An Overview of Healthcare Systems in Comoros: The Effects of Two Decades of Political Instability.


Journal

Annals of global health
ISSN: 2214-9996
Titre abrégé: Ann Glob Health
Pays: United States
ID NLM: 101620864

Informations de publication

Date de publication:
2021
Historique:
entrez: 30 8 2021
pubmed: 31 8 2021
medline: 1 10 2021
Statut: epublish

Résumé

There is ongoing scientific evidence pointing out the adverse effects of conflict on population health and development. Union of Comoros has experienced nearly two decades of political instability and military rule. This comprehensive review was carried out to ask whether the health crisis in Comoros is attributable to the consequences of the chronic political instability. This study involved a series of semi-structured interviews with key informants complemented by a comprehensive literature search of electronic databases and grey literature. A literature search was performed using all identified keywords associated with health indicators in Comoros to identify potential eligible publications in both English and French from 1975 to July 2020. The analysis demonstrated that political instability and lack of proper leadership from the Government undermine the establishment of health policies which contributed dramatically to the decline in health performance. Additionally, the resurgence and emergence of old and new diseases such as cholera, chikungunya, malaria, HIV/AIDS as indicators of inadequate health services were most likely during political turmoil. Data also showed an out-migration of the health workforce and an increased overseas medical treatment demand, which indicate less attractive working conditions and weak health systems in the country. Meanwhile, an increasing performance of health status indicators was observed after the comprehensive peace process of the 2000-Fomboni Declaration. The chronic political instability in Comoros has contributed to the health crisis facing the Union of Comoros. It has hampered the implementation of proper institutions, which might guarantee the socio-economic development and prosperity of the population. Further studies were needed to evaluate the health burden associated with the two decades of political instability and military rule.

Sections du résumé

Background
There is ongoing scientific evidence pointing out the adverse effects of conflict on population health and development. Union of Comoros has experienced nearly two decades of political instability and military rule. This comprehensive review was carried out to ask whether the health crisis in Comoros is attributable to the consequences of the chronic political instability.
Methods
This study involved a series of semi-structured interviews with key informants complemented by a comprehensive literature search of electronic databases and grey literature. A literature search was performed using all identified keywords associated with health indicators in Comoros to identify potential eligible publications in both English and French from 1975 to July 2020.
Results
The analysis demonstrated that political instability and lack of proper leadership from the Government undermine the establishment of health policies which contributed dramatically to the decline in health performance. Additionally, the resurgence and emergence of old and new diseases such as cholera, chikungunya, malaria, HIV/AIDS as indicators of inadequate health services were most likely during political turmoil. Data also showed an out-migration of the health workforce and an increased overseas medical treatment demand, which indicate less attractive working conditions and weak health systems in the country. Meanwhile, an increasing performance of health status indicators was observed after the comprehensive peace process of the 2000-Fomboni Declaration.
Conclusions
The chronic political instability in Comoros has contributed to the health crisis facing the Union of Comoros. It has hampered the implementation of proper institutions, which might guarantee the socio-economic development and prosperity of the population. Further studies were needed to evaluate the health burden associated with the two decades of political instability and military rule.

Identifiants

pubmed: 34458108
doi: 10.5334/aogh.3100
pmc: PMC8378088
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

84

Informations de copyright

Copyright: © 2021 The Author(s).

Déclaration de conflit d'intérêts

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Auteurs

Kassim Said Mohamed (KS)

Department of Gastroenterology of Zhuhai Hospital, Sun Yat Sen University Guangzhou, China.
Institute for Chemical Carcinogenesis, Guangzhou Medical University, Guangzhou 511436, China.

Kassim Said Abasse (KS)

Département de Management, Centre de Recherche en Gestion des Services de Sante, Faculté des sciences de l'administration (FSA), Université Laval (UL), Centre Hospitalière Universitaire (CHU) de Québec, Québec, G1V 0A6, Canada.

Muhammad Abbas (M)

State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing 210023, PR China.

Dahiru Nasiru Sintali (DN)

Center For Research Development and Evaluation of Pharmaceutical Excipients and Generic Drugs, Department of Pharmaceutics, School of Pharmacy, China Pharmaceutical University, China.

Mirza Muhammad Faran Ashraf Baig (MMFA)

State Key Laboratory of Analytical Chemistry for Life Sciences, School of Chemistry and Chemical Engineering, Nanjing University. Nanjing, 210023, China.

Andre Cote (A)

Département de Management, Centre de Recherche en Gestion des Services de Sante, Faculté des sciences de l'administration (FSA), Université Laval (UL), Centre Hospitalière Universitaire (CHU) de Québec, Québec, G1V 0A6, Canada.
VITAM, Centre de recherche en santé durable, Université Laval, Quebec, QC, Canada.

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