Pandemic Influenza Community Preparedness Planning: Second National Congress on Health System Readiness

ABSTRACT H2 influenza viruses have not circulated in humans since 1968, and therefore a large segment of the population would likely be susceptible to infection should H2 influenza viruses reemerge. The development of an H2 pandemic influenza virus vaccine candidate should therefore be considered a priority in pandemic influenza preparedness planning. We selected a group of geographically and temporally diverse wild-type H2 influenza viruses and evaluated the kinetics of replication and compared the ability of these viruses to induce a broadly cross-reactive antibody response in mice and ferrets. In both mice and ferrets, A/Japan/305/1957 (H2N2), A/mallard/NY/1978 (H2N2), and A/swine/MO/2006 (H2N3) elicited the broadest cross-reactive antibody responses against heterologous H2 influenza viruses as measured by hemagglutination inhibition and microneutralization assays. These data suggested that these three viruses may be suitable candidates for development as live attenuated H2 pandemic influenza virus vaccines.

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Exploring health system readiness for adopting interventions to address intimate partner violence: a case study from the occupied Palestinian Territory

Health Policy and Planning ◽

10.1093/heapol/czz151 ◽

2019 ◽

Vol 35 (3) ◽

pp. 245-256 ◽

Cited By ~ 3

Author(s):

Manuela Colombini ◽

Abdulsalam Alkaiyat ◽

Amira Shaheen ◽

Claudia Garcia Moreno ◽

Gene Feder ◽

...

Keyword(s):

Health Care ◽

Health System ◽

Health Systems ◽

Partner Violence ◽

Scale Up ◽

Successful Implementation ◽

Occupied Palestinian Territory ◽

System Readiness ◽

Palestinian Territory

Abstract Domestic violence (DV) against women is a widespread violation of human rights. Adoption of effective interventions to address DV by health systems may fail if there is no readiness among organizations, institutions, providers and communities. There is, however, a research gap in our understanding of health systems’ readiness to respond to DV. This article describes the use of a health system’s readiness assessment to identify system obstacles to enable successful implementation of a primary health-care (PHC) intervention to address DV in the occupied Palestinian Territory (oPT). This article describes a case study where qualitative methods were used, namely 23 interviews with PHC providers and key informants, one stakeholder meeting with 19 stakeholders, two health facility observations and a document review of legal and policy materials on DV in oPT. We present data on seven dimensions of health systems. Our findings highlight the partial readiness of health systems and services to adopt a new DV intervention. Gaps were identified in: governance (no DV legislation), financial resources (no public funding and limited staff and infrastructure) and information systems (no uniform system), co-ordination (disjointed referral network) and to some extent around the values system (tension between patriarchal views on DV and more gender equal norms). Additional service-level barriers included unclear leadership structure at district level, uncertain roles for front-line staff, limited staff protection and the lack of a private space for identification and counselling. Findings also pointed to concrete actions in each system dimension that were important for effective delivery. This is the first study to use an adapted framework to assess health system readiness (HSR) for implementing an intervention to address DV in low- and middle-income countries. More research is needed on HSR to inform effective implementation and scale up of health-care-based DV interventions.

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Health system readiness for innovation scale-up: the experience of community-based distribution of injectable contraceptives in Nigeria

BMC Health Services Research ◽

10.1186/s12913-019-4786-6 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Oluwaseun Akinyemi ◽

Bronwyn Harris ◽

Mary Kawonga

Keyword(s):

Health System ◽

Community Health ◽

Health Workers ◽

Scale Up ◽

Task Shifting ◽

Policy Framework ◽

Framework Analysis ◽

Community Based ◽

System Readiness ◽

Injectable Contraceptives

Abstract Background Following the successful pilot of the community-based distribution of injectable contraceptives (CBDIC) by community health extension workers (CHEWs) in Gombe, northern Nigeria in 2010, there was a policy decision to scale-up the innovation to other parts of the country. However, there is limited understanding of health system factors that may facilitate or impede the successful scale-up of this innovation beyond the pilot site. Thus, this study assessed the health system readiness to deliver CBDIC in Nigeria and how this may influence the scale-up process. Methods This study was conducted in two Local Government Areas in Gombe State in September 2016. Seven key informant interviews were held with purposively sampled senior officials of the ministries of health at the federal and state levels as well as NGO program managers. Also, 10 in-depth interviews were carried out with health workers. All transcripts were analyzed using the thematic framework analysis approach. Result The availability of a policy framework that supports task-shifting and task-sharing, as well as application of evidence from the pilot programme and capacity building programmes for health workers provided a favourable environment for scale-up. Health system challenges for the scale-up process included insufficient community health workers, resistance to the task-shifting policy from professional health groups (who should support the CHEWs), limited funding and poor logistics management which affected commodity distribution and availability. However, there were also a number of health worker innovations which kept the scale-up going. Health workers sometimes used personal resources to make up for logistics failures and poor funding. They often modify the process in order to adapt to the realities on the ground. Conclusion This study shows health system weaknesses that may undermine scale-up of CBDIC. The study also highlights what happens when scale-up is narrowly focused on the intervention without considering system context, capacity and readiness. However, agency and discretionary decision-making among frontline health workers facilitated the process of scaling up, although the sustainability of this is questionable. Benefits observed during the pilot may not be realised on a larger scale if health system challenges are not addressed.

