Enhancing the Understanding of Resilience in Health Systems of Low- and Middle-Income Countries: A Qualitative Evidence Synthesis.
Enhancing the Understanding of Resilience in Health Systems of Low- and Middle-Income Countries: A Qualitative Evidence Synthesis.
复制标题
加强对低收入和中等收入国家卫生系统复原力的理解：定性证据综合。
DOI：
10.34172/ijhpm.2020.261
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发表时间：
2022-07-01
影响因子：
3.5
通讯作者：
Wyss, Kaspar
中科院分区：
文献类型：
--
作者：
Grimm, Pauline Yongeun;Oliver, Sandy;Merten, Sonja;Han, Wai Wai;Wyss, Kaspar
关键词：
背景：一个国家的卫生系统在受到意想不到的冲击时面临压力，比如我们在冠状病毒病2019年(新冠肺炎)大流行中观察到的情况。在这方面，复原力的概念具有很强的相关性，是卫生系统能够抵御未来冲击的先决条件。通过探讨如何应用复原力卫生系统框架的关键方面，本系统审查综合了低收入和中等收入国家复原力卫生系统的重要特征。这项审查的目的是通过更好地了解卫生系统复原力的层面、用途和影响，确定其在重大冲击背景下的相关性。方法：本综述采用最佳框架合成法。选择了先验概念框架并创建了编码框架。经系统搜索，从电子数据库和非政府组织的报告中发现了4284条独特的引文，其中12条符合纳入标准。根据预先存在的主题提取数据并进行编码。对先验框架之外的主题进行了整理，形成了一份精炼的主题清单。然后，在每项研究的背景下，使用新的主题清单重新审查了所有12项研究。结果：分析产生了10个主题。五人证实了一个先验的概念框架，它捕捉到了弹性系统的动态属性。五个新主题被确定为实现复原力的基础：重新调整的关系、作为驱动力的远见和动力，以及作为组织机制的应急准备和变革管理。结论：精炼的概念模型显示了主题如何相互联系。复原力的基础似乎对解锁复原力的动态属性至关重要，尤其是在资源有限的情况下。这一审查促使各国考虑建立这里所述的复原力基础，将其作为优先事项，以便更好地为未来的冲击做好准备。
Background: A country’s health system faces pressure when hit by an unexpected shock, such as what we observe in the midst of the coronavirus disease 2019 (COVID-19) pandemic. The concept of resilience is highly relevant in this context and is a prerequisite for a health system capable of withstanding future shocks. By exploring how the key dimensions of the resilient health system framework are applied, the present systematic review synthesizes the vital features of resilient health systems in low- and middle-income countries. The aim of this review is to ascertain the relevance of health system resilience in the context of a major shock, through better understanding its dimensions, uses and implications. Methods: The review uses the best-fit framework synthesis approach. An a priori conceptual framework was selected and a coding framework created. A systematic search identified 4284 unique citations from electronic databases and reports by non-governmental organisations, 12 of which met the inclusion criteria. Data were extracted and coded against the pre-existing themes. Themes outside of the a priori framework were collated to form a refined list of themes. Then, all twelve studies were revisited using the new list of themes in the context of each study. Results: Ten themes were generated from the analysis. Five confirmed the a priori conceptual framework that capture the dynamic attributes of a resilient system. Five new themes were identified as foundational for achieving resilience: realigned relationships, foresight and motivation as drivers, and emergency preparedness and change management as organisational mechanisms. Conclusion: The refined conceptual model shows how the themes inter-connect. The foundations of resilience appear to be critical especially in resource-constrained settings to unlock the dynamic attributes of resilience. This review prompts countries to consider building the foundations of resilience described here as a priority to better prepare for future shocks.
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影响因子：
3.2
作者：
Barasa EW;Cloete K;Gilson L
通讯作者：
Gilson L
影响因子：
7.2
作者：
Ammar, Walid;Kdouh, Ola;Zalloua, Pierre A.
通讯作者：
Zalloua, Pierre A.
影响因子：
3.2
作者：
Ling, Emilia J.;Larson, Elysia;Kruk, Margaret E.
通讯作者：
Kruk, Margaret E.
通过将国际卫生法规要求纳入国家卫生系统来加强全球卫生安全。
影响因子：
8.1
作者：
Kluge H;Martín-Moreno JM;Emiroglu N;Rodier G;Kelley E;Vujnovic M;Permanand G
通讯作者：
Permanand G
影响因子：
3.2
作者：
Barker, Kathryn M.;Ling, Emilia J.;Kruk, Margaret E.
通讯作者：
Kruk, Margaret E.