An analysis of compounding factors of epidemics in complex emergencies: a system dynamics approach

IF 3.2 Q2 MANAGEMENT
Russell Harpring, A. Maghsoudi, Christian Fikar, Wojciech Piotrowicz, Graham Heaslip
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引用次数: 14

Abstract

PurposeThis study aims to describe the compounding factors in a complex emergency, which exacerbate a cholera epidemic among vulnerable populations due to supply chain disruptions. Basic needs such as food, medicine, water, sanitation and hygiene commodities are critical to reduce the incidence rate of cholera and control the spread of infection. Conflicts cause damage to infrastructure, displace vulnerable populations and restrict the flow of goods from both commercial and humanitarian organizations. This study assesses the underlying internal and external factors that either aggravate or mitigate the risk of a cholera outbreak in such settings, using Yemen as a case study.Design/methodology/approachThis study adopts a system dynamics methodology to analyze factors that influence cholera outbreaks in the context of the Yemeni Civil War. A causal loop diagram with multiple components was constructed to represent the complexities of humanitarian situations that require critical decision-making. The model was built using data from humanitarian organizations, non-governmental organizations and practitioners, along with literature from academic sources. Variables in the model were confirmed through semi-structured interviews with a field expert.FindingsCompounding factors that influenced the cholera outbreak in Yemen are visualized in a causal loop diagram, which can improve the understanding of relationships where numerous uncertainties exist. A strong link exists between humanitarian response and the level of infrastructure development in a country. Supply chains are affected by constraints deriving from the Yemeni conflict, further inhibiting the use of infrastructure, which limits access to basic goods and services. Aligning long-term development objectives with short-term humanitarian response efforts can create more flexible modes of assistance to prevent and control future outbreaks.Research limitations/implicationsThe model focuses on the qualitative aspects of system dynamics to visualize the logistics and supply chain-related constraints that impact cholera prevention, treatment and control through humanitarian interventions. The resulting causal loop diagram is bounded by the Yemen context; thus, an extension of the model adapted for other contexts is recommended for further study.Practical implicationsThis study presents a systematic view of dynamic factors existing in complex emergencies that have cause-and-effect relationships. Several models of cholera outbreaks have been used in previous studies, primarily focusing on the modes and mechanisms of transmission throughout a population. However, such models typically do not include other internal and external factors that influence the population and context at the site of an outbreak. This model incorporates those factors from a logistics perspective to address the distribution of in-kind goods and cash and voucher assistance.Social implicationsThis study has been aligned with six of the United Nations Sustainable Development Goals (SDGs), using their associated targets in the model as variables that influence the cholera incidence rate. Recognizing that the SDGs are interlinked, as are the dynamic factors in complex humanitarian emergencies, the authors have chosen to take an interdisciplinary approach to consider social, economic and environmental factors that may be impacted by this research.Originality/valueThis paper provides an insight into the underlying inter-relations of internal and external factors present in the context of a cholera outbreak in a complex crisis. Supply chains for food; water, sanitation and hygiene; and health products are crucial to help prevent, control and treat an outbreak. The model exposes vulnerabilities in the supply chain, which may offer guidance for decision makers to improve resilience, reduce disruptions and decrease the severity of cholera outbreaks.
复杂突发事件中流行病复合因素的系统动力学分析
本研究旨在描述在复杂紧急情况下,由于供应链中断而加剧弱势人群霍乱流行的复合因素。食品、药品、水、环境卫生和个人卫生商品等基本需求对于降低霍乱发病率和控制感染蔓延至关重要。冲突对基础设施造成破坏,使脆弱人口流离失所,并限制商业和人道主义组织的货物流动。本研究以也门为个案,评估了在这些环境中加剧或减轻霍乱爆发风险的潜在内部和外部因素。设计/方法/方法本研究采用系统动力学方法分析也门内战背景下影响霍乱爆发的因素。构建了具有多个组成部分的因果循环图,以表示需要作出关键决策的人道主义局势的复杂性。该模型是使用来自人道主义组织、非政府组织和从业人员的数据以及来自学术来源的文献建立的。模型中的变量通过与现场专家的半结构化访谈得到确认。研究结果影响也门霍乱爆发的综合因素在因果循环图中可视化,这可以提高对存在众多不确定因素的关系的理解。人道主义反应与一个国家的基础设施发展水平之间存在着密切的联系。供应链受到也门冲突的制约,进一步抑制了基础设施的使用,从而限制了获得基本商品和服务的机会。将长期发展目标与短期人道主义应对努力结合起来,可以创造更灵活的援助模式,以预防和控制未来的疫情。研究局限/意义该模型侧重于系统动力学的定性方面,以可视化通过人道主义干预影响霍乱预防、治疗和控制的物流和供应链相关限制。由此产生的因果循环图受到也门情况的限制;因此,建议对模型进行扩展,以适应其他情况,以供进一步研究。实际意义本研究对复杂突发事件中存在的具有因果关系的动态因素提出了系统的看法。以前的研究使用了几种霍乱暴发模型,主要侧重于在人群中传播的模式和机制。然而,此类模型通常不包括影响疫情发生地人口和环境的其他内部和外部因素。这一模式从后勤角度考虑了这些因素,以解决实物货物和现金及代金券援助的分配问题。该研究与联合国可持续发展目标(sdg)中的6个目标保持一致,在模型中使用它们的相关目标作为影响霍乱发病率的变量。认识到可持续发展目标是相互关联的,复杂的人道主义紧急情况中的动态因素也是如此,作者选择采用跨学科的方法来考虑可能受本研究影响的社会、经济和环境因素。原创性/价值本文提供了对在复杂危机中霍乱爆发的背景下存在的内部和外部因素的潜在相互关系的见解。食品供应链;水、环境卫生和个人卫生;卫生产品对于帮助预防、控制和治疗疫情至关重要。该模型揭示了供应链中的脆弱性,可为决策者提供指导,以提高复原力、减少中断和降低霍乱暴发的严重程度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.40
自引率
20.00%
发文量
20
期刊介绍: The Journal of Humanitarian Logistics and Supply Chain Management (JHLSCM) is targeted at academics and practitioners in humanitarian public and private sector organizations working on all aspects of humanitarian logistics and supply chain management. The journal promotes the exchange of knowledge, experience and new ideas between researchers and practitioners and encourages a multi-disciplinary and cross-functional approach to the resolution of problems and exploitations of opportunities within humanitarian supply chains. Contributions are encouraged from diverse disciplines (logistics, operations management, process engineering, health care, geography, management science, information technology, ethics, corporate social responsibility, disaster management, development aid, public policy) but need to have a logistics and/or supply chain focus. JHLSCM publishes state of the art research, utilizing both quantitative and qualitative approaches, in the field of humanitarian and development aid logistics and supply chain management.
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