scholarly journals Investing in Operational Research Capacity Building for Front-Line Health Workers Strengthens Countries’ Resilience to Tackling the COVID-19 Pandemic

2020 ◽  
Vol 5 (3) ◽  
pp. 118
Author(s):  
Rony Zachariah ◽  
Selma Dar Berger ◽  
Pruthu Thekkur ◽  
Mohammed Khogali ◽  
Karapet Davtyan ◽  
...  

(1) Introduction. The Structured Operational Research and Training IniTiative (SORT IT) supports countries to build operational research capacity for improving public health. We assessed whether health workers trained through SORT IT were (1) contributing to the COVID-19 pandemic response and if so, (2) map where and how they were applying their SORT IT skills. (2) Methods. An online questionnaire survey of SORT IT alumni trained between 2009 and 2019. (3) Results. Of 895 SORT IT alumni from 93 countries, 652 (73%) responded to the survey and 417 were contributing to the COVID-19 response in 72 countries. Of those contributing, 307 (74%) were applying their SORT IT skills to tackle the pandemic in 60 countries and six continents including Africa, Asia, Europe, South Pacific and North/South America. Skills were applied to all the pillars of the emergency response with the highest proportions of alumni applying their skills in data generation/analysis/reporting (56%), situation analysis (55%) and surveillance (41%). Skills were also being used to mitigate the health system effects of COVID-19 on other diseases (27%) and in conducting research (26%). (4) Conclusion. Investing in people and in research training ahead of public health emergencies generates downstream dividends by strengthening health system resilience for tackling pandemics. It also strengthens human resources for health and the integration of research within health systems.

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 583
Author(s):  
Rony Zachariah ◽  
Dermot Maher ◽  
Abraham Aseffa ◽  
Mahnaz Vahedi ◽  
Pascal Launois ◽  
...  

Background:  TDR, The Special Programme for Research and Training hosted at the World Health Organization, has long supported Low- and Middle-Income Countries in strengthening research capacity through three training programmes: the Postgraduate Training Scheme (PGTS), the Clinical Research and Development Fellowship (CRDF), and the Structured Operational Research Training InitiaTive (SORT IT). In the advent of the COVID-19 pandemic, we assessed whether those trained through these programmes were involved in the COVID-19 response and if so, in which area(s) of the emergency response they were applying their skills. Methods: From the records for each training programme, we identified the individuals who had completed training during the relevant timespan of each programme: 1999-2018 for the CRDF scheme, 2015-2020 for PGTS, and 2009-2019 for SORT-IT. Between March and April 2020, we sent trainees an online questionnaire by e-mail. Results: Out of 1254 trained, 1143 could be contacted and 699 responded to the survey. Of the latter, 411 were involved with the COVID-19 response, of whom 315 (77%) were applying their acquired skills in 85 countries. With some overlap between programmes, 84% of those trained through CRDF were applying their skills in 27 countries, 91% of those trained through PGTS were applying their skills in 19 countries, and through SORT IT, this was 73% in 62 countries.  Skills were being applied in various areas of the emergency response, including: emergency preparedness, situation analysis/surveillance, infection control and clinical management, data generation, mitigating the effect of COVID on the health system, and research.  Depending on the type of training programme, 26-74% were involved in implementation, operational or clinical research. Conclusion: Research training programmes build research capacity and equip health workers with transferable core competencies and skillsets prior to epidemics. This becomes invaluable in building health system resilience at a time of pandemics.


2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Ning Feng ◽  
Jeffrey Karl Edwards ◽  
Philip Odhiambo Owiti ◽  
Guo-Min Zhang ◽  
Zulma Vanessa Rueda Vallejo ◽  
...  

Abstract Background Chinese Center for Disease Control and Prevention (China CDC) introduced the Structured Operational Research Training Initiative (SORT IT) into China to build a special capacity and equip public health professionals with an effective tool to support developing countries in strengthening their operational research. The paper aims to investigate and analyze the implementation, outcomes and challenges of the first cycle of SORT IT in China. Main text As a result of the successful implementation, SORT IT China, Cycle 1 has demonstrated fruitful outputs as exemplified by the 18-month follow-up to the post-training initiatives of the twelve participants, who all achieved the four milestones required by SORT IT. Eleven of twelve (92%) manuscripts generated that focused on the prevention and control of malaria, influenza, HIV/AIDS, hepatitis B, schistosomiasis, tuberculosis and Japanese encephalitis were published by peer-reviewed international journals with the impact factor ranging from 2.6 to 4.8. The most up-to-date citation count on February 19, 2021 was 53 times out of which 31 times were cited by Science Citation Index papers with 94.827 impact factor in total. Six senior professionals from China CDC also facilitated the whole SORT IT training scheme as co-mentors under the guidance of SORT IT mentors. The twelve participants who gained familiarity with the SORT IT courses and training principles are likely become potential mentors for future SORT IT, but they as the non-first language speakers/users of English also faced the challenge in thoroughly understanding the modules delivered in English and writing English academically to draft the manuscripts. Conclusion The outcomes from the first cycle of SORT IT in China have led to studies contributing to narrowing the knowledge gap among numerous public health challenges nationally and internationally. It is believed the researchers who participated will continue to apply the skills learned within their domain and help build the training capacity for future operational research courses both in China and in developing countries with similar needs. Graphic Abstract


F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 583
Author(s):  
Rony Zachariah ◽  
Dermot Maher ◽  
Abraham Aseffa ◽  
Mahnaz Vahedi ◽  
Pascal Launois ◽  
...  

