scholarly journals COVID-19 response by the Hopi Tribe: impact of systems improvement during the first wave on the second wave of the pandemic

2021 ◽  
Vol 6 (5) ◽  
pp. e005150
Author(s):  
Duane Humeyestewa ◽  
Rachel M. Burke ◽  
Harpriya Kaur ◽  
Darren Vicenti ◽  
Royce Jenkins ◽  
...  

The Hopi Tribe is a sovereign nation home to ~7500 Hopi persons living primarily in 12 remote villages. The Hopi Tribe, like many other American Indian nations, has been disproportionately affected by COVID-19. On 18 May 2020, a team from the US Centers for Disease Control and Prevention (CDC) was deployed on the request of the tribe in response to increases in COVID-19 cases. Collaborating with Hopi Health Care Center (the reservation’s federally run Indian Health Service health facility) and CDC, the Hopi strengthened public health systems and response capacity from May to August including: (1) implementing routine COVID-19 surveillance reporting; (2) establishing the Hopi Incident Management Authority for rapid coordination and implementation of response activities across partners; (3) implementing a community surveillance programme to facilitate early case detection and educate communities on COVID-19 prevention; and (4) applying innovative communication strategies to encourage mask wearing, hand hygiene and physical distancing. These efforts, as well as community adherence to mitigation measures, helped to drive down cases in August. As cases increased in September–November, the improved capacity gained during the first wave of the pandemic enabled the Hopi leadership to have real-time awareness of the changing epidemiological landscape. This prompted rapid response coordination, swift scale up of health communications and redeployment of the community surveillance programme. The Hopi experience in strengthening their public health systems to better confront COVID-19 may be informative to other indigenous peoples as they also respond to COVID-19 within the context of disproportionate burden.

Public Health ◽  
2020 ◽  
Author(s):  
Ellen Whitney ◽  
Katherine Seib ◽  
Jessica Blackburn ◽  
Jacob Clemente ◽  
Courtenay M. Dusenbury ◽  
...  

More than one hundred countries around the world have established national public health institutes (NPHIs) to coordinate and lead their public health systems. Some NPHIs, such as the US Centers for Disease Control and Prevention (CDC), South African National Institute for Communicable Diseases (NICD), Brazilian Oswaldo Cruz Foundation (FIOCRUZ), and Chinese Center for Disease Control and Prevention, have developed over time. Others, such as the Public Health Agency of Canada (PHAC), emanated in response to more recent global public health threats like severe acute respiratory syndrome (SARS). NPHI functionalities range from combatting primarily infectious diseases to comprehensive mandates to lead national efforts for prevention and control of both infectious and noncommunicable disease threats. The International Association of National Public Health Institutes (IANPHI), envisioned in 2001 and chartered in 2006, serves to link and catalyze the capacity of NPHIs around the world through a robust international professional and scientific network. IANPHI works closely with the World Health Organization (WHO) through a formal partnership agreement. The Bill & Melinda Gates Foundation, the Rockefeller Foundation, member dues and peer assistance, bilateral cooperative agreements, and private-sector partnerships support its activities. IANPHI’s members encompass more than five billion people across six continents. IANPHI is the only organization whose mission is to strengthen national public health institutes. To do this, IANPHI’s work focuses on (a) supporting a robust scientific community of NPHI directors through an annual meeting, a listserv, and collaborative activities; (b) developing and distributing guidelines and tools that strengthen NPHIs’ abilities to conduct and evaluate public health programs and efforts, including the IANPHI NPHI development framework, the Staged Development Tool, NPHI-to-NPHI evaluation guidance, and a best practices series; and (c) investing in projects designed to create NPHIs and strengthen public health systems in low-resource countries. IANPHI helps NPHIs by advocating for strong and well-supported NPHIs and providing timely information and insights for public health programs and actions.


