Hospital resilience in the aftermath of Typhoon Haiyan in the Philippines

2017 ◽  
Vol 26 (4) ◽  
pp. 424-436 ◽  
Author(s):  
Charlie Labarda ◽  
Meredith Del Pilar Labarda ◽  
Exaltacion Ellevera Lamberte
Keyword(s):  
Health Services ◽  
Disaster Preparedness ◽  
The Philippines ◽  
Local Health ◽  
Disaster Resilience ◽  
Public And Private ◽  
Content Type ◽  
Health Services Delivery ◽  
Services Delivery ◽  
The Impact

Purpose Resilient health facilities, particularly hospitals, are critical for a responsive local health system in post-disaster settings. The purpose of this paper is to look at the experiences of two hospitals (public and private) in Tacloban City, Philippines in the aftermath of a super typhoon and their respective delivery of health services in such setting. Design/methodology/approach It described the impact of Typhoon Haiyan on health services delivery capacity and the factors instrumental in the resilience of the case hospitals. Lessons learned from the hospitals’ experiences, both at the level of the hospital staff and the institution, were also drawn. Disaster preparedness of case hospitals were assessed along several domains of resilience. Key informant interviews among stakeholders were conducted with key themes on disaster resilience extracted. Findings Disaster preparedness scores for case hospitals were different from each other and were reflected in their experiences of health services delivery in the aftermath of the disaster. Research limitations/implications This study on hospital resilience of two case hospitals, in the aftermath of Typhoon Haiyan, is exploratory in nature. The retrospective design of the study made it prone to recall bias. Further, the use of self-report measures for hospital resilience needs to be validated by more objective measures. The lack of baseline pre-disaster resilience indicators and the unpredictability of disasters could perhaps be addressed by a longitudinal study on hospital resilience in disasters in the future. Originality/value This study revealed several key findings. Some of the themes that emerged were: public health in disaster is the responsibility of both public and private hospitals; need for flexibility in disaster preparedness and planning, disaster resilience is an emergent process not a static construct, chaos results from zeal without coordination, and the need for integration of disaster preparedness in daily processes and structures of hospital facilities.

scholarly journals Impact of Eastern Congo Ebola Outbreak on Child Health Services Delivery: Decline of Routine Child Immunization and Need for Vaccine Supplementation

2019 ◽  
Author(s):  
Nzaji Michel-Kabamba ◽  
Lungoyo Christophe-Luhata ◽  
Nlandu Roger Ngatu ◽  
Charlotte Othepa ◽  
Mwimba Bertin-Lora ◽  
...  
Keyword(s):  
Health Services ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Child Health Services ◽  
Child Immunization ◽  
Health Services Delivery ◽  
Services Delivery ◽  
North Kivu ◽  
The Impact ◽  
Routine Child Immunization

Abstract Background An Ebola disaster, the deadliest in the history of Ebola in the Democratic Republic of Congo (DRC), is unfolding in North Kivu and Ituri provinces. An interdisciplinary research team investigated the impact of the Ebolavirus disease (EVD) outbreak on vital health services delivery under the coordination of DRC National Vaccination Program, Ministry of Health. We report on the impact of the ongoing Eastern Congo EVD outbreak on routine child immunization in the EVD-affected in North Kivu province, DRC. Methods This was a retrospective longitudinal study consisting in a time-trend analysis that was conducted in 40 public health facilities that organize routine child immunization in four of the 34 ‘Health Zones’ of the North Kivu province, namely Beni, Butembo, Katwa and Mabalako. Data were collected during two distinct 3-month periods: the “pre-Ebola period” (1 May through July 2018) and the “Ebola period” (1 August through October 2018), to compare the vaccination trends. Mean number of vaccine doses administered in pre-Ebola and Ebola periods were compared (unpaired t test). Results Compared to the “pre-Ebola period”, overall monthly mean vaccines uptake dropped during the “Ebola period”: BCG (157.1 ± 150.3 vs. 227.5 ± 138.4; p<0.0001), Oral polio (OPV: 505.1 ± 474.6 vs. 631.3 ± 353.9; p<0.001), Measles vaccine (147.6 ± 126.7 vs. 184.7 ± 102.5; p<0.001), pneumoccocal vaccine (PCV13: 445.8 ± 395.5 vs. 554.3 ± 299.8; p<0.001) and inactivated polio vaccine (IPV: 183.9 ± 141 vs. 153.9 ± 146.6; p<0.01). Furthermore, when considering the trend in child immunization in each of the four Health Zones during ‘Ebola period’, vaccine uptake shrank considerably in most health zones, whereas a complete disruption of vaccine delivery was observed in Mabalako health zone where the epicenter of this outbreak is located. Conclusion The ongoing Ebola outbreak has a negative impact on child health services, routine vaccination in particular. Supplementary immunization coupled with the strengthening of routine child vaccination services should be implemented to address gaps in immunity among children in affected provinces and reduce the risk of other infectious diseases outbreaks. Keywords: Democratic Republic of Congo; Ebola virus disease; Child immunization; Outbreak.

