Predictive Preparedness and Recurrent Shock Reduction in Somalia: The Roles of Adaptive Governance and Institutional Fragmentation.

IF 2.6 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Risk Management and Healthcare Policy Pub Date : 2026-09-28 eCollection Date: 2026-01-01 DOI:10.2147/RMHP.S629815
Abdifatah Nour Rage
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引用次数: 0

Abstract

Introduction: Somalia faces recurrent shocks including droughts, floods, conflict, and displacement that overwhelm governance systems and sustain reactive humanitarian responses. This quantitative cross-sectional study examines the associations between predictive preparedness, adaptive governance, institutional fragmentation, and recurrent shock reduction in Somalia, testing adaptive governance as a mediating mechanism and institutional fragmentation as a boundary condition.

Methods: Survey data from 315 disaster professionals, government officials, humanitarian workers, and community leaders across Somalia's federal member states were analyzed using partial least squares structural equation modeling (PLS-SEM) with 5,000 bootstraps. Multi-item scales measured predictive preparedness, adaptive governance, institutional fragmentation, and recurrent shock reduction based on self-reported perceptions.

Results: Predictive preparedness was positively associated with recurrent shock reduction (β = 0.28, p < 0.001) and adaptive governance (β = 0.42, p < 0.001). Adaptive governance partially mediated this relationship, with the indirect effect accounting for 35% of the total effect (indirect β = 0.15; 95% CI: 0.07, 0.23) and the direct effect accounting for the remaining 65% (β = 0.28; 95% CI: 0.16, 0.40). This partial mediation indicates that predictive preparedness operates through both governance-mediated and direct pathways. Institutional fragmentation significantly weakened the predictive preparedness-adaptive governance relationship (interaction β = -0.18, p < 0.001) and the adaptive governance-shock reduction relationship (interaction β = -0.22, p < 0.001). The conditional indirect effect was positive at low fragmentation (0.10, 95% CI: 0.04, 0.16, p < 0.001) but non-significant at high fragmentation (-0.10, 95% CI: -0.18, -0.02, p = 0.012). The model explained 48% of variance in shock reduction and 35% in adaptive governance.

Discussion: Predictive preparedness is associated with recurrent shock reduction through both direct and governance-mediated pathways, with governance serving as a force multiplier rather than a prerequisite. Institutional fragmentation severely constrains these associations, fully attenuating the mediated pathway at high fragmentation levels. These findings suggest that preparedness investments should not be withheld pending governance reforms, as direct benefits may accrue even in fragmented contexts, but governance strengthening should proceed in parallel to amplify benefits. However, given the cross-sectional design and self-reported measures, all relationships should be interpreted as associations requiring longitudinal validation.

索马里的预测性准备和减少经常性冲击:适应性治理和机构分裂的作用。
索马里面临经常性冲击,包括干旱、洪水、冲突和流离失所,这些冲击使治理系统不堪重负,并维持被动的人道主义应对。本定量横断面研究考察了索马里预测性准备、适应性治理、制度碎片化和经常性减少冲击之间的关系,检验了适应性治理作为中介机制和制度碎片化作为边界条件。方法:对索马里联邦成员国315名灾害专业人员、政府官员、人道主义工作者和社区领导人的调查数据进行了分析,使用了5000个bootstrap的偏最小二乘结构方程模型(PLS-SEM)。多项目量表测量了预测性准备、适应性治理、制度碎片化和基于自我报告感知的经常性冲击减少。结果:预测性准备与复发性休克减少(β = 0.28, p < 0.001)和适应性治理(β = 0.42, p < 0.001)呈正相关。适应性治理在一定程度上介导了这种关系,间接效应占总效应的35%(间接β = 0.15; 95% CI: 0.07, 0.23),直接效应占剩余65% (β = 0.28; 95% CI: 0.16, 0.40)。这种部分中介表明,预测性准备通过治理中介和直接途径发挥作用。制度碎片化显著削弱了预测准备-适应性治理关系(交互作用β = -0.18, p < 0.001)和适应性治理-冲击减少关系(交互作用β = -0.22, p < 0.001)。条件间接效应在低碎片化时为正(0.10,95% CI: 0.04, 0.16, p < 0.001),但在高碎片化时不显著(-0.10,95% CI: -0.18, -0.02, p = 0.012)。该模型解释了48%的减震差异和35%的适应性治理差异。讨论:预测性准备与通过直接途径和治理介导途径反复减少冲击有关,治理是力量倍增器而不是先决条件。制度碎片化严重限制了这些关联,在高碎片化水平下完全削弱了中介途径。这些研究结果表明,在治理改革之前不应扣留备灾投资,因为即使在分散的情况下也可能产生直接效益,但应同时加强治理以扩大效益。然而,考虑到横断面设计和自我报告的测量,所有的关系都应该被解释为需要纵向验证的关联。
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来源期刊
Risk Management and Healthcare Policy
Risk Management and Healthcare Policy Medicine-Public Health, Environmental and Occupational Health
CiteScore
6.20
自引率
2.90%
发文量
242
审稿时长
16 weeks
期刊介绍: Risk Management and Healthcare Policy is an international, peer-reviewed, open access journal focusing on all aspects of public health, policy and preventative measures to promote good health and improve morbidity and mortality in the population. Specific topics covered in the journal include: Public and community health Policy and law Preventative and predictive healthcare Risk and hazard management Epidemiology, detection and screening Lifestyle and diet modification Vaccination and disease transmission/modification programs Health and safety and occupational health Healthcare services provision Health literacy and education Advertising and promotion of health issues Health economic evaluations and resource management Risk Management and Healthcare Policy focuses on human interventional and observational research. The journal welcomes submitted papers covering original research, clinical and epidemiological studies, reviews and evaluations, guidelines, expert opinion and commentary, and extended reports. Case reports will only be considered if they make a valuable and original contribution to the literature. The journal does not accept study protocols, animal-based or cell line-based studies.
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