Background:  TDR, The Special Programme for Research and Training hosted at the World Health Organization, has long supported Low- and Middle-Income Countries in strengthening research capacity through three training programmes: the Postgraduate Training Scheme (PGTS), the Clinical Research and Development Fellowship (CRDF), and the Structured Operational Research Training InitiaTive (SORT IT). In the advent of the COVID-19 pandemic, we assessed whether those trained through these programmes were involved in the COVID-19 response and if so, in which area(s) of the emergency response they were applying their skills. Methods: From the records for each training programme, we identified the individuals who had completed training during the relevant timespan of each programme: 1999-2018 for the CRDF scheme, 2015-2020 for PGTS, and 2009-2019 for SORT-IT. Between March and April 2020, we sent trainees an online questionnaire by e-mail. Results: Out of 1254 trained, 1143 could be contacted and 699 responded to the survey. Of the latter, 411 were involved with the COVID-19 response, of whom 315 (77%) were applying their acquired skills in 85 countries. With some overlap between programmes, 84% of those trained through CRDF were applying their skills in 27 countries, 91% of those trained through PGTS were applying their skills in 19 countries, and through SORT IT, this was 73% in 62 countries.  Skills were being applied in various areas of the emergency response, including: emergency preparedness, situation analysis/surveillance, infection control and clinical management, data generation, mitigating the effect of COVID on the health system, and research.  Depending on the type of training programme, 26-74% were involved in implementation, operational or clinical research. Conclusion: Research training programmes build research capacity and equip health workers with transferable core competencies and skillsets prior to epidemics. This becomes invaluable in building health system resilience at a time of pandemics.


2021 ◽  
Author(s):  
Jaideep Menon ◽  
Mathews Numpeli ◽  
Sajeev.P. Kunjan ◽  
Beena.V. Karimbuvayilil ◽  
Aswathy Sreedevi ◽  
...  

UNSTRUCTURED Abstract: India has a massive non-communicable disease (NCD) burden at an enormous cost to the individual, family, society and health system at large, in spite of which prevention and surveillance is relatively neglected. Risk factors for atherosclerotic cardiovascular disease if diagnosed early and treated adequately would help decrease the mortality and morbidity burden. India is in a stage of rapid epidemiological transition with the state of Kerala being at the forefront, pointing us towards likely disease burden and outcomes for the rest of the country, in the future. A previous study done by the same investigators, in a population of >100,000, revealed poor awareness and treatment of NCDs and also poor adherence to medicines in individuals with CVD. The investigators are looking at a sustainable, community based model of surveillance for NCDs with corporate support wherein frontline health workers check all individuals in the target group ( > age 30 years) with further follow up and treatment planned in a “spoke and hub” model using the public health system of primary health centres (PHCs) as spokes to the hubs of Taluk or District hospitals. All data entry done by frontline health workers would be on a Tab PC ensuring rapid acquisition and transfer of participant health details to PHCs for further follow up and treatment. The model will be evaluated based on the utilisation rate of various services offered at all tier levels. The proportions of the target population screened, eligible individuals who reached the spoke or hub centres for risk stratification and care and community level control for hypertension and diabetes in annual surveys will be used as indicator variables. The model ensures diagnosis and follow up treatment at no cost to the individual entirely through the tiered public health system of the state and country.


Significance Public sector doctors have been on strike since early December citing multiple grievances including pay, conditions at facilities and lack of investment in the public health system. The bitter dispute is the latest in a series of public-sector strikes and comes amid campaigning for August’s general elections. Impacts Agreeing to the strikers' full demands would add pressure for higher salaries in private facilities and the public sector. A national settlement could slow progress towards full devolution of health responsibilities to the counties. Elite segments of society do not rely on the public health system and may be less sympathetic to health workers’ grievances.


Author(s):  
Babar Tasneem Shaikh

Abstract Aim: To gauge the level of preparedness of health system of Pakistan in the wake of Corona Virus Disease 2019 (COVID-19) pandemic. Background: The global COVID-19 outbreak and its subsequent repercussions and implications, after being declared as a pandemic by the World Health Organization (WHO), exposed all the inherent, lingering, and acute shortcomings of the health systems in many developing countries and Pakistan was no exception. Methods: A detailed literature review was done which included peer-reviewed articles on COVID-19 and health system, published in local and international journals, WHO and World Bank’s publications, and the documents and official reports of the government. Focus was to glean and cite strategies adopted by the developing countries in response to COVID-19 and to see the applicability of those which are feasible for Pakistan. Findings: Level of preparedness was minimal and the response to manage the outbreak was weak. Based on toll of the cases and number of deaths, this public health threat turned out to be a catastrophe beyond the controlling authority and capacity of the health system, and hence other sectors and agencies had to be engaged for devising a concerted and integrated response to deal with the emergency. Governance was disorderly, financing was inadequate, human resources were not trained, supplies and logistic were not stocked, information system was patchy, and research capacity was limited, and most of all the service delivery was in a biggest chaos of times. COVID-19 demanded to re-configure the health system of Pakistan. Conclusion: Improving the emergency preparedness of the hospitals is the foremost and an urgent need. A strong national public health system in Pakistan is needed to rapidly investigate and analyze the reports, assess the magnitude of the public health risk, share real-time information, and implement public health control measures in a concerted and systematic demeanor.