scholarly journals Assessing the impact of polio supplementary immunisation activities on routine immunisation and health systems: a systematic review

2021 ◽  
Vol 6 (11) ◽  
pp. e006568
Author(s):  
Amy Vassallo ◽  
Kimberly Dunbar ◽  
Busayo Ajuwon ◽  
Christopher Lowbridge ◽  
Martyn Kirk ◽  
...  
Keyword(s):  
Health Services ◽  
Health Systems ◽  
Vaccine Coverage ◽  
Polio Eradication ◽  
Routine Immunisation ◽  
Financial Investment ◽  
Health Services Delivery ◽  
Services Delivery ◽  
Social Mobilisation ◽  
The Impact

IntroductionThe Global Polio Eradication Initiative uses polio supplementary immunisation activities (SIAs) as a strategy to increase vaccine coverage and cease poliovirus transmission. Impact of polio SIAs on immunisation systems is frequently debated. We reviewed the impact of polio SIAs on routine immunisation and health systems during the modern era of polio eradication.MethodsWe searched nine databases for studies reporting on polio SIAs and immunisation coverage, financial investment, workforce and health services delivery. We conducted a narrative synthesis of evidence. Records prior to 1994, animal, modelling or case studies data were excluded.Results20/1637 unique records were included. Data on vaccine coverage were included in 70% (14/20) studies, workforce in 65% (13/20) and health services delivery in 85% (17/20). SIAs positively contributed to vaccination uptake of non-polio vaccines in seven studies, neutral in three and negative in one. Some polio SIAs contributed to workforce strengthening through training and capacity building. Polio SIAs were accompanied with increased social mobilisation and community awareness building confidence in vaccination programmes. Included studies were programmatic in nature and contained variable data, thus could not be justly critically appraised.ConclusionPolio SIAs are successful at increasing polio vaccine coverage, but the resources and infrastructures were not always utilised for delivery of non-polio vaccines and integration into routine service delivery. We found a gap in standardised tools to evaluate SIAs, which can then inform service integration. Our study provides data to inform SIAs evaluations, and provides important considerations for COVID-19 vaccine roll-out to strengthen health systems.PROSPERO registration numberCRD42020152195.

scholarly journals Impact of Eastern Congo Ebola Outbreak on Child Health Services Delivery: Decline of Routine Child Immunization and Need for Vaccine Supplementation

2019 ◽  
Author(s):  
Nzaji Michel-Kabamba ◽  
Lungoyo Christophe-Luhata ◽  
Nlandu Roger Ngatu ◽  
Charlotte Othepa ◽  
Mwimba Bertin-Lora ◽  
...  
Keyword(s):  
Health Services ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Child Health Services ◽  
Child Immunization ◽  
Health Services Delivery ◽  
Services Delivery ◽  
North Kivu ◽  
The Impact ◽  
Routine Child Immunization

Abstract Background An Ebola disaster, the deadliest in the history of Ebola in the Democratic Republic of Congo (DRC), is unfolding in North Kivu and Ituri provinces. An interdisciplinary research team investigated the impact of the Ebolavirus disease (EVD) outbreak on vital health services delivery under the coordination of DRC National Vaccination Program, Ministry of Health. We report on the impact of the ongoing Eastern Congo EVD outbreak on routine child immunization in the EVD-affected in North Kivu province, DRC.Methods This was a longitudinal study conducted in 40 public health facilities that organize routine child immunization in four of the 34 ‘Health Zones’ of the North Kivu province, namely Beni, Butembo, Katwa and Mabalako. Data were collected during two distinct 3-month periods: the “pre-Ebola period” (1 May through July 2018) and the “Ebola period” (1 August through October 2018), to compare the vaccination trends. Mean number of vaccine doses administered in pre-Ebola and Ebola periods were compared (unpaired t test).Results Compared to the “pre-Ebola period”, overall monthly mean vaccines uptake dropped during the “Ebola period”: BCG (157.1 ± 150.3 vs. 227.5 ± 138.4; p<0.0001), Oral polio (OPV: 505.1 ± 474.6 vs. 631.3 ± 353.9; p<0.001), Measles vaccine (147.6 ± 126.7 vs. 184.7 ± 102.5; p<0.001), pneumoccocal vaccine (PCV13: 445.8 ± 395.5 vs. 554.3 ± 299.8; p<0.001) and inactivated polio vaccine (IPV: 183.9 ± 141 vs. 153.9 ± 146.6; p<0.01). Furthermore, when considering the trend in child immunization in each of the four Health Zones during ‘Ebola period’, vaccine uptake shrank considerably in most health zones, whereas a complete disruption of vaccine delivery was observed in Mabalako health zone where the epicenter of this outbreak is located.Conclusion The ongoing Ebola outbreak has a negative impact on child health services, routine vaccination in particular. Supplementary immunization coupled with the strengthening of routine child vaccination services should be implemented to address gaps in immunity among children in affected provinces and reduce the risk of other infectious diseases outbreaks. Keywords: Democratic Republic of Congo; Ebola virus disease; Child immunization; Outbreak.

