Integrating laboratory networks, surveillance systems and public health institutes in Africa

The Ebola outbreak in West Africa underlined the urgent need for integration of public health systems, including the establishment of national laboratory networks, surveillance systems, and health research institutions at all levels of service delivery. The integration schema presented here would assist in driving the immediate steps needed for integration of public health systems, particularly laboratory networks, in support of the implementation of International Health Regulations and the Global Health Security Agenda in the African region. Increased funding, political willingness from countries, and coordination through enhanced technical assistance from international partners, are critical in achieving this objective.

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Adequacy of Existing Surveillance Systems to Monitor Racism, Social Stigma and COVID Inequities: A Detailed Assessment and Recommendations

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182413099 ◽

2021 ◽

Vol 18 (24) ◽

pp. 13099

Author(s):

Chandra L. Ford ◽

Bita Amani ◽

Nina T. Harawa ◽

Randall Akee ◽

Gilbert C. Gee ◽

...

Keyword(s):

Public Health ◽

Critical Race Theory ◽

Real Time ◽

Health Systems ◽

Social Stigma ◽

Evaluation Criteria ◽

Surveillance Systems ◽

Related Factors ◽

Public Health Systems ◽

Detailed Assessment

The populations impacted most by COVID are also impacted by racism and related social stigma; however, traditional surveillance tools may not capture the intersectionality of these relationships. We conducted a detailed assessment of diverse surveillance systems and databases to identify characteristics, constraints and best practices that might inform the development of a novel COVID surveillance system that achieves these aims. We used subject area expertise, an expert panel and CDC guidance to generate an initial list of N > 50 existing surveillance systems as of 29 October 2020, and systematically excluded those not advancing the project aims. This yielded a final reduced group (n = 10) of COVID surveillance systems (n = 3), other public health systems (4) and systems tracking racism and/or social stigma (n = 3, which we evaluated by using CDC evaluation criteria and Critical Race Theory. Overall, the most important contribution of COVID-19 surveillance systems is their real-time (e.g., daily) or near-real-time (e.g., weekly) reporting; however, they are severely constrained by the lack of complete data on race/ethnicity, making it difficult to monitor racial/ethnic inequities. Other public health systems have validated measures of psychosocial and behavioral factors and some racism or stigma-related factors but lack the timeliness needed in a pandemic. Systems that monitor racism report historical data on, for instance, hate crimes, but do not capture current patterns, and it is unclear how representativeness the findings are. Though existing surveillance systems offer important strengths for monitoring health conditions or racism and related stigma, new surveillance strategies are needed to monitor their intersecting relationships more rigorously.

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Challenges of healthcare delivery in the context of COVID-19 pandemic in Sub-Saharan Africa

Iberoamerican Journal of Medicine ◽

10.53986/ibjm.2020.0018 ◽

2020 ◽

Vol 2 (2) ◽

pp. 100-109

Author(s):

Bamidele Johnson Alegbeleye ◽

◽

Rana Kadhim Mohammed ◽

Keyword(s):

Public Health ◽

Health Systems ◽

Healthcare Delivery ◽

Sub Saharan Africa ◽

African Countries ◽

Health Security ◽

Public Health Systems ◽

Public Health Infrastructure ◽

Health Infrastructure ◽

Sub Saharan

Introduction: Public health security is concerned with infection prevention and control worldwide. These measures are the concern of all and sundry to ensure prevention of any outbreaks of diseases that has epidemic potential. Africa may be uniquely positioned to have the most severe and under-detected outcomes related to COVID-19 infection. This article seeks to highlight such challenges of healthcare delivery systems in the context of the COVID-19 pandemic in sub-Saharan Africa. The communique also suggests possible strategies for improvement in such settings. Method: We identified relevant articles to date using a manual library search, journal publications on the subject, and critically reviewed them. Results: We identified and exhaustively discussed the main limitations to public health security in sub-Saharan Africa as follows i) Continuing deterioration of the public health infrastructure for disease control, ii) The changing outlooks of contagious diseases, iii) Private sector reforms like the managed care, iv) Relatively weak health care systems, and v) Poor organizational structures. Conclusion: Most Africans are eager to see the desired transformation in our public health systems. Unfortunately, the political will to invest in public health infrastructure is lacking. Also, the system is characterized by human resources shortage and diverted resources, which significantly impacted the provision for emerging COVID-19 pandemic –related care. Interestingly the monumental breakthroughs in research development for bio-therapeutics and vaccines in African countries appear a mirage even with extensive past study experience with such products from China and the Western world. Finally, notwithstanding these challenges in our public health systems as elaborated, the facts are that enormous capacities exist that can be harnessed in African countries for the COVID-19 preparedness and response.

