Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
BMC Health Serv Res. 2022 Sep 3;22(1):1118. doi: 10.1186/s12913-022-08510-4.
The recurrence of emerging infectious diseases reminds us that rapid response to related outbreaks require coordinated inter-sectoral/ organizational and trans-disciplinary approaches. This study examined the challenges for implementation of inter-sectoral efforts to improve COVID-19 pandemic response in Iran using the consolidated framework for implementation research (CFIR).
We conducted a qualitative content analysis of in-depth interviews between March 2020 and February 2021 in Tehran, Iran. Participants included health professionals and experts involved in the prevention, treatment and control of COVID-19 pandemic from different levels of the health system (macro: Ministry of Health and Iranian National Institute of Health Research; meso: universities of medical sciences and health services; and micro: hospitals), selected using purposive sampling. Recorded interviews were transcribed verbatim and coded using a deductive approach (CFIR constructs).
In total, 12 interviews with the participants were conducted; and eight themes emerged as the most important challenges for implementation of inter-sectoral efforts to improve outbreak response in COVID-19. These challenges include lack of proper intervention sources, complexity, poor networking with external organizations, cultural issues, inadequate availability of resources, inadequate access to knowledge and information about inter-sectoral collaboration implementation, and planning issues for it.
Implementing inter-sectoral efforts to improve outbreak response require addressing several implementation challenges. There should be effective leadership and command system, prioritizing the problem, having proper intra-sector collaboration, adequate supervisory, strong social capital, managers and officials' positive beliefs and organizational culture towards inter-sectoral collaboration, sufficient knowledge and information about the implementation, and providing proper programs to implement inter-sectoral collaboration. These findings recall the need to develop and in particular, implement a specific infra-structure through a well-designed program at the government level to strengthen this approach.
新发传染病的反复出现提醒我们，快速应对相关疫情需要协调跨部门/组织和跨学科的方法。本研究使用实施研究综合框架 (CFIR) 检查了在伊朗实施跨部门努力以改善 COVID-19 大流行应对的挑战。
我们于 2020 年 3 月至 2021 年 2 月在伊朗德黑兰进行了定性内容分析，参与者包括来自不同卫生系统层级（宏观：卫生部和伊朗国家卫生研究院；中观：医科大学和卫生服务；微观：医院）的预防、治疗和控制 COVID-19 大流行的卫生专业人员和专家，通过目的抽样选择。记录的访谈逐字转录并使用演绎方法（CFIR 结构）进行编码。
共对 12 名参与者进行了访谈；并出现了 8 个主题，这些主题是实施跨部门努力以改善 COVID-19 疫情应对的实施挑战。这些挑战包括缺乏适当的干预源、复杂性、与外部组织的网络联系不佳、文化问题、资源供应不足、获取关于跨部门合作实施的知识和信息不足，以及对其进行规划的问题。
实施跨部门努力以改善疫情应对需要解决几个实施挑战。应建立有效的领导和指挥系统，优先考虑问题，进行适当的部门内合作，充分监督，强大的社会资本，管理人员和官员对跨部门合作的积极信念和组织文化，充分了解实施情况，并提供适当的方案来实施跨部门合作。这些发现提醒我们需要在政府层面制定和特别是实施一个特定的基础设施，通过一个精心设计的方案来加强这种方法。