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A long-term care facility pandemic influenza preparedness planning assessment tool

American Journal of Disaster Medicine ◽

10.5055/ajdm.2011.0061 ◽

2011 ◽

Vol 6 (4) ◽

pp. 219-230 ◽

Cited By ~ 2

Author(s):

Philip W. Smith, MD ◽

Keith Hansen, BS ◽

Harlan Sayles, MS ◽

Brendan Brodersen ◽

Sharon Medcalf, RN, Med

Keyword(s):

Pandemic Influenza ◽

Long Term Care ◽

Assessment Tool ◽

Care Facility ◽

Term Care ◽

Term Care Facility ◽

Long Term Care Facility ◽

Preparedness Planning

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O351 Model-based pandemic influenza preparedness planning

International Journal of Antimicrobial Agents ◽

10.1016/s0924-8579(07)70233-9 ◽

2007 ◽

Vol 29 ◽

pp. S73

Author(s):

M. Schwehm ◽

H. Duerr ◽

S. Brockmann ◽

M. Eichner

Keyword(s):

Pandemic Influenza ◽

Preparedness Planning ◽

Model Based

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Flucast: a real-time tool to predict severity of an influenza season (Preprint)

10.2196/preprints.11780 ◽

2018 ◽

Author(s):

Aye Moa ◽

David Muscatello ◽

Abrar Chughtai ◽

Xin Chen ◽

C Raina MacIntyre

Keyword(s):

Health System ◽

Real Time ◽

Capacity Planning ◽

Predictive Accuracy ◽

Influenza Season ◽

Ease Of Use ◽

Influenza Surveillance ◽

Seasonal Activity ◽

Surge Capacity ◽

Preparedness Planning

BACKGROUND Influenza causes serious illness requiring annual health system surge capacity, yet annual seasonal variation makes it difficult to forecast and plan for the severity of an upcoming season. Research shows that hospital and health system stakeholders indicated a preference of forecasting tools that are easy to use and understand, to assist with surge capacity planning for influenza. OBJECTIVE This study aimed to develop a simple risk prediction tool, Flucast, to predict the severity of an emerging influenza season. METHODS Study data were obtained from the National Notifiable Diseases Surveillance System and Australian Influenza Surveillance Reports, Department of Health, Australia. We tested Flucast using retrospective seasonal data for eleven Australian influenza seasons. We compared five different models, using parameters known early in the season and which may be associated with the severity of the season. To calibrate the tool, the resulting estimates of seasonal severity were validated against independent reports of influenza-attributable morbidity and mortality. A model with highest predictive accuracy against retrospective seasonal activity was chosen as a best fit model to develop the Flucast tool. The tool was prospectively tested against the emerging 2018 influenza season. RESULTS The Flucast tool predicted the severity of all retrospectively studied years correctly for influenza seasonal activity in Australia. For 2018, the tool provided a reliable early prediction of severe seasonal influenza with the use of real-time data. The tool meets stakeholder preferences for simplicity and ease of use to assist with surge capacity planning. CONCLUSIONS The Flucast tool may be useful to inform future health system influenza preparedness planning, surge capacity and intervention programs in real time and can be adapted for different settings and geographic locations. CLINICALTRIAL NA

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Exploring the role of mass immunisation in influenza pandemic preparedness: a modelling study for the UK context

10.1101/775270 ◽

2019 ◽

Cited By ~ 1

Author(s):

Luca Grieco ◽

Jasmina Panovska-Griffiths ◽

Edwin van Leeuwen ◽

Peter Grove ◽

Martin Utley

Keyword(s):

