Spiegel Jerry M, Zungu Muzimkhulu, Yassi Annalee, Lockhart Karen, Wilson Kerry Sidwell, Okpani Arnold I, Jones David, Sanabria Natasha
School of Population and Public Health University of British Columbia VancouverBritish Columbia Canada School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
National Institute for Occupational Health a division of National Health Laboratory Service Johannesburg South Africa National Institute for Occupational Health, a division of National Health Laboratory Service, Johannesburg, South Africa.
Rev Panam Salud Publica. 2023 Mar 10;47:e33. doi: 10.26633/RPSP.2023.33. eCollection 2023.
To ascertain whether and how working as a partnership of two World Health Organization collaborating centres (WHOCCs), based respectively in the Global North and Global South, can add insights on "what works to protect healthcare workers (HCWs) during a pandemic, in what contexts, using what mechanism, to achieve what outcome".
A realist synthesis of seven projects in this research program was carried out to characterize context (C) (including researcher positionality), mechanism (M) (including service relationships) and outcome (O) in each project. An assessment was then conducted of the role of the WHOCC partnership in each study and overall.
The research found that lower-resourced countries with higher economic disparity, including South Africa, incurred greater occupational health risk and had less acceptable measures to protect HCWs at the onset of the COVID-19 pandemic than higher-income more-equal counterpart countries. It showed that rigorously adopting occupational health measures can indeed protect the healthcare workforce; training and preventive initiatives can reduce workplace stress; information systems are valued; and HCWs most at-risk (including care aides in the Canadian setting) can be readily identified to trigger adoption of protective actions. The C-M-O analysis showed that various ways of working through a WHOCC partnership not only enabled knowledge sharing, but allowed for triangulating results and, ultimately, initiatives for worker protection.
The value of an international partnership on a North-South axis especially lies in providing contextualized global evidence regarding protecting HCWs as a pandemic emerges, particularly with bi-directional cross-jurisdiction participation by researchers working with practitioners.
确定分别位于全球北方和全球南方的两个世界卫生组织合作中心(WHOCCs)结成伙伴关系开展工作,是否以及如何能够为“在大流行期间,在何种背景下,通过何种机制,采取何种措施来保护医护人员(HCWs)并取得何种成果”提供深刻见解。
对该研究项目中的七个项目进行了实证综合分析,以描述每个项目中的背景(C)(包括研究人员的立场)、机制(M)(包括服务关系)和结果(O)。然后评估了WHOCC伙伴关系在每项研究及整体研究中的作用。
研究发现,包括南非在内的经济差距较大、资源较少的国家,在新冠疫情初期比高收入且更平等的对应国家面临更大的职业健康风险,且保护医护人员的措施也更难令人接受。研究表明,严格采取职业健康措施确实可以保护医护人员队伍;培训和预防举措可以减轻工作场所的压力;信息系统很重要;可以很容易地识别出风险最高的医护人员(包括加拿大环境下的护理助手),从而促使采取保护行动。C-M-O分析表明,通过WHOCC伙伴关系开展工作的各种方式不仅能够促进知识共享,还能对结果进行三角验证,并最终推动保护工人的举措。
南北轴向上的国际伙伴关系的价值尤其在于,在大流行出现时提供关于保护医护人员的情境化全球证据,特别是让研究人员与从业者进行双向跨辖区参与。