Author(s):  
Sumit Kane ◽  
Anjali Radkar ◽  
Mukta Gadgil ◽  
Barbara McPake

Background: Over the last 20 years, community health workers (CHWs) have become a mainstay of human resources for health in many low- and middle-income countries (LMICs). A large body of research chronicles CHWs’ experience of their work. In this study we focus on 2 narratives that stand out in the literature. The first is the idea that social, economic and health system contexts intersect to undermine CHWs’ experience of their work, and that a key factor underpinning this experience is that LMIC health systems tend to view CHWs as just an ‘extra pair of hands’ to be called upon to provide ‘technical fixes.’ In this study we show the dynamic and evolving nature of CHW programmes and CHW identities and the need, therefore, for new understandings. Methods: A qualitative case study was carried out of the Indian CHW program (CHWs are called accredited social health activists: ASHAs). It aimed to answer the research question: How do ASHAs experience being CHWs, and what shapes their experience and performance? In depth interviews were conducted with 32 purposively selected ASHAs and key informants. Analysis was focused on interpreting and on developing analytical accounts of ASHAs’ experiences of being CHWs; it was iterative and occurred throughout the research. Interviews were transcribed verbatim and transcripts were analysed using a framework approach (with Nvivo 11). Results: CHWs resent being treated as just another pair of hands at the beck and call of formal health workers. The experience of being a CHW is evolving, and many are accumulating substantial social capital over time – emerging as influential social actors in the communities they serve. CHWs are covertly and overtly acting to subvert the structural forces that undermine their performance and work experience. Conclusion: CHWs have the potential to be influential actors in the communities they serve and in frontline health services. Health systems and health researchers need to be cognizant of and consciously engage with this emerging global social dynamic around CHWs. Such an approach can help guide the development of optimal strategies to support CHWs to fulfil their role in achieving health and social development goals.


2020 ◽  
Vol 3 (38) ◽  
pp. 4-9
Author(s):  
Kanat Tossekbaev ◽  
◽  
Timur Sultangaziyev ◽  

Abstract One of the most important components of strengthening the national health system is the introduction of an effective strategy for the development of human capital in the industry based on improving the status of health workers, changing the sectoral system of qualifications and their confirmation, changing approaches to the health education system, as well as improving the system of state planning for training health workers. The implementation of these measures will ensure an increase in the efficiency of human resources management in the industry, ensuring the provision of quality healthcare services. At the same time, the new sectoral policy of human resource management should be based on such principles as the availability of the necessary human resources, the proper competence of employees, integrated development of human resources, responsiveness of human resources to the needs of the population, continuous professional development, productivity of human resources, and social recognition. Key words: human resources for health, training of health workers, status of health workers


2019 ◽  
Author(s):  
Jacopo Bianchi ◽  
Chiara Milani ◽  
Angela Bechini ◽  
Sara Boccalini ◽  
Maria José Caldes Pinilla ◽  
...  

Abstract Background Because of its low cost and its capability in reducing child mortality and morbidity, vaccination is considered a successful preventive deed in Low and Middle-Income Countries. In Senegal, vaccines are provided free of charge by the public health system, but the provision of the service is not evenly distributed between and within the Regions. Our study aimed at identifying barriers and enabling factors towards vaccination in three Regions of Senegal. Methods We performed 41 face-to-face semi-structured interviews with health services’ workers and three focus groups with local women in nine different structures in three different Regions of Senegal. We combined health workers’ (HW) and mothers’ points of view with direct observation in order to fulfill our purpose. Results We identified three groups of barriers – structural, personal and psychological – and many subthemes for each of them. Structural and personal barriers such as inadequacy of health structures, shortage of HW, lack of money, distance between villages and health facilities and lack of public transport, hamper mothers from utilising the vaccination service, even when they want to. The lack of effective communication between health personnel and mothers, the lack of collaboration between traditional and conventional medicine and the lack of trust in the public health system as a whole, are major problems to the vaccination uptake too. Conclusions The interlink of several elements in conditioning vaccination coverage suggests the need of implementing global and national strategies to overcome them. The key factor is the presence of a solid health system, publicly funded, based on primary health care. On the other hand, context-specific determinants cannot be detected based on global and non-specific information. The role of community health workers (CHWs) is crucial in overcoming wrong beliefs, lack of knowledge and distrust. They must be regarded as a bridge between HW and population. CHWs should be formally included in the organization of the social-health system, adequately formed and enhanced.


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