Iranian’s healthcare system challenges during natural disasters: the qualitative case study of Kermanshah earthquake

Abstract Background In order to the significance of lessons learned from the natural disasters for health care systems particularly in developing and under-developed countries, the main purpose of this study was to identify challenges and limitations in light of the earthquake experience in Kermanshah Province. Methods The present study was conducted in 2019 as a qualitative research using content analysis method. In this regard, 19 key informants were selected using snowball sampling. To enhance the accuracy of the study, the four validation criteria for qualitative studies in data coding developed by Guba and Lincoln including credibility, transferability, dependability and confirmability were used. Data was analyzed applying Graneheim and Lundman (2004) approach for analyzing the qualitative content of an interview text. Results Analysis of the data led to the identification of 2 main themes, 5 sub- themes and 17 main categories. The first main theme was health system oriented challenges containing challenges of medication supply and preparation, structural challenges, challenges in crisis-scene management and challenges of service delivery and the second main theme was non-health system oriented challenges including social and psychosocial challenges. Conclusion According to the results, along with health system oriented challenges with the inter-sectoral or intra-sectoral nature, the non-health system oriented challenges the same as social, cultural and psychological factors can be considered as the major challenges of Iran’s healthcare system in the face of crises. This complicated context can shed the light to policy makers that not only attention to the medicine and medical equipment supply chain, manpower preparation and service delivery system can be considered as an emergency, but also careful attention to the structural challenges and crisis-scene management should be planned and considered as a priority. Besides, the policy makers and the local managers should try to plan and act in a contingent situation according to the social and cultural characteristics of the region and the psychological condition and the mental needs of the people.

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Health System Preparedness for Coincidence of Natural Disasters and COVID-19: A Systematic Literature Review

10.21203/rs.3.rs-118316/v1 ◽

2021 ◽

Author(s):

Sanaz Sohrabizadeh ◽

Shiva Yousefian ◽

Amir hosein Bahramzadeh ◽

Mohammad Hosein Vaziri

Keyword(s):

Health System ◽

Natural Disasters ◽

Healthcare Professionals ◽

Final Analysis ◽

Lessons Learned ◽

World Health ◽

Inclusion Criteria ◽

Policy Makers ◽

Chinese City ◽

Health Organization

Abstract Background: In December 2019, the Chinese city of Wuhan has reported a novel pneumonia caused by COVID-19. While the COVID-19 pandemic has been increasingly affecting the world, the occurrence of natural disasters resulted in complex emergencies. The present review is aimed to identify the research focused on coincidence of natural disasters and COVID-19 and describe the preparedness and response actions applied by affected countries. Methods: This study was conducted and reported based on PRISMA checklist. The databases of Web of Sciences, PubMed, Scopus, Google Scholar and World Health Organization Library were searched. The inclusion criteria were all forms of published articles which investigated the dual risk or coincidence of natural disasters and COVID-19 pandemic. Once the studies selection was completed and the relevant papers was finalized, the analysis was done.Findings: Out of 1245 studies generated by initial search, a number of 13 articles was selected for final analysis. Earthquake was the most frequent disaster which its coincidence with COVID-19 was studied by researchers (31%). The implications of researchers for healthcare system were explained in three sections of climatic events, earthquakes and all hazard approach in relation to COVID-19.Conclusion: Extracting the lessons learned from the regions affected by disasters at the time of COVID-19 pandemic can be helpful for healthcare professionals and policy-makers to modify their preparedness and response plans for cascading risk of natural disasters and a serious pandemic such as COVID-19. Further research is needed to identify the factors strengthen the preparedness of health system for the dual risk of natural hazards and pandemics.

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Value-Based Health Care Supported by Data Science

Fundamentals of Clinical Data Science ◽

10.1007/978-3-319-99713-1_14 ◽

2018 ◽

pp. 193-212 ◽

Cited By ~ 1

Author(s):

Tiffany I. Leung ◽

G. G. van Merode

Keyword(s):

Health Care ◽

Service Delivery ◽

Health System ◽

Healthcare System ◽

Patient Outcomes ◽

Data Science ◽

Costs Of Care ◽

Learning Health System ◽

Measuring Outcomes ◽

Cost Measurement

AbstractThe value agenda involves measuring outcomes that matter and costs of care to optimize patient outcomes per dollar spent. Outcome and cost measurement in the value-based health care framework, centered around a patient condition or segment of the population, depends on data in every step towards healthcare system redesign. Technological and service delivery innovations are key components of driving transformation towards high-value health care. The learning health system and network-based thinking are complementary frameworks to the value agenda. Health care and medicine exist in a data-rich environment, and learning about how data can be used to measure and improve value of care for patients is and increasingly essential skill for current and future clinicians.

