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From disease- to people-centred pandemic management: organized communities, community-oriented primary care and health information systems
BACKGROUND: The COVID-19 pandemic exposed the health equity gap between and within countries. Western countries were the first to receive vaccines and mortality was higher among socially deprived, minority and indigenous populations. Surprisingly, many sub-Saharan countries reported low excess morta...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10591360/ https://www.ncbi.nlm.nih.gov/pubmed/37872591 http://dx.doi.org/10.1186/s12939-023-02032-z |
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author | Leyns, Christine Willems, Sara Powell, Richard A. Camacho, Vivian Fabrega, Ricardo De Maeseneer, Jan Rawaf, Salman Mangtani, Punam El-Osta, Austen |
author_facet | Leyns, Christine Willems, Sara Powell, Richard A. Camacho, Vivian Fabrega, Ricardo De Maeseneer, Jan Rawaf, Salman Mangtani, Punam El-Osta, Austen |
author_sort | Leyns, Christine |
collection | PubMed |
description | BACKGROUND: The COVID-19 pandemic exposed the health equity gap between and within countries. Western countries were the first to receive vaccines and mortality was higher among socially deprived, minority and indigenous populations. Surprisingly, many sub-Saharan countries reported low excess mortalities. These countries share experiences with community organization and participation in health. The aim of this article was to analyse if and how this central role of people can promote a successful pandemic response. METHODS: This analysis was partly based on local and national experiences shared during an international and Latin American conference on person-and people-centred care in 2021. Additionally, excess mortality data and pandemic control-relevant data, as well as literature on the pandemic response of countries with an unexpected low excess mortality were consulted. RESULTS: Togo, Mongolia, Thailand and Kenya had a seven times lower mean excess mortality for 2020 and 2021 than the United States of America. More successful pandemic responses were observed in settings with experience in managing epidemics like Ebola and HIV, well-established community networks, a national philosophy of mutual aid, financial government assistance, more human resources for primary care and paid community health workers. DISCUSSION: Since trust in authorities and health needs vary greatly, local strategies are needed to complement national and international pandemic responses. Three key levers were identified to promote locally-tailored pandemic management: well-organized communities, community-oriented primary care, and health information systems. An organized community structure stems from a shared ethical understanding of humanity as being interconnected with each other and the environment. This structure facilitates mutual aid and participation in decision making. Community-oriented primary care includes attention for collective community health and ways to improve health from its roots. A health information system supports collective health and health equity analysis by presenting health needs stratified for social deprivation, ethnicity, and community circumstances. CONCLUSIONS: The difference in excess mortality between countries during the COVID-19 pandemic and various country experiences demonstrate the potential of the levers in promoting a more just and effective health emergency response. These same levers and strategies can promote more inclusive and socially just health systems. |
format | Online Article Text |
id | pubmed-10591360 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-105913602023-10-24 From disease- to people-centred pandemic management: organized communities, community-oriented primary care and health information systems Leyns, Christine Willems, Sara Powell, Richard A. Camacho, Vivian Fabrega, Ricardo De Maeseneer, Jan Rawaf, Salman Mangtani, Punam El-Osta, Austen Int J Equity Health Research BACKGROUND: The COVID-19 pandemic exposed the health equity gap between and within countries. Western countries were the first to receive vaccines and mortality was higher among socially deprived, minority and indigenous populations. Surprisingly, many sub-Saharan countries reported low excess mortalities. These countries share experiences with community organization and participation in health. The aim of this article was to analyse if and how this central role of people can promote a successful pandemic response. METHODS: This analysis was partly based on local and national experiences shared during an international and Latin American conference on person-and people-centred care in 2021. Additionally, excess mortality data and pandemic control-relevant data, as well as literature on the pandemic response of countries with an unexpected low excess mortality were consulted. RESULTS: Togo, Mongolia, Thailand and Kenya had a seven times lower mean excess mortality for 2020 and 2021 than the United States of America. More successful pandemic responses were observed in settings with experience in managing epidemics like Ebola and HIV, well-established community networks, a national philosophy of mutual aid, financial government assistance, more human resources for primary care and paid community health workers. DISCUSSION: Since trust in authorities and health needs vary greatly, local strategies are needed to complement national and international pandemic responses. Three key levers were identified to promote locally-tailored pandemic management: well-organized communities, community-oriented primary care, and health information systems. An organized community structure stems from a shared ethical understanding of humanity as being interconnected with each other and the environment. This structure facilitates mutual aid and participation in decision making. Community-oriented primary care includes attention for collective community health and ways to improve health from its roots. A health information system supports collective health and health equity analysis by presenting health needs stratified for social deprivation, ethnicity, and community circumstances. CONCLUSIONS: The difference in excess mortality between countries during the COVID-19 pandemic and various country experiences demonstrate the potential of the levers in promoting a more just and effective health emergency response. These same levers and strategies can promote more inclusive and socially just health systems. BioMed Central 2023-10-23 /pmc/articles/PMC10591360/ /pubmed/37872591 http://dx.doi.org/10.1186/s12939-023-02032-z Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Leyns, Christine Willems, Sara Powell, Richard A. Camacho, Vivian Fabrega, Ricardo De Maeseneer, Jan Rawaf, Salman Mangtani, Punam El-Osta, Austen From disease- to people-centred pandemic management: organized communities, community-oriented primary care and health information systems |
title | From disease- to people-centred pandemic management: organized communities, community-oriented primary care and health information systems |
title_full | From disease- to people-centred pandemic management: organized communities, community-oriented primary care and health information systems |
title_fullStr | From disease- to people-centred pandemic management: organized communities, community-oriented primary care and health information systems |
title_full_unstemmed | From disease- to people-centred pandemic management: organized communities, community-oriented primary care and health information systems |
title_short | From disease- to people-centred pandemic management: organized communities, community-oriented primary care and health information systems |
title_sort | from disease- to people-centred pandemic management: organized communities, community-oriented primary care and health information systems |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10591360/ https://www.ncbi.nlm.nih.gov/pubmed/37872591 http://dx.doi.org/10.1186/s12939-023-02032-z |
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