How has Guinea learnt from the response to outbreaks? A learning health system analysis.
cross-sectional survey
health systems
systematic review
Journal
BMJ global health
ISSN: 2059-7908
Titre abrégé: BMJ Glob Health
Pays: England
ID NLM: 101685275
Informations de publication
Date de publication:
02 2023
02 2023
Historique:
received:
17
10
2022
accepted:
23
01
2023
entrez:
28
2
2023
pubmed:
1
3
2023
medline:
3
3
2023
Statut:
ppublish
Résumé
Learning is a key attribute of a resilient health system and, therefore, is central to health system strengthening. The main objective of this study was to analyse how Guinea's health system has learnt from the response to outbreaks between 2014 and 2021. We used a retrospective longitudinal single embedded case study design, applying the framework conceptualised by Sheikh and Abimbola for analysing learning health systems. Data were collected employing a mixed methods systematic review carried out in March 2022 and an online survey conducted in April 2022. The 70 reports included in the evidence synthesis were about the 2014-2016 Ebola virus disease (EVD), Measles, Lassa Fever, COVID-19, 2021 EVD and Marburg virus disease. The main lessons were from 2014 to 2016 EVD and included: early community engagement in the response, social mobilisation, prioritising investment in health personnel, early involvement of anthropologists, developing health infrastructure and equipment and ensuring crisis communication. They were learnt through information (research and experts' opinions), action/practice and double-loop and were progressively incorporated in the response to future outbreaks through deliberation, single-loop, double-loop and triple-loop learning. However, advanced learning aspects (learning through action, double-loop and triple-loop) were limited within the health system. Nevertheless, the health system successfully controlled COVID-19, the 2021 EVD and Marburg virus disease. Survey respondents' commonly reported that enablers were the creation of the national agency for health security and support from development partners. Barriers included cultural and political issues and lack of funding. Common recommendations included establishing a knowledge management unit within the Ministry of Health with representatives at regional and district levels, investing in human capacities and improving the governance and management system. Our study highlights the importance of learning. The health system performed well and achieved encouraging and better outbreak response outcomes over time with learning that occurred.
Identifiants
pubmed: 36854489
pii: bmjgh-2022-010996
doi: 10.1136/bmjgh-2022-010996
pmc: PMC9980363
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : World Health Organization
ID : 001
Pays : International
Informations de copyright
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
Clin Infect Dis. 2015 Jun 15;60(12):1825-7
pubmed: 25770170
J Med Libr Assoc. 2015 Apr;103(2):96-9
pubmed: 25918490
Implement Sci. 2012 Mar 20;7:20
pubmed: 22433980
Glob Health Sci Pract. 2016 Dec 28;4(4):626-646
pubmed: 28031301
Int J Health Policy Manag. 2014 Dec 02;4(1):55-6
pubmed: 25584356
BMJ Glob Health. 2021 Jan;6(1):
pubmed: 33495284
BMC Infect Dis. 2017 Apr 24;17(1):304
pubmed: 28438127
Lancet Glob Health. 2017 Apr;5(4):e448-e457
pubmed: 28237252
Viruses. 2020 Sep 23;12(10):
pubmed: 32977629
BMJ Glob Health. 2019 Dec 15;4(6):e001925
pubmed: 31908867
PLoS Med. 2018 Jul 17;15(7):e1002613
pubmed: 30016319
BMC Public Health. 2020 Aug 27;20(1):1298
pubmed: 32854668
BMJ Glob Health. 2023 Jan;8(1):
pubmed: 36599498
Epidemiol Infect. 2016 Aug;144(11):2338-44
pubmed: 27086773
Emerg Microbes Infect. 2020 Dec;9(1):1055-1064
pubmed: 32459576
Rev Epidemiol Sante Publique. 2018 Nov;66(6):369-374
pubmed: 30318335
Emerg Infect Dis. 2020 Feb;26(2):206-211
pubmed: 31961292
Euro Surveill. 2018 Mar;23(12):
pubmed: 29589579
BMJ. 2021 Mar 29;372:n71
pubmed: 33782057
Arch Dis Child. 2018 Nov;103(11):1013-1019
