Balancing safety and good care in the context of infectious disease outbreaks: learning health systems for infection prevention and control in Uganda

在传染病爆发的情况下平衡安全和良好护理：学习乌干达感染预防和控制的卫生系统

• 批准号: MR/V015192/1
• 负责人: Georgina Pearson
• 金额: $ 33.28万
• 依托单位: Queen Margaret University
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2022
• 资助国家: 英国
• 起止时间: 2022 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FV015192%2F1
• 关键词: Balancing; safety; good; care; context

Learning from the responses and experiences of people and institutions that have undergone infectious disease (ID) outbreaks in the past is a critical yet neglected aspect of preparing for current and future epidemics. In resource poor and fragmented health systems experiencing ID outbreaks including Coronavirus disease, health care workers (HCW) respond to the demands of global standards for infection prevention control (IPC) within the locally specific contextual constraints and conditions. They must also balance the need to provide good care for patients alongside safety measures to protect patients and themselves from infection. Set in Uganda, a country that has experienced multiple ID outbreaks in recent decades, this project examines how IPC measures are implemented in the context of care relations in health facilities and communities. Our aim is to contribute to strengthening the health systems capacity to draw on past and existing information and experiences of preparing for, and responding to, epidemic outbreaks, both during and beyond the COVID-19 crisis. We draw on methods from policy research, anthropology and geography to examine the implementation of IPC measures within the broader context of historical, geographic, and social distances that characterise provision of care in two contrasting regions of Uganda. First, we employ documentary analysis methods alongside key informant interviews and life history methods to examine the influence of past ID outbreaks on current ideas and practices of IPC in health facilities and communities. Second, we use interviews, observations, and participatory mapping techniques to examine how physical barrier and distancing methods relate to social, professional, and geographic hierarchies of care provision. Through these methods, we will also elicit how formal and informal caregivers attend to care needs and mitigate risk and safety in the context of ID outbreaks including COVID-19. Third, we will summarise data in textual and visual forms to share it in a series of consultation workshops with stakeholders. These participatory exchanges aim to assess where and how health care workers and communities' experiences of providing care in the context of ID outbreaks can be usefully integrated into current IPC and health systems strengthening initiatives. Working with relevant stakeholders at national and regional level, our project aims to deliver insights that can inform health protection practices and protocols, optimise safe and compassionate care for vulnerable populations, and strengthen capacity of the health system for future epidemic preparedness both within and beyond Uganda's borders.

从过去经历过传染病暴发的人和机构的反应和经验中学习，是为当前和未来流行病做准备的一个关键但又被忽视的方面。在经历包括冠状病毒病在内的传染病暴发的资源贫乏和分散的卫生系统中，卫生保健工作者（HCW）在当地特定的环境限制和条件下应对感染预防控制（IPC）全球标准的要求。他们还必须在为患者提供良好护理的需要与保护患者和自己免受感染的安全措施之间取得平衡。该项目以乌干达为背景，该国家近几十年来经历了多次艾滋病疫情，研究如何在卫生设施和社区的护理关系背景下实施IPC措施。我们的目标是促进加强卫生系统的能力，利用过去和现有的信息和经验，在2019冠状病毒病危机期间和之后防备和应对流行病暴发。我们利用政策研究、人类学和地理学的方法，在更广泛的历史、地理和社会距离背景下检查IPC措施的实施情况，这些背景是乌干达两个截然不同地区提供护理的特征。首先，我们采用文献分析方法、关键信息者访谈和生活史方法来检查过去的传染病暴发对卫生机构和社区目前的IPC理念和做法的影响。其次，我们使用访谈、观察和参与式绘图技术来研究物理障碍和距离方法与护理提供的社会、专业和地理等级之间的关系。通过这些方法，我们还将了解在包括COVID-19在内的疫情暴发背景下，正式和非正式护理人员如何满足护理需求，并降低风险和安全。第三，我们将以文本和视觉形式总结数据，并在与利益相关者的一系列咨询研讨会上分享。这些参与性交流旨在评估在何处以及如何将卫生保健工作者和社区在疫情背景下提供护理的经验有效地纳入当前的IPC和卫生系统加强行动。我们的项目与国家和地区层面的相关利益攸关方合作，旨在提供见解，为健康保护实践和协议提供信息，优化对弱势群体的安全和富有同情心的护理，并加强卫生系统在乌干达境内外的未来流行病防范能力。