Centers for Disease Control and Prevention Public Health Response to Humanitarian Emergencies, 2007-2016.
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ABSTRACT:
SUBMITTER: Boyd AT
PROVIDER: S-EPMC5711329 | biostudies-literature | 2017 Dec
REPOSITORIES: biostudies-literature
Publications
Centers for Disease Control and Prevention Public Health Response to Humanitarian Emergencies, 2007-2016.
Boyd Andrew T AT Cookson Susan T ST Anderson Mark M Bilukha Oleg O OO Brennan Muireann M Handzel Thomas T Hardy Colleen C Husain Farah F Cardozo Barbara Lopes BL Colorado Carlos Navarro CN Shahpar Cyrus C Talley Leisel L Toole Michael M Gerber Michael M
Emerging infectious diseases 20171201 13
Humanitarian emergencies, including complex emergencies associated with fragile states or areas of conflict, affect millions of persons worldwide. Such emergencies threaten global health security and have complicated but predictable effects on public health. The Centers for Disease Control and Prevention (CDC) Emergency Response and Recovery Branch (ERRB) (Division of Global Health Protection, Center for Global Health) contributes to public health emergency responses by providing epidemiologic s ...[more]
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Project description:BackgroundGender-based violence (GBV) is a global health, human rights, and protection issue, which can increase during emergencies. GBV coordination is an essential component of every humanitarian response, ensuring that, from the earliest phases of a crisis, accessible and safe services are available and prevention and mitigation mechanisms are implemented to reduce GBV. We sought to address the limited evidence on GBV coordination, by reviewing literature on GBV coordination in emergencies, identifying facilitators and barriers influencing effectiveness.MethodsWe conducted a scoping review on GBV coordination in emergencies from 1990 to 2020. Studies explicitly discussing GBV coordination in humanitarian, natural disaster and public health emergencies, in low or middle-income countries, were included. Using thematic analysis, we developed a six-topic framework to synthesise evidence on effective GBV coordination and present recommendations for strengthening GBV coordination in emergencies.FindingsWe included 28 of 964 sources identified, covering 30 different emergency settings across 22 countries. Sources spanned emergency settings, with minimal evidence in public health emergencies and none focussed solely on GBV coordination. Several sources suggested that timely establishment of GBV coordination mechanisms, led by dedicated, experienced coordinators, increased funding and strengthened service provision. GBV risk mitigation was compromised by weak commitment across sectors, poor accountability systems, and limited engagement of affected women. Inclusive GBV coordination, involving national and local actors is vital but engagement efforts have been inadequate and localisation funding targets not yet achieved. Implementation of the GBV Information Management System has reinforced coordination, funding allocation and service provision. While specialist GBV services remain insufficient, emergencies can present opportunities for expansion. Sustainability and long-term impact are compromised by over-reliance on international leadership and funding, weak commitment by governments, and limited attention to GBV prevention.ConclusionDespite enhanced global commitments to addressing GBV in recent years, it remains consistently under-prioritised and under-resourced. Recommendations to strengthen GBV coordination in emergencies include: funding dedicated GBV coordination positions across all types of emergencies, building the global GBV coordination workforce, expanding inclusion of national actors and investing in GBV risk mitigation and prevention through multiyear funding. The evidence-based framework for effective GBV coordination presented here, can guide further research in diverse emergencies.
| S-EPMC9238064 | biostudies-literature
Project description:IntroductionHumanitarian emergencies, of either natural or anthropogenic origins, are equivalent to major disasters, which can lead to population displacement, food insecurity and health system disruptions. Almost two-thirds of people affected by humanitarian emergencies inhabit malaria endemic regions, particularly the WHO African Region, which currently accounts for 93% and 94% of malaria cases and deaths, respectively. As of late 2020, the United Nations Refugee Agency estimates that there are globally 79.5 million forcibly displaced people, including 45.7 million internally displaced people, 26 million refugees, 4.2 million asylum-seekers and 3.6 million Venezuelans displaced abroad.Methods and analysesA systematic review and meta-analysis will be conducted to evaluate the impact of different vector control interventions on malaria disease burden during humanitarian emergencies. Published and grey literatures will be systematically retrieved from 10 electronic databases and 3 clinical trials registries. A systematic approach to screening, reviewing and data extraction will be applied based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Two review authors will independently assess full-text copies of potentially relevant articles based on inclusion criteria. Included studies will be assessed for risk of bias according to Cochrane and certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Eligible studies with reported or measurable risk ratios or ORs with 95% CIs will be included in a meta-analysis. Subgroup analyses, including per study design, emergency phase and primary mode of intervention, may be performed if substantial heterogeneity is encountered.Ethics and disseminationEthical approval is not required by the London School of Hygiene and Tropical Medicine to perform secondary analyses of existing anonymous data. Study findings will be disseminated via open-access publications in peer-reviewed journals, presentations to stakeholders and international policy makers, and will contribute to the latest WHO guidelines for malaria control during humanitarian emergencies.Prospero registration numberCRD42020214961.
