Yauka Nyasulu Juliet Charity, Mahomed Hassan, Uwimana-Nicol Jeannine, Maseti Elizabeth, Mapahla Lovemore, Oduwole Elizabeth, Khuzwayo Landiwe, Jassen Ahmad, English Rene
Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch; AFRIQUIP, Health Systems Strengthening, Johannesburg, South Africa. ORCID: https://orcid.org/0000-0003-1158-6302.
Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch; Metro Health Services, Western Cape Government: Health & Wellness, Cape Town, South Africa. ORCID: https://orcid.org/0000-0001-6775-9482.
Am J Disaster Med. 2024;19(3):225-235. doi: 10.5055/ajdm.0485.
More needs to be known on how the South African health system contained the coronavirus disease 2019 (COVID-19) pandemic and maintained the core business of health service delivery. We describe the practices that have shown to affect the health systems' resilience in ensuring maintenance of polio surveillance and immunization systems in South Africa (SA) during the COVID-19 pandemic.
This is a descriptive, reflective desk review study using the South African polio surveillance systems and immunization coverage as a case study. We applied a health systems' resilience framework to highlight how the South African health system contained the pandemic and maintained its core business. Routine immunization and polio surveillance data were obtained and analyzed.
The effect of SA's immunization campaigns, which contributed positively to maintaining the polio immunization coverage during the COVID-19 pandemic, is highlighted, with varied performances among provinces. We established delayed integration of pandemic services and missing public health emergency response structures, which led to redeployment of service providers compromising on the health systems' core business.
Immunization campaigns are key in maintaining coverage, with individualized approaches in supporting the provinces. The existing health systems' structures of countries are a critical determinant of response to pandemics regardless of the available resources. Therefore, to ensure that the health systems maintain a balance between containing pandemics like COVID-19 and maintaining its core business, we recommend the establishment of a public health structure from the national to the community level to respond to public health emergencies and the early integration of pandemic services into the day-to-day health systems' business.
关于南非卫生系统如何遏制2019冠状病毒病（COVID-19）大流行并维持卫生服务提供的核心业务，仍有更多需要了解的地方。我们描述了在COVID-19大流行期间，南非在确保维持脊髓灰质炎监测和免疫接种系统方面已被证明会影响卫生系统复原力的做法。
这是一项描述性、反思性案头审查研究，以南非脊髓灰质炎监测系统和免疫接种覆盖率为案例研究。我们应用了卫生系统复原力框架，以突出南非卫生系统如何遏制大流行并维持其核心业务。获取并分析了常规免疫接种和脊髓灰质炎监测数据。
强调了南非免疫接种活动在COVID-19大流行期间对维持脊髓灰质炎免疫接种覆盖率产生的积极影响，各省份的表现各不相同。我们发现大流行服务的整合延迟以及公共卫生应急响应结构缺失，这导致服务提供者重新部署，损害了卫生系统的核心业务。
免疫接种活动是维持覆盖率的关键，应采取个性化方法支持各省份。无论可用资源如何，各国现有的卫生系统结构都是应对大流行的关键决定因素。因此，为确保卫生系统在遏制COVID-19等大流行与维持其核心业务之间保持平衡，我们建议建立从国家到社区层面的公共卫生结构，以应对公共卫生紧急情况，并将大流行服务尽早纳入日常卫生系统业务。
