World Health Organization Regional Office for Africa, Brazzaville, Republic of the Congo.
Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa.
PeerJ. 2024 Sep 4;12:e17869. doi: 10.7717/peerj.17869. eCollection 2024.
Unpredictable events, such as the outbreak of infectious diseases and humanitarian crises, are putting a strain on health care systems. As a result, African countries will need to prepare themselves with appropriate strategies to withstand such occurrences. Therefore, the purpose of this scoping review was to map available evidence about what type and what components of health systems are needed to help countries cope with health emergencies and to foster health system resilience in the WHO African Region.
A systematic search was performed independently in Scopus and PubMed electronic databases as well as grey literature. Studies were selected based on set eligibility criteria based on the Joanna Brigg's Institute (JBI) methodology for scoping reviews. The key findings were focused on health system resilience and were mapped based on the WHO's core health system components. Our data were tabulated, and a narrative synthesis was conducted.
A total of 28 studies were included in this scoping review, mostly conducted in the WHO African Region and region of the Americas. Studies focused on a variety of strategies, such as the continuous delivery of essential services, the strengthening of the health workforce, including community health care workers, community engagement, the provision of protective mechanisms for the health workforce, and flexible leadership and governance measures.
Our findings suggest that strategies to improve health system resilience must include all areas of the healthcare delivery process, including primary care. A resilient health system should be ready for a crisis and have adaptable policies in place to offer adequate response at all levels, as well as post-recovery planning. Such health systems should also seek for continuous improvement. More research is needed to assess the efficacy of initiatives for improving health system resilience, particularly in vulnerable African health systems.
不可预测的事件，如传染病的爆发和人道主义危机，正给医疗保健系统带来压力。因此，非洲国家需要准备适当的策略来应对这些情况。因此，本范围综述的目的是绘制现有证据，了解需要什么样的卫生系统类型和组成部分来帮助各国应对卫生紧急情况，并增强世卫组织非洲区域卫生系统的弹性。
在 Scopus 和 PubMed 电子数据库以及灰色文献中独立进行了系统搜索。研究是根据基于乔安娜·布里格斯研究所 (JBI) 范围综述方法的一套既定资格标准选择的。主要发现侧重于卫生系统的弹性，并根据世卫组织的核心卫生系统组成部分进行了映射。我们将数据制成表格，并进行了叙述性综合。
本范围综述共纳入 28 项研究，其中大部分在世界卫生组织非洲区域和美洲区域进行。研究侧重于各种策略，例如持续提供基本服务、加强卫生工作队伍，包括社区卫生工作者、社区参与、为卫生工作者提供保护机制以及灵活的领导和治理措施。
我们的研究结果表明，提高卫生系统弹性的策略必须包括医疗保健提供过程的所有领域，包括初级保健。有弹性的卫生系统应随时准备应对危机，并制定适应性政策，以便在各个层面提供充分的应对，并进行恢复后规划。此类卫生系统还应寻求持续改进。需要更多的研究来评估提高卫生系统弹性的举措的效果，特别是在脆弱的非洲卫生系统中。
