The link between the West African Ebola outbreak and health systems in Guinea, Liberia and Sierra Leone: a systematic review.
The link between the West African Ebola outbreak and health systems in Guinea, Liberia and Sierra Leone: a systematic review.
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DOI：
10.1186/s12992-016-0224-2
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发表时间：
2017-01-04
影响因子：
10.8
通讯作者：
Rawaf S
中科院分区：
文献类型：
--
作者：
Shoman H;Karafillakis E;Rawaf S
埃博拉疫情于2013年12月在几内亚爆发，2014年蔓延到利比里亚和塞拉利昂。这三个国家的卫生系统缺乏快速应对疫情的基础设施和准备，世界卫生组织（世卫组织）于2014年8月8日宣布国际关注的突发公共卫生事件。这项研究的目的是确定卫生系统的组织和绩效对几内亚、利比里亚和塞拉利昂西非埃博拉疫情的影响以及吸取的经验教训。世卫组织卫生系统的组成部分被用来评价这些国家卫生系统的业绩。根据PRISMA指南，对从开始到2015年7月发表的文章进行了系统综述。检索电子数据库，包括Medline、Embase、Global Health和科克伦图书馆，以查找相关文献。还通过Google Scholar和Scopus检索了灰色文献。根据一组入选和排除标准导出并选择文献。然后将数据提取到电子表格中，并进行描述性分析。每项研究均使用Crowe Critical Appraisal Tool进行批判性评价。审查还辅以专家访谈，访谈的参与者是从参考名单中确定的，并使用滚雪球法。该研究包括13篇文章，并采访了来自不同组织的6位专家。根据世卫组织卫生系统的组成部分对调查结果进行了分析。卫生工作人员的短缺对埃博拉的控制产生了重要影响，但也是疫情爆发的最大受害者。其次是信息和研究、医疗产品和技术、卫生筹资以及领导和治理。监测不力和缺乏适当的沟通也促成了疫情的爆发。缺乏可用资金妨碍了支付和购买基本资源和药品。领导和治理方面的结论最少，但总体共识是，这有助于迅速作出反应、充分协调和管理资源。确保充足和高效的卫生工作队伍对于确保强大的卫生系统和对新的疫情作出快速反应至关重要。充分的服务提供来自其他区块的集体成功。卫生筹资及其管理对于确保医疗产品的供应、支付工作人员费用和购买必要设备至关重要。然而，领导和治理需要严格探索其主要缺陷，以控制疫情。
An Ebola outbreak started in December 2013 in Guinea and spread to Liberia and Sierra Leone in 2014. The health systems in place in the three countries lacked the infrastructure and the preparation to respond to the outbreak quickly and the World Health Organisation (WHO) declared a public health emergency of international concern on August 8 2014. The aim of this study was to determine the effects of health systems’ organisation and performance on the West African Ebola outbreak in Guinea, Liberia and Sierra Leone and lessons learned. The WHO health system building blocks were used to evaluate the performance of the health systems in these countries. A systematic review of articles published from inception until July 2015 was conducted following the PRISMA guidelines. Electronic databases including Medline, Embase, Global Health, and the Cochrane library were searched for relevant literature. Grey literature was also searched through Google Scholar and Scopus. Articles were exported and selected based on a set of inclusion and exclusion criteria. Data was then extracted into a spreadsheet and a descriptive analysis was performed. Each study was critically appraised using the Crowe Critical Appraisal Tool. The review was supplemented with expert interviews where participants were identified from reference lists and using the snowball method. Thirteen articles were included in the study and six experts from different organisations were interviewed. Findings were analysed based on the WHO health system building blocks. Shortage of health workforce had an important effect on the control of Ebola but also suffered the most from the outbreak. This was followed by information and research, medical products and technologies, health financing and leadership and governance. Poor surveillance and lack of proper communication also contributed to the outbreak. Lack of available funds jeopardised payments and purchase of essential resources and medicines. Leadership and governance had least findings but an overarching consensus that they would have helped prompt response, adequate coordination and management of resources. Ensuring an adequate and efficient health workforce is of the utmost importance to ensure a strong health system and a quick response to new outbreaks. Adequate service delivery results from a collective success of the other blocks. Health financing and its management is crucial to ensure availability of medical products, fund payments to staff and purchase necessary equipment. However, leadership and governance needs to be rigorously explored on their main defects to control the outbreak.
DOI：
10.1056/nejmoa1411100
发表时间：
2014-10-16
期刊：
The New England journal of medicine
影响因子：
--
作者：
WHO Ebola Response Team;Aylward B;Barboza P;Bawo L;Bertherat E;Bilivogui P;Blake I;Brennan R;Briand S;Chakauya JM;Chitala K;Conteh RM;Cori A;Croisier A;Dangou JM;Diallo B;Donnelly CA;Dye C;Eckmanns T;Ferguson NM;Formenty P;Fuhrer C;Fukuda K;Garske T;Gasasira A;Gbanyan S;Graaff P;Heleze E;Jambai A;Jombart T;Kasolo F;Kadiobo AM;Keita S;Kertesz D;Koné M;Lane C;Markoff J;Massaquoi M;Mills H;Mulba JM;Musa E;Myhre J;Nasidi A;Nilles E;Nouvellet P;Nshimirimana D;Nuttall I;Nyenswah T;Olu O;Pendergast S;Perea W;Polonsky J;Riley S;Ronveaux O;Sakoba K;Santhana Gopala Krishnan R;Senga M;Shuaib F;Van Kerkhove MD;Vaz R;Wijekoon Kannangarage N;Yoti Z
通讯作者：
Yoti Z
影响因子：
158.5
作者：
Baize, Sylvain;Pannetier, Delphine;Guenther, Stephan
通讯作者：
Guenther, Stephan
影响因子：
3.8
作者：
Alexander KA;Sanderson CE;Marathe M;Lewis BL;Rivers CM;Shaman J;Drake JM;Lofgren E;Dato VM;Eisenberg MC;Eubank S
通讯作者：
Eubank S