Thinking differently: lessons learned by international public health specialists while supporting the Integrated Disease Surveillance and Response system in Pakistan.
Thinking differently: lessons learned by international public health specialists while supporting the Integrated Disease Surveillance and Response system in Pakistan.
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DOI：
10.1136/bmjgh-2020-003593
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发表时间：
2020-10
影响因子：
8.1
通讯作者：
Cartwright C
中科院分区：
文献类型：
--
作者：
Wilson A;Cartwright C
近年来，国际支持的旨在建设公共卫生能力和提高对《国际卫生条例（2005）》遵守情况的活动，使各国能够更好地“预防、防范、控制疾病的国际传播并提供公共卫生应对措施”，这些活动产生了积极影响。然而，尽管技术指导、工具和路线图不断涌现，正如最近的 COVID-19 紧急情况所表明的那样，重大挑战仍然存在。人们日益认识到，各国内部独特而复杂的环境是系统强化活动要取得成功需要更多考虑的一个因素。本文反思并概述了作者努力支持巴基斯坦政府改善对国际卫生条例的遵守情况的历程，特别是通过加强其综合疾病监测和应对 (IDSR) 系统。为了实现变革，公共卫生技术专家将他们扎实的技术和科学专业知识以及较软的公共卫生技能（包括建立关系和多部门工作等）结合起来。根据作者的经验，花时间建立和维持牢固的信任关系和同伴支持的重要性一直是成功的关键。这种关系的性质和持续的反思性对话使得能够共同构建背景环境的现实，这反过来又导致对 IDSR 所需系统的更现实的愿景，因此能够提供更合适的定制技术支持，从而设计和初步实施一个考虑到可持续性而开发的国家拥有的系统。
Internationally supported activities to build public health capacity and improve compliance with International Health Regulations (2005) so that countries are better able to ‘prevent, protect against, control and provide a public health response to the international spread of disease’ have had a positive impact in recent years. However, despite the proliferation of technical guidance, tools and roadmaps, as the recent COVID-19 emergency demonstrates, a significant challenge still remains. The unique and complex environment within countries is increasingly being recognised as a factor which needs greater consideration if system strengthening activities are to be successful. This paper reflects on the learning from and charts out the journey of the authors’ in their efforts to support the Pakistan government to improve compliance with International Health Regulations, specifically through strengthening its Integrated Disease Surveillance and Response (IDSR) system. To effect change, public health technical specialists bring their grounded technical and scientific expertise along with their softer public health skills of, among other things, relationship building and multisector working. In the authors’ experience, the importance of taking time throughout to build and maintain strong trusted relationships and peer-to-peer support has been the key to the successes experienced. The nature of this relationship and ongoing reflexive dialogue enabled the co-construction of the reality of the background environment, which, in turn, led to more realistic visioning of the desired system for IDSR, and therefore more appropriate bespoke technical support to be given, leading to the design and initial implementation of a country owned system developed with sustainability in mind.
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