pubmed: 29514814
Int J Health Plann Manage. 2022 Jan;37(1):553-555
pubmed: 34525245
Clin Infect Dis. 2016 Nov 15;63(10):1353-1356
pubmed: 27585800
Health Res Policy Syst. 2019 Feb 21;17(1):21
pubmed: 30791925
Health Policy Plan. 2016 Oct;31(8):1031-8
pubmed: 27060787
Learn Health Syst. 2021 Jul 22;6(2):e10287
pubmed: 35434353
BMJ Glob Health. 2022 Sep;7(Suppl 7):
pubmed: 36130793
Nature. 2020 Jul;583(7818):667-668
pubmed: 32694873
Lancet. 2015 May 9;385(9980):1910-2
pubmed: 25987159
Global Health. 2017 Aug 3;13(1):54
pubmed: 28774319
Viruses. 2015 Jul 09;7(7):3789-97
pubmed: 26184283
Philos Trans R Soc Lond B Biol Sci. 2017 May 26;372(1721):
pubmed: 28396475
Epidemiol Infect. 2021 Sep 08;149:e258
pubmed: 34493348
Lancet Infect Dis. 2017 Dec;17(12):1276-1284
pubmed: 29033032
N Engl J Med. 2015 Aug 27;373(9):787-9
pubmed: 26222382
Learn Health Syst. 2021 Nov 26;6(2):e10295
pubmed: 35434354
PLoS One. 2018 Feb 28;13(2):e0192798
pubmed: 29489836
BMJ. 2021 Mar 11;372:n486
pubmed: 33707174
Philos Trans R Soc Lond B Biol Sci. 2017 May 26;372(1721):
pubmed: 28396476
Health Info Libr J. 2009 Jun;26(2):91-108
pubmed: 19490148
Front Digit Health. 2022 Jun 27;4:911089
pubmed: 35832657
BMJ Glob Health. 2022 Sep;7(Suppl 7):
pubmed: 36130796
Lancet Infect Dis. 2015 Sep;15(9):1017-1023
pubmed: 26116183
BMJ Glob Health. 2017 Mar 16;2(2):e000202
pubmed: 28589018
JBI Evid Synth. 2020 Oct;18(10):2108-2118
pubmed: 32813460
JMIR Public Health Surveill. 2020 Apr 29;6(2):e15860
pubmed: 32347809
Front Public Health. 2022 Jan 20;9:761196
pubmed: 35127614
Infect Dis Poverty. 2017 Dec 01;6(1):159
pubmed: 29191243
Glob Public Health. 2020 Dec;15(12):1767-1777
pubmed: 32673146
Harv Bus Rev. 2007 Nov;85(11):68-76, 149
pubmed: 18159787
BMC Public Health. 2020 Aug 4;20(1):1200
pubmed: 32753044
BMJ Glob Health. 2019 Dec 10;4(6):e002059
pubmed: 31908875
Emerg Nurse. 2009 Jun;17(3):32-5
pubmed: 19552332
BMJ Glob Health. 2020 Aug;5(8):
pubmed: 32784215
J Infect. 2020 Mar;80(3):326-332
pubmed: 31958541
PLoS One. 2018 Feb 28;13(2):e0193291
pubmed: 29489885
Epidemiol Health. 2015 Sep 16;37:e2015040
pubmed: 26493654
BMJ Glob Health. 2019 Jan 25;4(Suppl 1):e001107
pubmed: 30775019
Korean J Intern Med. 2018 Mar;33(2):233-246
pubmed: 29506344
Nature. 2018 Mar 22;555(7697):421-422
pubmed: 29565399
BMJ Glob Health. 2022 Sep;7(Suppl 7):
pubmed: 36130795
BMJ Glob Health. 2019 Aug 10;4(Suppl 7):e001769
pubmed: 31478018
Learn Health Syst. 2020 Aug 28;5(4):e10244
pubmed: 34667871
Public Health Pract (Oxf). 2021 Nov;2:100073
pubmed: 33521738
BMC Public Health. 2016 May 17;16:410
pubmed: 27185252
Health Res Policy Syst. 2017 Mar 1;15(1):16
pubmed: 28249608
C R Biol. 2018 Nov - Dec;341(9-10):433-443
pubmed: 30429072
BMC Med Educ. 2021 Jul 28;21(1):406
pubmed: 34320967
Lancet. 2020 Feb 15;395(10223):476-477
pubmed: 32061280
J Glob Health. 2021 Jan 16;11:03008
pubmed: 33643618
Nature. 2021 Sep;597(7877):539-543
pubmed: 34526718
Glob Health Promot. 2016 Mar;23(1):79-82
pubmed: 26518037
Front Public Health. 2021 Jun 04;9:659504
pubmed: 34178918
J Glob Health. 2018 Dec;8(2):020601
pubmed: 30023054
Prev Med Rep. 2020 Dec;20:101206
pubmed: 32959011
PLoS One. 2018 Aug 23;13(8):e0202468
pubmed: 30138407
PLoS Negl Trop Dis. 2018 Nov 6;12(11):e0006829
pubmed: 30399142
Am J Trop Med Hyg. 2022 Feb 25;:
pubmed: 35213814
Hum Resour Health. 2019 Nov 1;17(1):81
pubmed: 31675955
BMJ Glob Health. 2022 Aug;7(8):
pubmed: 35914831
BMJ Glob Health. 2021 Oct;6(10):
pubmed: 34607893
CMAJ. 2009 Aug 4;181(3-4):165-8
pubmed: 19620273
Reprod Health. 2019 Jan 18;16(1):5
pubmed: 30658674
Front Public Health. 2022 Aug 11;10:715356
pubmed: 36033803
J Contin Educ Health Prof. 2006 Winter;26(1):13-24
pubmed: 16557505
Jt Comm J Qual Patient Saf. 2011 Dec;37(12):532-43
pubmed: 22235538
Health Res Policy Syst. 2018 Aug 6;16(1):78
pubmed: 30081918
Reprod Health. 2018 Apr 10;15(1):60
pubmed: 29631599
Sante Publique. 2021 Mar 2;32(5):537-548
pubmed: 33723960
Korean J Intern Med. 2021 Mar;36(2):271-285
pubmed: 32872738