Noormahomed Emilia Virginia, Reid Michael J A, Mubuuke Aloysius Gonzaga, Gachuno Onesmus, Sewankambo Nelson K, Tsegaye Aster, Celentano Jess, Kiguli-Malwadde Elsie, Ismail Mamudo, Odaibo Georgina, Phaladze Nthabiseng, Nachega Jean B
Universidade Eduardo Mondlane, Maputo, Mozambique.
University of California, San Francisco, CA, USA.
Sci Afr. 2024 Mar;23. doi: 10.1016/j.sciaf.2024.e02103. Epub 2024 Jan 26.
The COVID-19 pandemic exposed weaknesses in healthcare systems and disparities in healthcare access across sub-Saharan Africa (SSA). The insights of frontline healthcare professionals (HCPs), and healthcare researchers involved with the response to COVID in SSA are crucial to ensuring that health systems are optimally prepared for the next pandemic threat. Nonetheless, there is limited consensus as to what are the clinical and public health research priorities necessary to ensure that SSA is optimally prepared and responsive to future pandemics. The aim of this Delphi consensus process was to collate the insights of leading HCPs engaged in research and clinical practice across SSA and prioritize a set of post-COVID-19 pandemic research priorities and determine the investment agenda necessary to address those priorities.
A modified Delphi process was designed to prioritize a shared agenda. A group of researchers from the African Forum for Research and Education in Health (AFREhealth) were asked to first list potential research topics. Then, members of the broader AFREhealth community were invited to rate the importance of each topic on a 4-point Likert scale, through two rounds of consensus-seeking. Consensus for inclusion was predefined as ≥70 % of respondents' rating.
Health professionals, academics, and scientists representing a variety of professions from twenty SSA countries responded to the survey rounds, delivered electronically. An initial subset of researchers suggested 11 initial topics; subsequently, 53 respondents completed round one, and 64 completed round two of the modified Delphi. A final list of 20 topics that met predetermined consensus was grouped into four technical domains: [1] Health workforce and health professions education research; [2] Epidemiology and surveillance; [3] Clinical and health systems research; and [4] and other cross-cutting topics. Across these four domains, the highest-ranking priorities included [1] leveraging digital tools to enhance the health workforce, [2] strengthening genomic surveillance, [3] assessing health system resiliency, and [4] conducting ethical research.
Post-pandemic research priorities for pandemic preparedness and response included strategies to determine to leverage digital tools to enhance workforce training and impact, leveraging genomic surveillance capacity to close epidemiologic gaps, and developing strategies to enhance health system resiliency. The priorities outlined in this analysis underscore the need for capacity-building and context-specific research in sub-Saharan Africa to ensure an effective and equitable response to future pandemics.
新冠疫情暴露了撒哈拉以南非洲(SSA)地区医疗系统的弱点以及医疗服务可及性方面的差异。一线医疗保健专业人员(HCPs)以及参与撒哈拉以南非洲地区新冠疫情应对工作的医疗研究人员的见解,对于确保卫生系统为应对下一次大流行威胁做好充分准备至关重要。然而,对于确保撒哈拉以南非洲地区为未来大流行做好充分准备并做出有效应对所需的临床和公共卫生研究重点,目前尚未达成广泛共识。本次德尔菲共识过程的目的是整理撒哈拉以南非洲地区从事研究和临床实践的主要医疗保健专业人员的见解,确定一组新冠疫情后大流行研究重点,并确定解决这些重点所需的投资议程。
设计了一个改良的德尔菲过程,以确定一个共同的议程。来自非洲卫生研究与教育论坛(AFREhealth)的一组研究人员首先被要求列出潜在的研究主题。然后,邀请更广泛的AFREhealth社区成员通过两轮寻求共识的过程,以4点李克特量表对每个主题的重要性进行评分。纳入的共识被预先定义为≥70%的受访者给予的评分。
来自撒哈拉以南非洲20个国家的代表各种专业的卫生专业人员、学者和科学家对通过电子方式进行的调查轮次做出了回应。一组初始研究人员提出了11个初始主题;随后,53名受访者完成了第一轮,64名受访者完成了改良德尔菲的第二轮。最终确定的20个符合预定共识的主题被分为四个技术领域:[1]卫生人力和卫生专业教育研究;[2]流行病学和监测;[3]临床和卫生系统研究;以及[4]其他交叉主题。在这四个领域中,排名最高的重点包括[1]利用数字工具加强卫生人力,[2]加强基因组监测,[3]评估卫生系统的弹性,以及[4]开展伦理研究。
大流行防范和应对的疫情后研究重点包括确定利用数字工具加强劳动力培训和影响的策略,利用基因组监测能力缩小流行病学差距,以及制定增强卫生系统弹性的策略。本分析中概述的重点强调了撒哈拉以南非洲地区进行能力建设和针对具体情况开展研究的必要性,以确保对未来大流行做出有效和公平的应对。