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Trends in Government e-Authentication

Handbook of Research on E-Government in Emerging Economies ◽

10.4018/978-1-4666-0324-0.ch034 ◽

2012 ◽

pp. 664-677

Author(s):

Mike Just ◽

Karen Renaud

Keyword(s):

Developing Countries ◽

Service Delivery ◽

Identity Management ◽

Developed Countries ◽

Lessons Learned ◽

Security And Privacy ◽

Effective Management ◽

Related Factors ◽

The Government ◽

Digital Channels

Government engagement of its citizens through digital channels offers the potential for efficiencies and savings, while at the same time allowing the government to reach out to constituents in novel ways. Yet such endeavours must be undertaken with care, especially with personalised service delivery, which requires effective management of security and privacy. Proper authentication and management of identity are key related factors. In this chapter, the authors examine government use and adoption of e-authentication and identity management technologies in order to securely interact with citizens. They first provide some background in which the state-of-the-art for protecting and managing identities is reviewed in terms of the various methods studied in academia and marketed by industry. The chapter then describes the degree to which these methods have been, and continue to be, used in the e-government initiatives of several developed countries. Finally, the authors consider the lessons learned, and how they might be applied to similar initiatives in developing countries.

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Trends in Government e-Authentication

Digital Democracy ◽

10.4018/978-1-4666-1740-7.ch089 ◽

2012 ◽

pp. 1792-1805

Author(s):

Mike Just ◽

Karen Renaud

Keyword(s):

Developing Countries ◽

Service Delivery ◽

Identity Management ◽

Developed Countries ◽

Lessons Learned ◽

Security And Privacy ◽

Effective Management ◽

Related Factors ◽

The Government ◽

Digital Channels

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Obstacles to advancing women’s health in Mozambique: a qualitative investigation into the perspectives of policy makers

Global Health Research and Policy ◽

10.1186/s41256-019-0119-x ◽

2019 ◽

Vol 4 (1) ◽

Cited By ~ 1

Author(s):

Mary Qiu ◽

Talata Sawadogo-Lewis ◽

Katia Ngale ◽

Réka Maulide Cane ◽

Amilcar Magaço ◽

...

Keyword(s):

Health System ◽

Women’S Health ◽

Women's Health ◽

National Level ◽

Health Indicators ◽

Government Support ◽

Health Policies ◽

Snowball Sampling ◽

Policy Makers ◽

Policies And Programs

Abstract Background Despite substantial investment in women’s health over the past two decades, and enthusiastic government support for MDG 5 and SDG 3, health indicators for women in Mozambique remain among the lowest in the world. Maternal mortality stayed constant from 2003 to 2011, with an MMR of 408; the estimated HIV prevalence for women of 15–24 years is over twice that for men; and only 12.1% of women are estimated to be using modern contraception. This study explores the perspectives of policy makers in the Mozambican health system and affiliates on the challenges that are preventing Mozambique from achieving greater gains in women’s health. Methods We conducted in-depth interviews with 39 senior- and mid-level policy makers in the Ministry of Health and affiliated institutions (32 women, 7 men). Participants were sampled using a combination of systematic random sampling and snowball sampling. Participants were asked about their experiences formulating and implementing health policies and programs, what is needed to improve women’s health in Mozambique, and the barriers and opportunities to achieving such improvement. Results Participants unanimously argued that women’s health is already sufficiently prioritized in national health policies and strategies in Mozambique; the problem, rather, is the implementation and execution of existing women’s health policies and programs. Participants raised challenges related to the policy making process itself, including an ever-changing, fragmented decision-making process, lack of long-term perspective, weak evaluation, and misalignment of programs across sectors. The disproportionate influence of donors was also mentioned, with lack of ownership, rapid transitions, and vertical programming limiting the scope for meaningful change. Finally, participants reported a disconnect between policy makers at the national level and realities on the ground, with poor dissemination of strategies, limited district resources, and poor consideration of local cultural contexts. Conclusions To achieve meaningful gains in women’s health in Mozambique, more focus must be placed on resolving the bottleneck that is the implementation of existing policies. Barriers to implementation exist across multiple health systems components, therefore, solutions to address them must also reach across these multiple components. A holistic approach to strengthening the health system across multiple sectors and at multiple levels is needed.