| S-EPMC8317076 | biostudies-literature
Project description:BackgroundDisasters and public health emergencies increasingly affect populations around the world, posing significant wide-ranging challenges for societies as well as for effective public health and suicide prevention. Intervention research is essential to inform evidence-based responses. Yet, despite evident public concern and growing research interest in heightened suicide risks and impacts, little is known about effective suicide prevention interventions in these contexts. We conducted a systematic review to examine the outcomes of suicide prevention strategies implemented in disasters and public health emergencies.MethodsWe searched five databases (Medline, Embase, PsycINFO, Web of Science, PTSDpubs) from inception to December 2022 for peer-reviewed quantitative studies that reported relevant intervention outcomes (changes in the frequency of suicide, suicide attempts, self-harm) for populations affected by disasters and public health emergencies. We assessed the quality of eligible studies using the Quality Assessment Tool for Quantitative Studies, and distilled review findings through narrative synthesis. The study protocol was registered with PROSPERO (CRD42021276195).ResultsTen eligible and mostly observational studies were included in this review, which examined a range of universal, selective, and indicated interventions. Three of five studies of interventions in public health emergencies indicated the potential effectiveness and buffering effects of generic disaster related mental health support, access to urban parks, as well as the beneficial role of video-enabled tablets in facilitating treatment access and outcomes. Similarly, three of five studies of interventions in disaster contexts provided evidence of the beneficial role of universal economic security measures, national gun laws and buy back schemes, and volunteer-delivered mental health support. Overall, four of six studies with favorable outcomes examined interventions specifically deployed in disaster or public health emergency contexts, whereas two studies examined ongoing existing interventions. Three studies, respectively, of suicide prevention focused interventions or generic interventions reported favorable outcomes. The quality of included studies was variable, with two studies being rated as 'strong', four studies rated as 'moderate', and four studies rated as 'weak'.ConclusionNotwithstanding the limited scope and variable quality of published evidence, our review findings highlight the breadth of interventions that have been applied in such contexts with some success. There is a need for further research on effective interventions and intervention adaptations to inform evidence-based suicide prevention responses to disasters and public health emergencies.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021276195, PROSPERO ID CRD42021276195.
| S-EPMC10876787 | biostudies-literature
Project description:IntroductionVolunteers are an integral part of the International Red Cross and Red Crescent (RCRC) Movement, with over 16 million people actively contributing to humanitarian action worldwide. Academic volunteerism within the Movement includes contributions from students, volunteers and professionals from academic institutions who offer their time and expertise. In this study we aimed to understand the process of embedding academic volunteers in humanitarian organizations such as the Canadian Red Cross (CRC) and assess the impact of their activities within the realm of public health education.MethodsWe used a qualitative case study design with an instrumental approach. All documents related to academic volunteers within the CRC database from September 2018 to August 2023 were gathered and reviewed. Data related to the processes around engaging with volunteers, timelines, outcomes and feedback surveys from students and staff members were extracted and a content analysis was conducted. A return-on-investment analysis (ROI) was conducted to assess the financial impact of engaging academic volunteers.ResultsA total of 68 academic volunteers were engaged with CRC, including unpaid or partially paid master's students, doctoral and postdoctoral fellows, and student volunteers. The collaboration between CRC and academic volunteers contributed to educational enrichment, professional development, knowledge transfer, operational efficiency, and talent pool expansion. Results from a survey on academic volunteerism further highlighted benefits such as maintaining project schedules, promoting diversity, and amplifying the Movement's voice on important matters. The return on investment for unpaid academic volunteers and Masters students was 70%. A five-fold increase was measured for partially paid academic volunteers resulting in 486% ROI.DiscussionAcademic volunteerism yields mutual benefits for students, academic researchers, and humanitarian organizations. These volunteers enhance operational efficiency and fortify resilience, fostering adaptability amid challenges. They play a crucial role in strengthening evidence-based programming within organizations like CRC and bolstering their capacity to address emerging health issues. These volunteers constitute a valuable talent pool, bringing organizational knowledge and experience to the table. They provide critical support for scaling up programs, especially during emergency situations, offering innovative solutions to address human resource shortages driven by funding constraints.
