Owusu-Addo Sally Baaba, Boateng Daniel, Amuasi John Humphrey
School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
Ashanti Regional Health Directorate, Ghana Health Service, Kumasi, Ghana.
BMJ Open. 2025 Sep 14;15(9):e100226. doi: 10.1136/bmjopen-2025-100226.
Health emergencies continue to stimulate greater interest in health systems and services, particularly their ability to respond to such shock. While studies have been done on health system response to health emergencies, there has been no attempt to synthesise this body of evidence to inform future emergency preparedness and response plan, particularly in low- and middle-income countries (LMICs) where health systems are deemed to be weak. This paper aims to provide a systematic review protocol for synthesising evidence on health system response to health emergencies in LMICs.
The WHO building blocks of health system functioning will be used as a conceptual framework for the review. The review will be conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Nine electronic databases will be searched: Medline, Embase, Ovid Emcare, Scopus, ScienceDirect, Academic Search Complete, HINARI, CINAHL and African Index Medicus. The search will be supplemented by citation searching, searching reference lists of included articles, search for grey literature in Google Scholar and relevant websites. Studies focusing on health system response to health emergencies in LMICs, published in English and between 2007 and 2025, will be eligible for inclusion. A narrative synthesis will be performed on all the included studies. Studies will be mapped and categorised into the WHO six building blocks of health system functioning, exploring relationships between and within studies, identifying the response mechanisms of the health system during health emergencies and their barriers and facilitators.
The data to be used do not include individual patient data, so ethical approval is not required. The results of the systematic review will be disseminated through a peer-reviewed journal publication, presentations at conferences and seminars.
CRD42024556271.
卫生紧急情况持续激发人们对卫生系统和服务的更大兴趣，尤其是其应对此类冲击的能力。虽然已经有关于卫生系统对卫生紧急情况应对的研究，但尚未有人尝试综合这一证据体系以为未来的应急准备和应对计划提供参考，特别是在卫生系统被认为薄弱的低收入和中等收入国家（LMICs）。本文旨在提供一个系统综述方案，以综合关于低收入和中等收入国家卫生系统对卫生紧急情况应对的证据。
世界卫生组织卫生系统功能的构成要素将用作本次综述的概念框架。本次综述将按照系统综述和Meta分析的首选报告项目声明进行实施和报告。将检索九个电子数据库：医学索引数据库（Medline）、荷兰医学文摘数据库（Embase）、Ovid循证医学数据库（Ovid Emcare）、Scopus数据库、科学Direct数据库、学术搜索完整版数据库（Academic Search Complete）、HINARI数据库、护理学与健康领域数据库（CINAHL）和非洲医学索引数据库（African Index Medicus）。检索将辅以引文检索、检索纳入文章的参考文献列表、在谷歌学术和相关网站上搜索灰色文献。2007年至2025年期间以英文发表的、聚焦于低收入和中等收入国家卫生系统对卫生紧急情况应对的研究将符合纳入条件。将对所有纳入研究进行叙述性综合分析。研究将被映射并归类到世界卫生组织卫生系统功能的六个构成要素中，探索研究之间及研究内部的关系，确定卫生紧急情况期间卫生系统的应对机制及其障碍和促进因素。
所使用的数据不包括个体患者数据，因此无需伦理批准。系统综述的结果将通过同行评审期刊发表、在会议和研讨会上进行展示的方式予以传播。
国际系统综述注册平台（PROSPERO）注册号：CRD42024556271。
