World Health Organisation, Regional Office for Africa, Emergency Preparedness and Response Programme, Brazzaville, Congo.
World Health Organisation, Regional Office for Africa, Emergency Preparedness and Response Programme, Nairobi, Hub, Kenya.
BMC Health Serv Res. 2022 May 28;22(1):711. doi: 10.1186/s12913-022-08035-w.
This study describes the coordination mechanisms that have been used for management of the COVID 19 pandemic in the WHO AFRO region; relate the patterns of the disease (length of time between onset of coordination and first case; length of the wave of the disease and peak attack rate) to coordination mechanisms established at the national level, and document best practices and lessons learned.
We did a retrospective policy tracing of the COVID-19 coordination mechanisms from March 2020 (when first cases of COVID-19 in the AFRO region were reported) to the end of the third wave in September 2021. Data sources were from document and Literature review of COVID-19 response strategies, plans, regulations, press releases, government websites, grey and peer-reviewed literature. The data was extracted to Excel file database and coded then analysed using Stata (version 15). Analysis was done through descriptive statistical analysis (using measures of central tendencies (mean, SD, and median) and measures of central dispersion (range)), multiple linear regression, and thematic analysis of qualitative data.
There are three distinct layered coordination mechanisms (strategic, operational, and tactical) that were either implemented singularly or in tandem with another coordination mechanism. 87.23% (n = 41) of the countries initiated strategic coordination, and 59.57% (n = 28) initiated some form of operational coordination. Some of countries (n = 26,55.32%) provided operational coordination using functional Public Health Emergency Operation Centres (PHEOCs) which were activated for the response. 31.91% (n = 15) of the countries initiated some form of tactical coordination which involved the decentralisation of the operations at the local/grassroot level/district/ county levels. Decentralisation strategies played a key role in coordination, as was the innovative strategies by the countries; some coordination mechanisms built on already existing coordination systems and the heads of states were effective in the success of the coordination process. Financing posed challenge to majority of the countries in initiating coordination.
Coordinating an emergency is a multidimensional process that includes having decision-makers and institutional agents define and prioritise policies and norms that contain the spread of the disease, regulate activities and behaviour and citizens, and respond to personnel who coordinate prevention.
本研究描述了世卫组织非洲区域用于管理 COVID-19 大流行的协调机制；将疾病模式（从协调开始到首例病例的时间间隔；疾病波的长度和发病高峰率）与在国家一级建立的协调机制联系起来，并记录最佳做法和经验教训。
我们对 2020 年 3 月（非洲区域首次报告 COVID-19 病例时）至 2021 年 9 月第三波疫情结束期间的 COVID-19 协调机制进行了回溯性政策跟踪。数据来源包括对 COVID-19 应对策略、计划、法规、新闻稿、政府网站、灰色和同行评议文献的文献回顾。将数据提取到 Excel 文件数据库中，并使用 Stata（版本 15）进行编码和分析。分析采用描述性统计分析（使用中心趋势（均值、标准差和中位数）和中心离散度（范围）测量值）、多元线性回归和定性数据的主题分析。
存在三个不同层次的协调机制（战略、运营和战术），这些机制单独实施或与另一个协调机制同时实施。87.23%（n=41）的国家启动了战略协调，59.57%（n=28）启动了某种形式的运营协调。一些国家（n=26,55.32%）使用功能公共卫生应急行动中心（PHEOC）提供运营协调，这些中心为应对疫情而启动。31.91%（n=15）的国家启动了某种形式的战术协调，涉及将行动分散到地方/基层/县/县级。权力下放策略在协调中发挥了关键作用，国家的创新策略也是如此；一些协调机制建立在现有的协调系统之上，国家元首在协调过程的成功中发挥了有效作用。筹资是大多数国家启动协调的一个挑战。
协调紧急情况是一个多维度的过程，包括决策者和机构代理人确定和优先考虑包含疾病传播的政策和规范、规范活动和行为以及协调预防的人员。
