by triangulation with the literature and expert validation to develop the assessment tool, which was then compared with four existing pandemic planning frameworks. 928 respondents from 66 countries (57% health care professionals) participated. Political and economic influences were consistently perceived as powerful negative forces and technology as a facilitator across high- and low-income countries. The 103-item tool developed for guiding rapid situational assessment for pandemic planning is comprehensive when compared to existing tools and highlights the interconnectedness of the 7 domains. The tool developed and proposed addresses the problems associated with decision making in disciplinary silos and offers a means to refine future use of epidemic modelling.

Sections du résumé

BACKGROUND BACKGROUND
Variation in the approaches taken to contain the SARS-CoV-2 (COVID-19) pandemic at country level has been shaped by economic and political considerations, technical capacity, and assumptions about public behaviours. To address the limited application of learning from previous pandemics, this study aimed to analyse perceived facilitators and inhibitors during the pandemic and to inform the development of an assessment tool for pandemic response planning.
METHODS METHODS
A cross-sectional electronic survey of health and non-health care professionals (5 May - 5 June 2020) in six languages, with respondents recruited via email, social media and website posting. Participants were asked to score inhibitors (-10 to 0) or facilitators (0 to +10) impacting country response to COVID-19 from the following domains - Political, Economic, Sociological, Technological, Ecological, Legislative, and wider Industry (the PESTELI framework). Participants were then asked to explain their responses using free text. Descriptive and thematic analysis was followed by triangulation with the literature and expert validation to develop the assessment tool, which was then compared with four existing pandemic planning frameworks.
RESULTS RESULTS
928 respondents from 66 countries (57% health care professionals) participated. Political and economic influences were consistently perceived as powerful negative forces and technology as a facilitator across high- and low-income countries. The 103-item tool developed for guiding rapid situational assessment for pandemic planning is comprehensive when compared to existing tools and highlights the interconnectedness of the 7 domains.
CONCLUSIONS CONCLUSIONS
The tool developed and proposed addresses the problems associated with decision making in disciplinary silos and offers a means to refine future use of epidemic modelling.

Identifiants

pubmed: 34221358
doi: 10.7189/jogh.11.05011
pii: jogh-11-05011
pmc: PMC8248749
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

05011

Informations de copyright

Copyright © 2021 by the Journal of Global Health. All rights reserved.

Déclaration de conflit d'intérêts

Competing interests: The authors completed the ICMJE Unified Competing Interest form (available upon request from the corresponding author), and declare no other conflicts of interest.

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Auteurs

Raheelah Ahmad (R)

National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance at Imperial College, Hammersmith Campus, London, UK.
Division of Health Services Research and Management, School of Health Sciences, City, University of London, Northampton Square, London, UK.
Institute of Business & Health Management, Dow University of Health Sciences, Karachi, Pakistan.

Rifat A Atun (RA)

National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance at Imperial College, Hammersmith Campus, London, UK.
Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA.

Gabriel Birgand (G)

National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance at Imperial College, Hammersmith Campus, London, UK.
Centre d'Appui à la Prévention des Infections Associées aux Soins (CPias), Pays de la Loire, Nantes University Hospital, Nantes, France.

Enrique Castro-Sánchez (E)

National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance at Imperial College, Hammersmith Campus, London, UK.
Division of Health Services Research and Management, School of Health Sciences, City, University of London, Northampton Square, London, UK.
Division of Nursing, School of Health Sciences, City, University of London, Northampton Square, London, UK.

Esmita Charani (E)

National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance at Imperial College, Hammersmith Campus, London, UK.
Division of Infectious Diseases & HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
Department of Medicine, Amrita Institute of Medical Sciences, Amrita University, Kerala, India.

Ewan B Ferlie (EB)

King's Business School, King's College London, Bush House, London, UK.

Izhar Hussain (I)

Institute of Business & Health Management, Dow University of Health Sciences, Karachi, Pakistan.

Andrew Kambugu (A)

Infectious Disease Institute, Makerere University, Kampala, Uganda.

Jaime Labarca (J)

Department of Infectious Diseases, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.

Gabriel Levy Hara (GL)

Unit of Infectious Diseases, Hospital Carlos G Durand, Buenos Aires, Argentina.

Martin McKee (M)

Department of Public Health, London School of Hygiene & Tropical Medicine, London, UK.

Marc Mendelson (M)

Division of Infectious Diseases & HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.

Sanjeev Singh (S)

Department of Medicine, Amrita Institute of Medical Sciences, Amrita University, Kerala, India.

Jay Varma (J)

Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia.

Nina J Zhu (NJ)

National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance at Imperial College, Hammersmith Campus, London, UK.

Walter Zingg (W)

National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance at Imperial College, Hammersmith Campus, London, UK.
Infection Control Programme and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals, Geneva, Switzerland.
Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, Zurich, Switzerland.

Alison H Holmes (AH)

National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance at Imperial College, Hammersmith Campus, London, UK.

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