| S-EPMC11744964 | biostudies-literature
Project description:The problem of repeated epidemic fluctuations in the normalized prevention and control stage is revealed by data from January 20, 2020, to January 30, 2023. In order to improve the collaborative response of the public and government departments to public health emergencies and avoid repeated fluctuations of the epidemic, a tripartite evolutionary game model of the public, local government, and central government departments is constructed, focusing on the evolutionary paths and evolutionary stabilization strategies of the three subjects, and the influence of each element on the evolutionary results is simulated by numerical simulation in Matlab, and based on the inadequacy of the static reward and punishment mechanism, a dynamic Based on the shortcomings of static reward and punishment mechanism, dynamic reward and punishment mechanism is introduced to control the stability of the evolving system. The study shows that (1) with the increase of the initial willingness of the three parties, the rate of the public choosing the discretionary flow strategy slows down, and the collaborative prevention and control process can be accelerated. (2) The reward and punishment mechanism of central government departments has a positive incentive effect on the local government's strict prevention and control and the public's conscious isolation. Appropriately increasing rewards, formulating reasonable subsidy strategies, and increasing penalties for violations are conducive to the overall optimization of the system, and the punishment mechanism is most sensitive to the regulation of the public's discretionary mobility behavior. (3) Government departments' prevention and control costs can influence their enthusiasm for strict prevention and control and real-time supervision. Reducing the human resources cost, time cost, and financial cost of prevention and control is conducive to government departments performing their duties more responsibly. (4) The static punishment mechanism fails to make timely adjustments according to the strategy choice of each actor. It cannot control the stability of the evolving system. In contrast, the dynamic punishment mechanism considers the punishment parameters to link the casual isolation rate with the lenient prevention and control rate, which can effectively control the system's fluctuating instability and is the system's stability control strategy. Finally, combining theoretical and simulation analysis, management suggestions are made for controlling repeated fluctuations of the epidemic in practice, and the research limitations of this paper are explained.
| S-EPMC10850330 | biostudies-literature
Project description:BackgroundThe COVID-19 pandemic has highlighted the continued inadequacy of the capability of Center for Disease Control and Prevention (CDC) public health personnel to respond effectively to emerging infectious disease outbreaks, as well as the urgent need for specific tools to assess the capability needed by CDC public health personnel in the post-pandemic era. Using network analysis, we aimed to analyze the comprehensive capacities of CDC public health staff and the relationships between these capacities. We also examined the impact of standardized public health training on their capacities and provided actionable recommendations for improving their training and overall capability.MethodsThis study employs a cross-sectional design. A self-developed questionnaire was used to evaluate the capabilities of public health personnel in CDC. Network analysis was conducted using the qgraph package in R (version 4.3.1) to construct a capability network model, while the bootnet package ensured the stability and reliability of the network through bootstrapping. The NetworkComparisonTest package was applied to compare network structures and identify differences between groups.ResultsOver half (51.80%, N = 11,912) of public health personnel rated their comprehensive capabilities as poor. Core capabilities, including research, motivation, and emergency response, were identified as pivotal within the capability network. The network stability coefficient for strength was 0.75, indicating reliable results. The capability networks of those who participated in standardized training differed significantly from those who did not (P = 0.04).ConclusionCDC public health personnel exhibit significant capability gaps, particularly in research and leadership. Standardized training provides some benefits but remains insufficient. Policymakers should address these gaps by aligning training content with critical capability needs, offering flexible and targeted training methods (e.g., virtual courses, self-paced modules), and implementing capability-based assessments to evaluate training outcomes.