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Access to a quality healthcare among prisoners – perspectives of health providers of a prison infirmary, Ghana

International Journal of Prisoner Health ◽

10.1108/ijph-02-2019-0014 ◽

2019 ◽

Vol 15 (4) ◽

pp. 349-365

Author(s):

Terrylyna Baffoe-Bonnie ◽

Samuel Kojo Ntow ◽

Kwasi Awuah-Werekoh ◽

Augustine Adomah-Afari

Keyword(s):

Health System ◽

Healthcare System ◽

Theoretical Perspective ◽

Integrated Approach ◽

Structured Interview ◽

Health Providers ◽

Policy Makers ◽

Content Type ◽

Quality Healthcare ◽

System Factors

Purpose The purpose of this paper is to explore the influence of health system factors on access to a quality healthcare among prisoners in Ghana. Design/methodology/approach Data were gathered using different qualitative methods (interviews and participant observation) with staff of the James Camp Prison, Accra. Findings were analyzed using a framework method for the thematic analysis of the semi-structured interview data; and interpreted with the theoretical perspective of health systems thinking and innovation. Findings The study concludes that health system factors such as inadequate funding for health services, lack of skilled personnel and a paucity of essential medical supplies and drugs negatively affected the quality of healthcare provided to inmates. Research limitations/implications The limited facilities available and the sample size (healthcare workers and prison administrators) impeded the achievement of varied views on the topic. Practical implications The paper recommends the need for health policy makers and authorities of the Ghana Prison Service to collaborate and coordinate in a unified way to undertake policy analysis in an effort to reform the prisons healthcare system. Social implications The national health insurance scheme was found to be the financing option for prisoners’ access to free healthcare with supplementation from the Ghana Prison Service. The study recommends that policy makers and healthcare stakeholders should understand and appreciate the reality that the provision of a quality healthcare for prisoners is part of the entire system of healthcare service delivery in Ghana and as such should be given the needed attention. Originality/value This is one of few studies conducted on male only prisoners/prison in the context of Ghana. It recommends the need for an integrated approach to ensure that the entire healthcare system achieves set objectives in response to the primary healthcare concept.

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A systematic review of health sector responses to the coincidence of disasters and COVID-19

BMC Public Health ◽

10.1186/s12889-021-10806-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sanaz Sohrabizadeh ◽

Shiva Yousefian ◽

Amirhosein Bahramzadeh ◽

Mohammad Hossein Vaziri

Keyword(s):

Health System ◽

Descriptive Analysis ◽

Health Sector ◽

Final Analysis ◽

Lessons Learned ◽

World Health ◽

System Response ◽

Policy Makers ◽

Health Organization ◽

Abstract Screening

Abstract Background In December 2019, the Chinese city of Wuhan reported a novel pneumonia caused by COVID-19. While the COVID-19 pandemic has been increasingly affecting the world, the occurrence of disasters resulted in complex emergencies. The present review is aimed to identify the literature focused on health system response to coincidence of COVID-19 and disasters as well as describing their finding, implications and lessons-learned. Methods This study was conducted and reported based on PRISMA guideline. The databases of Web of Sciences, PubMed, Scopus, Google Scholar and World Health Organization Library were searched. The inclusion criteria were all forms of published articles which investigated the coincidence of disasters and COVID-19 pandemic. Using the title and abstract screening, the selections of studies were performed by two researchers. Once, the relevant papers were finalized, the analysis was done in two parts of descriptive analysis and implications for health systems. Results Out of 1245 studies generated by initial search, a number of 13 articles was selected for final analysis. Earthquake was the most frequent disaster which its coincidence with COVID-19 was studied by researchers (31%). The implications of researchers for healthcare system were explained in three sections of climatic events, earthquakes and all hazard approach in relation to COVID-19. Conclusion Extracting the lessons learned from the regions affected by disasters at the time of COVID-19 pandemic can be helpful for healthcare professionals and policy-makers to improve their preparedness and response during disasters and a serious pandemic such as COVID-19. Further research is needed to identify the factors which strengthen the preparedness of health system for the dual risk of natural hazards and pandemics.

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Challenges and lessons learned in promoting adoption of standardized local public health service delivery data through the application of the Public Health Activities and Services Tracking model

Journal of the American Medical Informatics Association ◽

10.1093/jamia/ocz160 ◽

2019 ◽

Vol 26 (12) ◽

pp. 1660-1663

Author(s):

Betty Bekemeier ◽

Seungeun Park ◽

Greg Whitman

Keyword(s):

Public Health ◽

Service Delivery ◽

Health System ◽

Public Health System ◽

Local Level ◽

Data Access ◽

Lessons Learned ◽

Standardized Measures ◽

The Public ◽

Tracking Model

Abstract Population-level prevention activities are often publicly invisible and excluded in planning and policymaking. This creates an incomplete picture of prevention service-related inputs, particularly at the local level. We describe the process and lessons learned by the Public Health Activities and Services Tracking team in promoting adoption of standardized service delivery measures developed to assess public health inputs and guide system transformations. The 3 factors depicted in our Public Health Activities and Services Tracking model—data need and use, data access, and standardized measures—must be realized to promote collection of standard public health system data. Bureaucratic, resource, system, and policy challenges hampered our efforts toward adoption of the standardized measures we promoted. Substantial investments of time, resources, and coordination appear necessary for systems to adopt changes needed for collecting comparable service delivery data. Lessons from our process of promoting adoption of standardized measures provide recommendations to support future efforts to measure public health system contributions to the public’s health.

