Conflict and fragmented public health emergency management system in Tigray region of Northern Ethiopia: A double burden to accommodate resilient and advanced public health emergency management. A commentary review for policy-makers and a call to action.
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引用次数: 0
Abstract
An estimated 2.5 million people have been internally and externally displaced in the Tigray region of northern Ethiopia in conflict and post-conflict settings. This induced a loss of access to basic and essential healthcare services. The situation was overwhelming, causing service inaccessibility, inadequate health facilities, unstable security to access the services, shortage of supplies and drugs, and medical equipment's in the region. The regional public health emergency management is one service delivery set up for the critically ill. It is characterized by weak emergency management capacities, poor coordination and integration. In addition, the system falls in to two independent sectors in the Tigray Health Bureau (THB), Tigray Health Research Institute (THRI). This leads to a fragmented system, an unclear leadership and governance role and a poor service delivery setup and tracking mechanism. The situation leads to resource duplication and poor business practice. Indeed, this type of service delivery setup secures personal and professional interest more than community interest. The situation exacerbated the occurrence of recurrent outbreaks in the region, with, for instance, zoonotic diseases (anthrax and rabies), acute watery diarrhoea, measles, malaria, yellow fever, and coronavirus disease 2019 (COVID-19) approaching to their level of epidemic. Moreover, they will spike as an epidemic in the future. All these circumstances made it evident that the system need reform to adhere with legal global, national, and regional frameworks, guidelines and proclamations. The system should have one service delivery set up at regional level. It must fall into regional public health institutes (PHIs) to adhere its service packages to the current advancements. Furthermore, integrated effort need from program implementers, relevant stakeholders and policy-makers should be committed and work together in the review and reform process.
在埃塞俄比亚北部提格雷地区,估计有 250 万人在冲突和冲突后背景下在境内外流离失所。这导致人们无法获得基本和必要的医疗保健服务。这种情况不堪重负,导致该地区无法获得服务、卫生设施不足、获得服务的安全不稳定、供应品和药品以及医疗设备短缺。地区公共卫生应急管理是为危重病人提供服务的一个机构。其特点是应急管理能力薄弱、协调和整合能力差。此外,该系统分属提格雷卫生局(Tigray Health Bureau,THB)和提格雷卫生研究所(Tigray Health Research Institute,THRI)两个独立部门。这导致系统支离破碎,领导和管理作用不明确,服务提供设置和跟踪机制不完善。这种情况导致了资源重复和不良的业务实践。事实上,这种服务设置更多的是为了确保个人和专业利益,而不是社区利益。这种情况加剧了该地区疾病的反复爆发,例如,人畜共患病(炭疽和狂犬病)、急性水样腹泻、麻疹、疟疾、黄热病和 2019 年冠状病毒病(COVID-19)已接近流行程度。此外,这些疾病在未来还将激增为流行病。所有这些情况都表明,该系统需要改革,以符合全球、国家和地区的法律框架、指导方针和公告。该系统应在地区一级建立统一的服务机构。它必须归属于地区公共卫生研究所(PHIs),使其服务包符合当前的发展。此外,在审查和改革过程中,计划执行者、相关利益方和政策制定者应共同努力。
期刊介绍:
Health Research Policy and Systems is an Open Access, peer-reviewed, online journal that aims to provide a platform for the global research community to share their views, findings, insights and successes. Health Research Policy and Systems considers manuscripts that investigate the role of evidence-based health policy and health research systems in ensuring the efficient utilization and application of knowledge to improve health and health equity, especially in developing countries. Research is the foundation for improvements in public health. The problem is that people involved in different areas of research, together with managers and administrators in charge of research entities, do not communicate sufficiently with each other.