A systems approach to examining health sector responses to cholera epidemics in Kenya

检查肯尼亚卫生部门应对霍乱疫情的系统方法

• 批准号: MR/T022078/1
• 负责人: Gilbert Kokwaro
• 金额: $ 20.37万
• 依托单位: Strathmore University
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2020
• 资助国家: 英国
• 起止时间: 2020 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FT022078%2F1
• 关键词: systems; approach; examining; health; sector

Simple SummaryKenya has experienced an increased disease burden due to cholera outbreaks characterized by continuous transmission in the refugee camp settings of Garissa and Turkana, and sporadic transmission in cities such as Nairobi and Mombasa. However, while inquiry has been made regarding how the health sector has responded to and how populations have been impacted by epidemics such as cholera, not enough attention has been paid to causal relationships between the unique components of the health systems leading to an inadequate understanding of how the building blocks of the health systems interact in disease surveillance and epidemic response. Consequently, this research effort focuses on examining the health sector responses to these epidemics, developing a systems-theory-based description of the said responses, and based on the results, provide recommendations that may help break the epidemic's continuous and cyclical nature. The study will be conducted in Turkana and Garissa in Kenya, as well as in Nairobi. These are counties that have diverse levels of health system sophistication and recent experiences of cholera epidemics. Moreover, the study draws on several systems analytic frameworks to determine the actors and their decisions, as well as their inter-relationships, linkages and dependencies. Thus, the study appropriates systems-oriented research techniques and applies them in a novel fashion to the assessment of health service delivery. The findings of this study are expected to guide interventions aimed at improving disease surveillance and epidemic response. The study will also act as a primer for the research community by assessing the utility of systems-thinking approaches in such settings, and subsequently opening a related research agenda.

简单总结 由于霍乱疫情，肯尼亚的疾病负担增加，其特点是在加里萨和图尔卡纳难民营环境中持续传播，在内罗毕和蒙巴萨等城市出现零星传播。然而，虽然人们对卫生部门如何应对以及人口如何受到霍乱等流行病的影响进行了调查，但对卫生系统独特组成部分之间的因果关系没有给予足够的重视，导致对卫生系统的组成部分在疾病监测和流行病应对中如何相互作用的了解不足。因此，这项研究工作的重点是检查卫生部门对这些流行病的反应，对上述反应进行基于系统理论的描述，并根据结果提供可能有助于打破流行病的持续性和周期性的建议。该研究将在肯尼亚的图尔卡纳和加里萨以及内罗毕进行。这些县的卫生系统复杂程度各不相同，最近也经历过霍乱流行。此外，该研究利用了几个系统分析框架来确定参与者及其决策，以及它们的相互关系、联系和依赖性。因此，该研究采用了面向系统的研究技术，并以一种新颖的方式将其应用于卫生服务提供的评估。这项研究的结果预计将指导旨在改善疾病监测和流行病应对的干预措施。该研究还将通过评估系统思维方法在此类环境中的效用，并随后开启相关的研究议程，作为研究界的入门读物。