Incident Management Systems Are Essential for Effective Coordination of Large Disease Outbreaks: Perspectives from the Coordination of the Ebola Outbreak Response in Sierra Leone
Incident Management Systems Are Essential for Effective Coordination of Large Disease Outbreaks: Perspectives from the Coordination of the Ebola Outbreak Response in Sierra Leone
复制标题
DOI：
10.3389/fpubh.2016.00254
复制
发表时间：
2016-11-21
影响因子：
5.2
通讯作者：
Dafae, Foday Mohamed
中科院分区：
文献类型：
--
作者：
Olu, Olushayo Oluseun;Lamunu, Margaret;Dafae, Foday Mohamed
背景：2014-2015年塞拉利昂埃博拉病毒病疫情的应对超出了国家控制能力，需要大规模的国际应对和强有力的协调平台。因此，塞拉利昂政府在国际人道主义社会的支持下，建立并实施了国家协调疫情的各种模式。在这篇文章中，我们回顾了塞拉利昂埃博拉病毒病疫情应对协调系统的优势和局限性，并提出了改进未来类似疫情协调的建议。结论：疫情协调主要采用两种框架；紧急行动中心（EOC）和国家埃博拉应对中心（NERC）。我们观察到，随着管理机制从EOC演变为NERC，疫情协调有所改善。两种协调制度各有优缺点；然而，NERC的协调机制似乎更为健全。我们确定了挑战，如众多协调小组之间的竞争和重复工作，资源动员缓慢，NERC/EOC工作人员卫生协调能力不足，以及过于集中的协调和决策系统，这些是疫情期间的主要协调挑战。建议：我们建议建立以简单的事件管理系统为基础的疫情前协调、政府强有力的领导、协调系统的分散化、职能向疫情中心转移、明确各级角色和职责、定期培训主要协调领导人、加强社区参与等方式，作为改善未来疾病疫情协调的方法。
Background: Response to the 2014-2015 Ebola virus disease (EVD) outbreak in Sierra Leone overwhelmed the national capacity to contain it and necessitated a massive international response and strong coordination platform. Consequently, the Sierra Leone Government, with support of the international humanitarian community, established and implemented various models for national coordination of the outbreak. In this article, we review the strengths and limitations of the EVD outbreak response coordination systems in Sierra Leone and propose recommendations for improving coordination of similar outbreaks in the future.Conclusion: There were two main frameworks used for the coordination of the outbreak; the Emergency Operation Center (EOC) and the National Ebola Response Center (NERC). We observed an improvement in outbreak coordination as the management mechanism evolved from the EOC to the NERC. Both coordination systems had their advantages and disadvantages; however, the NERC coordination mechanism appeared to be more robust. We identified challenges, such as competition and duplication of efforts between the numerous coordination groups, slow resource mobilization, inadequate capacity of NERC/EOC staff for health coordination, and an overtly centralized coordination and decision-making system as the main coordination challenges during the outbreak.Recommendations: We recommend the establishment of EOCs with simple incident management system-based coordination prior to outbreaks, strong government leadership, decentralization of coordination systems, and functions to the epicenter of outbreaks, with clear demarcation of roles and responsibilities between different levels, regular training of key coordination leaders, and better community participation as methods to improve coordination of future disease outbreaks.