Beyond the crisis: did the Ebola epidemic improve resilience of Liberia's health system?
Beyond the crisis: did the Ebola epidemic improve resilience of Liberia's health system?
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DOI：
10.1093/heapol/czx109
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发表时间：
2017-11-01
影响因子：
3.2
通讯作者：
Kruk, Margaret E.
中科院分区：
文献类型：
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作者：
Ling, Emilia J.;Larson, Elysia;Kruk, Margaret E.
在2014-15年西非埃博拉疫情之后，韧性被广泛认为是强大的卫生系统的关键属性。在利比里亚、塞拉利昂和几内亚，控制疾病的努力和许多卫生服务的暂停表明，卫生系统必须在危机发生之前很久就为复原力做好计划。然而，复原力的操作要素以及危机经历塑造复原力的方式在文献中没有得到很好的描述。为了了解卫生系统如何适应危机，以及不同卫生系统行为者的优先事项如何影响这种反应，我们于2015年7月至9月，即利比里亚首次宣布无埃博拉病毒几个月后，对利比里亚的全球、国家和当地受访者进行了采访(n=108)。我们发现，在疫情期间，全球和国家行为者优先考虑的卫生系统复原力职能比社区领导人和地方卫生行为者重视的职能得到了更大程度的改善。尽管埃博拉疫情刺激了利比里亚卫生系统的一些积极适应，但建立一个真正有弹性的卫生系统将需要在危机之后很长一段时间内进行长期投资和持续关注。
Resilience was widely identified as a critical attribute for strong health systems following the 2014-15 West Africa Ebola epidemic. In Liberia, Sierra Leone and Guinea, struggles to control the disease and suspension of the operation of many health services demonstrated that health systems must plan for resilience long before a crisis. However, the operational elements of resilience and ways that a crisis experience can shape resilience are not well described in the literature. To understand how a health system adapts to crisis and how the priorities of different health system actors influence this response we conducted interviews with global, national, and local respondents in Liberia between July and September 2015 (n = 108), several months after the country was first declared Ebola-free. We found that health system resilience functions prioritized by global and national actors improved to a greater extent than those valued by community leaders and local health actors over the course of the epidemic. Although the Ebola epidemic stimulated some positive adaptations in Liberia's health system, building a truly resilient health system will require longer-term investments and sustained attention long beyond the crisis.