Pandemic Influenza ◽

Net Present Value ◽

Vaccine Development ◽

Influenza Pandemic ◽

Immunisation Programme ◽

Health Economic Analysis ◽

Preparedness Planning ◽

Wide Range ◽

The Uk ◽

Interactive Visualisation

AbstractExisting modelling work on preparedness to pandemic influenza has focused on evaluating specific countermeasures for pandemics with specific characteristics (typically based on historical instances). The aim of this study was to inform policy on preparedness planning for pandemic influenza based on the assessment of a wide range of scenarios and free from restrictive assumptions about timing and features of the next pandemic.We carried out epidemiological modelling and health economic analysis of an extensive set of scenarios, each comprising a combination of pandemic, vaccine and immunisation programme characteristics in presence or absence of access to effective antivirals. Preparedness policies that incorporate mass immunisation were evaluated on the basis of there being a given chance of a pandemic each year. To support understanding and exploration of model output, an interactive visualisation tool was devised and made available online.We evaluated over 29 million combinations of pandemic and policy characteristics. Preparedness plans incorporating mass immunisation show positive net present value for a wide range of pandemic scenarios, predominantly in the absence of effective antivirals. Plans based on the responsive purchase of vaccine have greater benefit than plans reliant on the purchase and maintenance of a stockpile if immunisation can start without extensive delays. This finding is not dependent on responsively purchased vaccine being more effective than stockpiled vaccine, but rather is driven by avoiding the costs of storing and replenishing a stockpile.While emerging technologies for rapid vaccine development and production increase the prospects for mass immunisation to be an effective countermeasure, policies based on the responsive purchase of vaccine not tailored to the pandemic should be explored. Focus is also required on the pandemic intelligence, decision, contractual and logistical processes on which timely commencement of immunisation in a pandemic is reliant.

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Number of cases of pandemic influenza in Brazil in 2009 and 2010

Panorama brasileiro de tungstênio (w) entre os anos de 2008 e 2014 ◽

10.32749/nucleodoconhecimento.com.br/health/pandemic-influenza ◽

2020 ◽

pp. 81-92

Author(s):

Carine Correa Torres ◽

Lucas Facco ◽

Amanda Alves Fecury ◽

Maria Helena Mendonça de Araújo ◽

Euzébio de Oliveira ◽

...

Keyword(s):

Infectious Disease ◽

Influenza Virus ◽

Health System ◽

Sore Throat ◽

Pandemic Influenza ◽

Women Of Childbearing Age ◽

Childbearing Age ◽

Runny Nose ◽

Unified Health System ◽

Difficulty Breathing

Pandemic Influenza is an extremely transmissible infectious disease. The main symptoms an individual may develop are: cough, sore throat, runny nose, fever and difficulty breathing. The objective of this work was to show the number of cases of pandemic influenza in Brazil in the years 2009 and 2010. Research carried out in the database of the Department of Informatics of the Unified Health System of Brazil – DATASUS (http://datasus.saude.gov.br/). The influenza virus has as characteristic its extreme transmissibility, a factor that contributed to the high number of infected. In 2010, a numerical reduction in cases was noted, probably due to the expansion of population knowledge about the prevention and knowledge of the disease and its organic implications. It was observed that, in 2009 and 2010, there were more cases of pandemic influenza among females (mostly in women of childbearing age, whether pregnant or not), in Brazil, and consequently higher number of deaths. When compared to 2009, in 2010 there were more cases in which the patient evolved positively, reaching the outcome of cure.

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Long-Term Impact of Disasters on the Public Health System: A Multi-Case Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17176251 ◽

2020 ◽

Vol 17 (17) ◽

pp. 6251

Author(s):

Nina Lorenzoni ◽

Verena Stühlinger ◽

Harald Stummer ◽

Margit Raich

Keyword(s):

Public Health ◽

Health System ◽

Public Health System ◽

Psychosocial Support ◽

Holistic Approach ◽

The Public ◽

Preparedness Planning ◽

Tunnel Fire ◽

Long Term Impact

As past events have shown, disasters can have a tremendous impact on the affected population’s health. However, research regarding the long-term impact on a systems level perspective is still scarce. In this multi-case study, we analyzed and compared the long-term impacts on the public health system of five disasters which took place in Europe: avalanche (Austria), terror attack (Spain), airplane crash (Luxembourg), cable-car tunnel fire (Austria), and a flood in Central Europe. We used a mixed-methods approach consisting of a document analysis and interviews with key stakeholders, to examine the various long-term impacts each of the disasters had on health-system performance, as well as on security and health protection. The results show manifold changes undertaken in the fields of psychosocial support, infrastructure, and contingency and preparedness planning. The holistic approach of this study shows the importance of analyzing long-term impacts from the perspective of the type (e.g., disasters associated with natural hazards) and characteristic (e.g., duration and extent) of a disaster, as well as the regional context where a disaster took place. However, the identified recurring themes demonstrate the opportunity of learning from case studies in order to customize the lessons and apply them to the own-disaster-management setting.

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