Anton Breinl Research Centre for Health Systems Strengthening, James Cook University, Townsville, QLD, Australia.
Atoifi Health Research Group, Atoifi Adventist Hospital, Malaita, Solomon Islands.
Front Public Health. 2020 Sep 16;8:507. doi: 10.3389/fpubh.2020.00507. eCollection 2020.
Health systems in the Asia-Pacific region are poorly prepared for pandemic threats, particularly in rural/provincial areas. Yet future emerging infectious diseases are highly likely to emerge in these rural/provincial areas, due to high levels of contact between animals and humans (domestically and through agricultural activities), over-stretched and under-resourced health systems, notably within the health workforce, and a diverse array of socio-cultural determinants of health. In order to optimally implement health security measures at the frontline of health services where the people are served, it is vital to build capacity at the local district and facility level to adapt national and global guidelines to local contexts, including health systems, and community and socio-cultural realities. During 2017/18 James Cook University (JCU) facilitated an implementation research training program (funded by Australian Department of Foreign Affairs and Trade) for rural/provincial and regional health and biosecurity workers and managers from Fiji, Indonesia, Papua New Guinea (PNG), Solomon Islands and Timor-Leste. This training was designed so frontline health workers could learn research in their workplace, with no funding other than workplace resources, on topics relevant to health security in their local setting. The program, based upon the WHO-TDR Structured Operational Research and Training IniTiative (SORT-IT) consists of three blocks of teaching and a small, workplace-based research project. Over 50 projects by health workers including surveillance staff, laboratory managers, disease control officers, and border security staff included: analysis and mapping of surveillance data, infection control, IHR readiness, prevention/response and outbreak investigation. Policy briefs written by participants have informed local, provincial and national health managers, policy makers and development partners and provided on-the-ground recommendations for improved practice and training. These policy briefs reflected the socio-cultural, health system and disease-specific realities of each context. The information in the policy briefs can be used collectively to assess and strengthen health workforce capacity in rural/provincial areas. The capacity to use robust but simple research tools for formative and evaluative purposes provides sustainable capacity in the health system, particularly the rural health workforce. This capacity improves responses to infectious diseases threats and builds resilience into fragile health systems.
亚太地区的卫生系统对大流行威胁的准备不足，特别是在农村/省级地区。然而，由于人与动物之间（在国内和通过农业活动）的接触水平很高，卫生系统过度紧张且资源不足，尤其是在卫生工作者方面，以及多样化的卫生保健社会文化决定因素，未来新出现的传染病很可能在这些农村/省级地区出现。为了在人民服务的卫生服务第一线最佳实施卫生安全措施，必须在地方地区和设施一级建设能力，以便将国家和全球准则适应当地情况，包括卫生系统以及社区和社会文化现实。2017/18 年期间，詹姆斯·库克大学（JCU）为斐济、印度尼西亚、巴布亚新几内亚（巴新）、所罗门群岛和东帝汶的农村/省级和地区卫生和生物安全工作者和管理人员提供了一个实施研究培训方案（由澳大利亚外交贸易部资助）。该培训旨在使一线卫生工作者能够在工作场所学习研究，除了工作场所资源外，无需任何资金，研究与其当地环境中的卫生安全相关的主题。该方案基于世界卫生组织-TDR 结构操作性研究和培训倡议（SORT-IT），由三个教学模块和一个基于工作场所的小型研究项目组成。50 多个卫生工作者的项目，包括监测人员、实验室管理人员、疾病控制官员和边境安全人员，包括：监测数据的分析和制图、感染控制、《国际卫生条例》准备情况、预防/应对和疫情调查。参与者撰写的政策简报为地方、省级和国家卫生管理人员、政策制定者和发展伙伴提供了信息，并为改进实践和培训提供了实地建议。这些政策简报反映了每个背景下的社会文化、卫生系统和疾病特异性现实。政策简报中的信息可用于集体评估和加强农村/省级地区的卫生人力能力。利用稳健但简单的研究工具进行形成性和评价性目的的能力为卫生系统，特别是农村卫生工作者提供了可持续的能力。这种能力提高了对传染病威胁的应对能力，并使脆弱的卫生系统具有弹性。
