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世卫组织非洲区域紧急医疗队倡议:过去 7 年的发展和进展回顾。

The emergency medical teams initiative in the WHO African region: a review of the development and progress over the past 7 years.

机构信息

World Health Organisation, Emergency Preparedness and Response Programme, Regional Hub for West Africa, Dakar, Senegal.

World Health Organisation, Emergency Medical Teams Initiative, Geneva, Switzerland.

出版信息

Front Public Health. 2024 Jun 25;12:1387034. doi: 10.3389/fpubh.2024.1387034. eCollection 2024.

Abstract

BACKGROUND

The WHO Emergency Medical Teams (EMT) Initiative coordinates the deployment of qualified medical teams who promptly respond to public health emergencies (PHEs) and provide quality service during emergencies whilst strengthening capacity. Globally, 40 EMTs have been classified between 2016 and the present (as of the writing of this article in December 2023) and are from across all the WHO regions except the WHO Africa Region (AFRO). However, WHO Africa has prioritised the implementation of EMTs in 10 priority countries to address the public health emergencies (PHEs) affecting the region.

OBJECTIVE

This article describes the development and progress of national EMTs in the WHO African Region over the past 7 years and elucidates the main lessons learned and the complexity and challenges in the process.

METHODS

This study employed a case study approach because of its appropriateness in examining a complex social phenomenon in a socio-political context in depth, using multiple lenses simultaneously. Data and information were obtained through document reviews and key informant interviews (KIIs) ( = 5) with the members of the EMT Initiative on shared field experiences. Data were systematically analysed using the Stages of Implementation Completion (SIC) framework, and the lessons learnt were presented using components of a framework from Adini et al.

RESULTS

The Initiative commenced in the WHO African Region following its launch in December 2017 in Senegal. The assessments of the concept's engagement (involved learning and deciding), feasibility (reviewing expectation and capacity), and readiness planning (collaborating and preparing) showed that the context-specific (African context) challenges, lessons from different emergency response actions mainly guided the Initiative's pre-implementation phase in the region and prompted the WHO emergency leadership on the urgency and need for the EMT concept in the region. The assessment of the implementation processes showed progress in key areas, with staff demonstrating improved competency, EMT services maintaining high fidelity, effective consultation launching critical components, and ongoing services providing successful support and monitoring. Creating the N-EMTs and revitalising the EMT concept required an aligned strategy with other regional emergency programmes and a futuristic vision. Proposed sustainability and governance components include creating N-EMT, developing a coordination structure, collaborating with partners, and finalising the N-EMT.

CONCLUSION

The Initiative is an imperative component that would allow better-targeted management of health emergencies in the region. The continuous refinement of the EMT initiative is crucial. There is a need to work on additional components, such as a context-specific framework for collaborations and partnerships that would enhance deployment and procurement modalities and the complementarity between other regional initiatives to improve the work. Emphasis should be placed on strengthening local health systems, enhancing training and capacity-building programmes, and fostering regional and international collaborations. Additionally, sustainable funding and resource allocation are essential to ensure the resilience of EMTs in the African region and their long-term success.

摘要

背景

世界卫生组织(WHO)应急医疗队(EMT)倡议协调派遣合格医疗队,这些医疗队迅速应对公共卫生紧急情况(PHEs),并在紧急情况下提供高质量的服务,同时加强能力建设。全球范围内,自 2016 年以来(截至 2023 年 12 月本文撰写之时),已有 40 支 EMT 被分类,来自世卫组织所有区域,但世卫组织非洲区域(AFRO)除外。然而,世卫组织非洲地区优先在 10 个重点国家实施 EMT,以应对影响该区域的公共卫生紧急情况。

目的

本文描述了过去 7 年来世卫组织非洲区域 EMT 的发展和进展,并阐述了主要经验教训以及在这一过程中面临的复杂性和挑战。

方法

由于其在深入研究社会政治背景下复杂社会现象方面的适当性,同时使用多个视角,本研究采用了案例研究方法。通过对 EMT 倡议成员的文献回顾和关键知情人访谈(KIIs)(=5)获取数据和信息,分享实地经验。使用实施完成阶段(SIC)框架系统地分析数据,并使用 Adini 等人的框架的组成部分展示所学到的经验。

结果

该倡议于 2017 年 12 月在塞内加尔启动后,在世界卫生组织非洲区域启动。对该概念参与度(涉及学习和决策)、可行性(审查期望和能力)和准备计划(合作和准备)的评估表明,具体情况(非洲情况)的挑战、主要来自不同应急响应行动的经验教训主要指导了该倡议在该区域的实施前阶段,并促使世卫组织应急领导层认识到 EMT 概念在该区域的紧迫性和必要性。对实施过程的评估表明,在关键领域取得了进展,工作人员展示了提高的能力, EMT 服务保持了高度的保真度,有效的咨询发起了关键组件,正在进行的服务提供了成功的支持和监测。创建国家 EMT 和振兴 EMT 概念需要与其他区域应急方案保持一致的战略和前瞻性的愿景。拟议的可持续性和治理组成部分包括创建国家 EMT、发展协调结构、与伙伴合作以及完成国家 EMT。

结论

该倡议是该区域更好地有针对性地管理卫生紧急情况的必要组成部分。不断完善 EMT 倡议至关重要。需要进一步研究其他组成部分,例如针对合作和伙伴关系的特定背景框架,这将增强部署和采购模式以及其他区域倡议之间的互补性,以改善工作。应重点加强当地卫生系统、强化培训和能力建设方案,并促进区域和国际合作。此外,可持续供资和资源分配对于确保 EMT 在非洲区域的弹性和长期成功至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d768/11231368/d8b889e041a1/fpubh-12-1387034-g001.jpg

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