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Coping With Hurricane Matthew: Lessons Learned on the Importance of Relationships

Innovation in Aging ◽

10.1093/geroni/igaa057.318 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 96-97

Author(s):

Allison Gibson ◽

Ethan Engelhardt ◽

Erin Murphy

Keyword(s):

Social Capital ◽

Natural Disasters ◽

Ethnic Minorities ◽

Low Income ◽

Lessons Learned ◽

Main Theme ◽

Theory Approach ◽

Structured Interviews ◽

Older Populations ◽

Racial Ethnic

Abstract The effects of natural disasters are daunting among older populations, especially those with intersecting vulnerable social locations, such as low-income aging racial/ethnic minorities. Yet, there is a paucity of literature on these experiences. The purpose of this study was to explore the experiences of this population before and during the 2016’s Hurricane Matthew. Using a modified grounded theory approach, study participants were recruited through a snowball method and through flyers that were posted throughout affected communities. Semi-structured interviews were used in this study. The analysis focused on the identification of themes. The study aimed to gain knowledge of the experiences of 15 aging minorities with Hurricane Matthew (n=15). The sample was primarily 73.3% females, with a mean age of 69, and of racial/ethnic minorities (53.3% Black and 46.7% Hispanic). All participants self-identified as low-income. The main theme that emerged from this study on how low-income aging minorities cope with natural disasters was the reliance on social capital and the importance of human relationships. The results suggest that in the context of having low-income, aging minority rely on a range of support. Some support came through information and tangible help they received from family, friends, church community, and neighbors. Bridging social capital came from federal and non-profit agencies as well as help received from their employers. Pre-disaster planning should focus on supporting older populations in building social capital. This may be especially beneficial for low-income, aging minority, who may lack adequate financial resources on which to rely.

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22.F. Workshop: What makes for resilient health systems? Evidence from the State of Health in the EU country profiles

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.1092 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

◽

Keyword(s):

Health System ◽

Health Systems ◽

Building Blocks ◽

The State ◽

Lessons Learned ◽

Three Dimensions ◽

Health System Strengthening ◽

New Work ◽

State Of Health ◽

The Eu

Abstract The European Commission's State of Health in the EU (SoHEU) initiative aims to provide factual, comparative data and insights into health and health systems in EU countries. The resulting Country Health Profiles, published every two years (current editions: November 2019) are the joint work of the European Observatory on Health Systems and Policies and the OECD, in cooperation with the European Commission. They are designed to support the efforts of Member States in their evidence-based policy making and to contribute to health care systems' strengthening. In addition to short syntheses of population health status, determinants of health and the organisation of the health system, the Country Profiles provide an assessment of the health system, looking at its effectiveness, accessibility and resilience. The idea of resilient health systems has been gaining traction among policy makers. The framework developed for the Country Profiles template sets out three dimensions and associated policy strategies and indicators as building blocks for assessing resilience. The framework adopts a broader definition of resilience, covering the ability to respond to extreme shocks as well as measures to address more predictable and chronic health system strains, such as population ageing or multimorbidity. However, the current framework predates the onset of the novel coronavirus pandemic as well as new work on resilience being done by the SoHEU project partners. This workshop aims to present resilience-enhancing strategies and challenges to a wide audience and to explore how using the evidence from the Country Profiles can contribute to strengthening health systems and improving their performance. A brief introduction on the SoHEU initiative will be followed by the main presentation on the analytical framework on resilience used for the Country Profiles. Along with country examples, we will present the wider results of an audit of the most common health system resilience strategies and challenges emerging from the 30 Country Profiles in 2019. A roundtable discussion will follow, incorporating audience contributions online. The Panel will discuss the results on resilience actions from the 2019 Country Profiles evidence, including: Why is resilience important as a practical objective and how is it related to health system strengthening and performance? How can countries use their resilience-related findings to steer national reform efforts? In addition, panellists will outline how lessons learned from country responses to the Covid-19 pandemic and new work on resilience by the Observatory (resilience policy briefs), OECD (2020 Health at a Glance) and the EC (Expert Group on Health Systems Performance Assessment (HSPA) Report on Resilience) can feed in and improve the resilience framework that will be used in the 2021 Country Profiles. Key messages Knowing what makes health systems resilient can improve their performance and ability to meet the current and future needs of their populations. The State of Health in the EU country profiles generate EU-wide evidence on the common resilience challenges facing countries’ health systems and the strategies being employed to address them.

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