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Cracks in the System: The Effects of the Coronavirus Pandemic on Public Health Systems

The American Review of Public Administration ◽

10.1177/0275074020941667 ◽

2020 ◽

Vol 50 (6-7) ◽

pp. 455-466 ◽

Cited By ~ 1

Author(s):

Kate Tulenko ◽

Dominique Vervoort

Keyword(s):

Public Health ◽

United States ◽

Health Systems ◽

Disease Outbreaks ◽

State Level ◽

The United States ◽

Public Health Services ◽

Health Security ◽

Public Health Systems ◽

The Impact

The novel coronavirus disease 2019 (COVID-19) pandemic has rapidly wrought havoc on the world, exposing the gaps in public health systems of countries that were previously considered most prepared for infectious disease outbreaks. Notably, despite being ranked highest on the Global Health Security Index, the United States has been severely hit with nearly two million confirmed cases and one hundred thousand deaths by the end of May 2020. In addition to the public health fragmentation from the federal to the state level and lagging regulations, early reports highlight substantial socioeconomic disparities and health system barriers contributing to the spread and impact of the pandemic in the United States. In this review, we explore the impact of COVID-19 on public health systems by assessing systems through the lens of the Centers for Disease Control and Prevention’s Ten Essential Public Health Services. Building on prepandemic and COVID-19 observations and lessons, we propose recommendations moving forward to prepare for future waves and other disease outbreaks.

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Developing a National Public Health Laboratories Policy and Strategy

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.254 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

J Boncy

Keyword(s):

Public Health ◽

National Laboratory ◽

International Health ◽

Action Planning ◽

Policy Formation ◽

The European Union ◽

Important Lesson ◽

Health Security ◽

National Network ◽

Policy And Strategy

Abstract With the support of the European Union, the National Laboratory for Public Health and partners did an analysis of the primary healthcare and hospital laboratories in health facilities and identified strengths and weaknesses of the national network of public health laboratories. With that knowledge the LNSP developed in a participatory way a new national Laboratory Policy and thereafter a Strategic Plan 2019 - 2024 that guides the country in strengthening the labs at all levels. This is very much needed as Haiti still suffers of high levels of malaria, tuberculosis, HIV and other infectious diseases. The policy fits in the international Health Security Agenda. Most important lesson learned: by a systematic step by step process of analysis, policy formation and action planning, a research institute can - with support of stakeholders - make an impact on policies and practices.

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Implementing extreme weather event advice and guidance in English public health systems

Journal of Public Health ◽

10.1093/pubmed/fdw094 ◽

2016 ◽

Author(s):

Jonathan Wistow ◽

Sarah Curtis ◽

Angie Bone

Keyword(s):

Public Health ◽

Health Systems ◽

Extreme Weather ◽

Extreme Weather Event ◽

Weather Event ◽

Public Health Systems

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Maternal health services in China’s western rural areas: uptake and correlates

China Agricultural Economic Review ◽

10.1108/caer-12-2014-0148 ◽

2016 ◽

Vol 8 (2) ◽

Cited By ~ 5

Author(s):

Chengfang Liu ◽

Linxiu Zhang ◽

Yaojiang Shi ◽

Huan ZHOU ◽

Alexis Medina ◽

...

Keyword(s):

Public Health ◽

Maternal Health ◽

Health Services ◽

Health Systems ◽

Uptake Rate ◽

Rural Areas ◽

Design Methodology ◽

Maternal Health Services ◽

Western China ◽

Public Health Systems

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.

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