A qualitative study examining the health system's response to COVID-19 in Sierra Leone.
A qualitative study examining the health system's response to COVID-19 in Sierra Leone.
复制标题
DOI：
10.1371/journal.pone.0294391
复制
发表时间：
2024
期刊：
影响因子：
3.7
通讯作者：
中科院分区：
文献类型：
--
作者：
本文考察了塞拉利昂卫生系统应对COVID-19的情况。它旨在探讨大流行如何影响服务提供、卫生工作者、患者获得服务、领导和治理。它还审查了2013 - 2016年埃博拉疫情的遗留问题在多大程度上影响了COVID-19应对和公众认知。利用世卫组织卫生系统构建模块框架，我们在塞拉利昂开展了一项定性研究，在2020年10月至12月期间对卫生工作者、政策制定者和患者进行了半结构化访谈。我们使用演绎和归纳方法应用主题分析。分析产生了12个主题：9个关于世卫组织的基本要素，2个关于患者的经历，1个关于埃博拉。我们发现常规服务受到加强感染预防控制措施的影响。卫生工作者面临着更多的责任和培训需求。据报告，设施内的沟通和决策是协调和有效的，尽管缺乏从国家一级到设施一级的最新情况。与以往严重受国际组织影响的突发卫生事件不同，我们发现COVID-19的应对工作是由国家领导层主导的。埃博拉的经历使他们减少了对COVID-19的恐惧，并加深了对公共卫生措施的了解。然而，这些措施也对患者的生计和就诊意愿产生了负面影响。我们的结论是，重要的是要解决卫生系统中现有的挑战，例如影响卫生系统应对突发事件能力的资源。优先考虑保健工作者的福祉和继续提供基本的常规保健服务是很重要的。在采取措施之前，需要考虑公共卫生措施对人口的社会经济影响。
The paper examines the health system’s response to COVID-19 in Sierra Leone. It aims to explore how the pandemic affected service delivery, health workers, patient access to services, leadership, and governance. It also examines to what extent the legacy of the 2013–16 Ebola outbreak influenced the COVID-19 response and public perception. Using the WHO Health System Building Blocks Framework, we conducted a qualitative study in Sierra Leone where semi-structured interviews were conducted with health workers, policymakers, and patients between Oct-Dec 2020. We applied thematic analysis using both deductive and inductive approaches. Twelve themes emerged from the analysis: nine on the WHO building blocks, two on patients’ experiences, and one on Ebola. We found that routine services were impacted by enhanced infection prevention control measures. Health workers faced additional responsibilities and training needs. Communication and decision-making within facilities were reported to be coordinated and effective, although updates cascading from the national level to facilities were lacking. In contrast with previous health emergencies which were heavily influenced by international organisations, we found that the COVID-19 response was led by the national leadership. Experiences of Ebola resulted in less fear of COVID-19 and a greater understanding of public health measures. However, these measures also negatively affected patients’ livelihoods and their willingness to visit facilities. We conclude, it is important to address existing challenges in the health system such as resources that affect the capacity of health systems to respond to emergencies. Prioritising the well-being of health workers and the continued provision of essential routine health services is important. The socio-economic impact of public health measures on the population needs to be considered before measures are implemented.
登录
查看更多内容
影响因子：
2.5
作者：
Pieterse, Pieternella;Lodge, Tom
通讯作者：
Lodge, Tom
影响因子：
2.7
作者：
Ilesanmi O;Afolabi A
通讯作者：
Afolabi A
影响因子：
168.9
作者：
Moon, Suerie;Sridhar, Devi;Piot, Peter
通讯作者：
Piot, Peter
影响因子：
8.1
作者：
Tsuei SH
通讯作者：
Tsuei SH
影响因子：
2.8
作者：
Bolkan, Hakon A.;van Duinen, Alex;von Schreeb, Johan
通讯作者：
von Schreeb, Johan