scholarly journals Impact of Eastern Congo Ebola Outbreak on Child Health Services Delivery: Decline of Routine Child Immunization and Need for Vaccine Supplementation

2019 ◽  
Author(s):  
Nzaji Michel-Kabamba ◽  
Lungoyo Christophe-Luhata ◽  
Nlandu Roger Ngatu ◽  
Charlotte Othepa ◽  
Mwimba Bertin-Lora ◽  
...  
Keyword(s):  
Health Services ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Child Health Services ◽  
Child Immunization ◽  
Health Services Delivery ◽  
Services Delivery ◽  
North Kivu ◽  
The Impact ◽  
Routine Child Immunization

Abstract Background An Ebola disaster, the deadliest in the history of Ebola in the Democratic Republic of Congo (DRC), is unfolding in North Kivu and Ituri provinces. An interdisciplinary research team investigated the impact of the Ebolavirus disease (EVD) outbreak on vital health services delivery under the coordination of DRC National Vaccination Program, Ministry of Health. We report on the impact of the ongoing Eastern Congo EVD outbreak on routine child immunization in the EVD-affected in North Kivu province, DRC. Methods This was a retrospective longitudinal study consisting in a time-trend analysis that was conducted in 40 public health facilities that organize routine child immunization in four of the 34 ‘Health Zones’ of the North Kivu province, namely Beni, Butembo, Katwa and Mabalako. Data were collected during two distinct 3-month periods: the “pre-Ebola period” (1 May through July 2018) and the “Ebola period” (1 August through October 2018), to compare the vaccination trends. Mean number of vaccine doses administered in pre-Ebola and Ebola periods were compared (unpaired t test). Results Compared to the “pre-Ebola period”, overall monthly mean vaccines uptake dropped during the “Ebola period”: BCG (157.1 ± 150.3 vs. 227.5 ± 138.4; p<0.0001), Oral polio (OPV: 505.1 ± 474.6 vs. 631.3 ± 353.9; p<0.001), Measles vaccine (147.6 ± 126.7 vs. 184.7 ± 102.5; p<0.001), pneumoccocal vaccine (PCV13: 445.8 ± 395.5 vs. 554.3 ± 299.8; p<0.001) and inactivated polio vaccine (IPV: 183.9 ± 141 vs. 153.9 ± 146.6; p<0.01). Furthermore, when considering the trend in child immunization in each of the four Health Zones during ‘Ebola period’, vaccine uptake shrank considerably in most health zones, whereas a complete disruption of vaccine delivery was observed in Mabalako health zone where the epicenter of this outbreak is located. Conclusion The ongoing Ebola outbreak has a negative impact on child health services, routine vaccination in particular. Supplementary immunization coupled with the strengthening of routine child vaccination services should be implemented to address gaps in immunity among children in affected provinces and reduce the risk of other infectious diseases outbreaks. Keywords: Democratic Republic of Congo; Ebola virus disease; Child immunization; Outbreak.

Federal-Provincial Insurance for Hospital and Physician's Care in Canada

1971 ◽  
Vol 1 (4) ◽  
pp. 398-414 ◽  
Author(s):  
J. E. F. Hastings
Keyword(s):  
Health Services ◽  
Social Insurance ◽  
Health Professions ◽  
The Public ◽  
Health Services Delivery ◽  
Provincial Hospital ◽  
Services Delivery ◽  
Insurance Program ◽  
Canadian Health ◽  
The Impact

The general Canadian background for health services and the evolution of social insurance programs for health services are described in this paper, with special emphasis on the universal federal–provincial Hospital Insurance and Diagnostic Services Program and the Medical Care Insurance Program. Other important Canadian health services developments are also outlined. Social insurance programs for health services are discussed in terms of financing and costs, manpower and facilities, and planning and organization. The impact of these programs on governments, the health professions, and the public is also given. New approaches, concepts, issues, and problems in providing health services in Canada are described. It may be seen that Canadian health services have undergone rapid and extensive change and growth in the last two decades. The process is still under way and the ultimate patterns of both social insurance for health services and health services delivery are not yet settled.

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