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Project description:Adherence to public health recommendations is critical for public safety and well-being. Effective and appropriate communication plays an important role in whether populations trust government and public health authorities, and the extent to which people follow public health recommendations. Poor trust in communication from public health authorities can pose significant challenges for mitigating public health emergencies and maintaining health security. This study aimed to explore the importance of trust in and understanding of communication from public health authorities in improving adherence to public health recommendations, and how that communication can be improved to develop and maintain public trust, particularly in the context of public health emergencies. To understand which factors are important for public trust in communication from public health authorities, we conducted in-depth interviews (n = 25) with a racially and demographically diverse group of individuals living in Baltimore. We found that communication source and communication transparency, such as timeliness, completeness, and clarity of information, were critical constructs of trust in communication from public health authorities. We also found that many participants misunderstood the flow of information from public health authorities to news media, and many were unaware that public health authorities provide the most reliable source of health information and recommendations during a public health emergency. To ensure adherence to public health recommendations, the public needs to trust that public health authorities are providing accurate, practical, and prudent recommendations. Drawing on these results, we provide several recommendations for developing and optimizing communication from various public health authorities.
| S-EPMC7047090 | biostudies-literature
Project description:Humanitarian medical response to natural and human-made disasters can be complicated by high clinician, staff, and patient turnover. While electronic medical records are being scaled up globally, their use remains limited in humanitarian response settings. The Fast Electronic Medical Record (fEMR) system is an open-source electronic health record system specifically designed for use in resource-limited settings and humanitarian crises. The system was developed between 2010-2014 through an iterative design process with multidisciplinary team members. It was operationalized in settings with and without internet connectivity. We analyzed data on fEMR usage since inception until October 2022 to estimate the number of patients served by the system. In eight years of implementation (2014-2022), the fEMR system has been deployed 60 times to 11 different countries across four different continents by 14 different organizations. These deployments collectively account for over 37,500 patient encounters with an estimated 31,940 distinct patients. The settings of fEMR use ranged from refugee and migrant health clinics near the Mexico-US border to the Poland-Ukraine border in the context of the 2022 war in Ukraine. User feedback demonstrated the program's ease of use by providers of different clinical and technical backgrounds. Feedback primarily emphasized improving the system's hardware requirements and workflow. The simple design allowed for clinician users to adapt the system to a variety of clinical scenarios. Ongoing and future work in adapting electronic health records to international humanitarian response will emphasize data security, patient privacy, equity, and the rapid translation of electronic health data to improve population health. In humanitarian response settings, electronic health records can improve quality of care and provide a source of clinical and management data for public health planning.
| S-EPMC11778788 | biostudies-literature
Project description:ContextData can guide decision-making to improve the health of communities, but potential for use can only be realized if public health professionals have data science skills. However, not enough public health professionals possess the quantitative data skills to meet growing data science needs, including at the Centers for Disease Control and Prevention (CDC).ProgramThe Data Science Upskilling (DSU) program increases data science literacy among staff and fellows working and training at CDC. The DSU program was established in 2019 as a team-based, project-driven, on-the-job applied upskilling program. Learners, within interdisciplinary teams, use curated learning resources to advance their CDC projects. The program has rapidly expanded from upskilling 13 teams of 31 learners during 2019-2020 to upskilling 36 teams of 143 learners during 2022-2023.EvaluationAll 2022-2023 cohort respondents to the end-of-project survey reported the program increased their data science knowledge. In addition, 90% agreed DSU improved their data science skills, 93% agreed it improved their confidence making data science decisions, and 96% agreed it improved their ability to perform data science work that benefits CDC.DiscussionDSU is an innovative, inclusive, and successful approach to improving data science literacy at CDC. DSU may serve as an upskilling model for other organizations.
| S-EPMC10860639 | biostudies-literature
Project description:In order to respond to nuclear or radiological emergencies effectively and protect the physical and mental health of the public, the national-, provincial-, municipal- and county-level public health response systems for nuclear or radiological emergencies had been established in China by the end of twentieth century. The health administrative departments at all levels have established professional emergency response teams, continue to improve their own level of emergency response systems and operating mechanisms, enhance the capabilities of radiation injury treatment, radiation monitoring and protection through training and exercises and also pay attention to the logistical support for emergency response. In this article the organizations, management system and capabilities of public health response to nuclear or radiological emergencies in China are briefly introduced. We try to strengthen information exchange and cooperation with foreign counterparts in this field in the future, so as to jointly promote the development of preparedness and response for nuclear or radiological emergencies.
| S-EPMC8438267 | biostudies-literature