2020 ◽  
Author(s):  
Claas Kirchhelle

COVID-19 has exposed significant differences in public health systems’ ability to mount effective test and trace responses. This article analyses the historical and structural reasons behind the relative success of Germany and the problems experienced in Britain and the US during the first wave of the pandemic. It also asks why recent international surveys overestimated Anglo-American preparedness. The article argues that the answer lies in the different evolution of public health systems as well as varying public health capacities at the local level. In Germany, post-1994 reforms of the decentralised public health system managed to overcome decades of political neglect and underinvestment and strengthen federal integration without compromising public health capacity at the state and communal level. This joint strengthening of the centre and hinterland allowed the Robert Koch Institute to function as an effective coordinating hub for locally tailored COVID-19 responses. By contrast, the decades after 1970 saw world-renowned Anglo-American public health systems face increasing challenges posed by funding cuts, privatisation, overambitious reforms, and increasing loss of political autonomy. Both the US Centers for Disease Control and Prevention and Public Health England retained significant prestige, which resulted in an overestimation of capacity by international reviews. However, once centres in Atlanta and Colindale had been overwhelmed, there was little local and state public health capacity to fall back on.


2021 ◽  
Author(s):  
Kerry A. Millington

The COVID-19 pandemic has had a tremendous negative impact on economies of most countries around the world. COVID-19 has disrupted the ability of health systems to deliver on essential health services and has also exposed pre-existing vulnerabilities and inequities in public health systems. According to a key informant survey conducted by WHO, over one year into the COVID-19 pandemic, there still exist substantial disruptions to essential health services. This rapid review examines evidence on successful interventions that could enable adaptive approaches to help manage and respond future pandemics and mitigate the risk of collapse of the public health systems. Countries must use the opportunity provided by the deployment of COVID-19 vaccines to strengthen health services and health systems and find long-lasting solutions for similar future challenges. The review notes that there still exist gaps in preparedness and response to the Covid-19 pandemic. New variants of concern threaten the effectiveness of existing COVID-19 vaccines, vaccine hesitancy slowing rollout, including in Africa, and interrupted and limited supply of COVID-19 tools. More funding is required though to scale up adaptive measures which are working, accelerating new approaches and innovations to improve service delivery. This review also highlights briefly the plight of marginalised social groups, people living with disabilities, women and children during the pandemic. According to estimates by Global Fund, Gavi, Global Financing Facility, access to life-saving health interventions for women, children and adolescents in 36 of the world’s poorest countries has dropped by as much as 25% due to COVID-19. Countries must build on the momentum of health innovations during the COVID-19 crisis to build more resilient health systems that can withstand disruptions by future pandemics.


Author(s):  
Chengfang Liu ◽  
Linxiu Zhang ◽  
Yaojiang Shi ◽  
Huan ZHOU ◽  
Alexis Medina ◽  
...  

Purpose Many public health systems have struggled with the dual questions of (1) why the uptake rate of maternal health services is low among some subpopulations; and (2) how to raise it. The objective of this study is to assess the uptake rate of a new set of maternal health services in poor rural areas of China. Design/methodology/approach The analysis is based on the survey responses of women’s representatives and village cadres from almost 1000 villages in June 2012 as part of a wide-scale public health survey in Sichuan, Gansu and Yunnan provinces in the western part of China. Findings We find that the uptake rate of maternal health services (including in-hospital delivery, antenatal care visits and post-partum care visits) in poor rural areas of western China are far below average in China, and that the rates vary across provinces and ethnic groups. Our analyses demonstrate that distance, income, ethnicity and availability appear to be systematically correlated with low uptake rates of all maternal health services. Demand-side factors seem to be by far the most important sources of the differences between subpopulations. We also find that there is potential for creating a Conditional Cash Transfer program to improve the usage of maternal health services. Originality/value We believe that our results will contribute positively to the exploration of answers to the dual questions that many public health systems have struggled with (1) why the uptake rate of maternal health services is low among some subpopulations; and (2) how to raise it.


2018 ◽  
Vol 69 (3) ◽  
pp. 167-170
Author(s):  
Aimee Lee ◽  
Marta Lomazzi ◽  
Hyewon Lee ◽  
Raman Bedi

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