Mitigating The Impacts And The Impediments To Quality Healthcare During Epidemics By Nurse Segun IGBINLADE

MITIGATING THE IMPACTS AND THE IMPEDIMENTS TO QUALITY HEALTHCARE DURING EPIDEMICS By Nurse Segun IGBINLADE Head, Dept of Nursing Science, Deputy Dean, Faculty of Health Sciences, National Open University of Nigeria Jabi-Abuja 2018 EDITION OF INTERNATIONAL NURSES WEEK (9TH MAY 2018)

Outlines

—Introduction

—Risks of epidemics/pandemics —Impacts of epidemics/pandemics —Mitigation of epidemics/pandemics

—Identification of knowledge gaps in epidemics/pandemics

—Epidemics /Pandemics Preparedness and Intervention

—Conclusion

 

Introduction

Infectious diseases, which are among the leading causes of death worldwide, do not confine themselves to national borders. Their capacity to spread rapidly across geographies – jeopardizing social and economic security as well as challenging human health and well-being in an ever growing world population projected to be 9.7 Billion by 2050 is highly challenging.

A combination of high population density, poverty, changes in social structures, and a lack of public health infrastructure create progressively more favourable  conditions for communicable diseases. These are issues that require appropriate proactive preventive measures (Mitigation) to curb possible disease(s) outbreak and spread in a community (Epidemic) to prevent fast global spread (Pandemic).

Risks of epidemics/pandemics

Pandemics have occurred throughout history and appear to be increasing in frequency, particularly because of the increasing emergence of viral disease from animals.

 

Pandemic risk is driven by the combined effects of spark risk (where a pandemic is likely to arise) and spread risk (how likely it is to diffuse broadly through human populations).

Some geographic regions with high spark risk, including Central and West Africa, lag behind the rest of the globe in pandemic preparedness

 

Global Distribution of Epidemic Preparedness, 2017

 

Impacts of Epidemics/Pandemic

v• Pandemics can cause significant, widespread increases in morbidity and mortality and have disproportionately higher mortality impacts on LMICs.

v• Pandemics can cause economic damage through multiple channels, including short-term fiscal shocks and longer-term negative shocks to economic growth.

• Individual behavioral changes, such as fear-induced aversion to workplaces and other public gathering places, are a primary cause of negative shocks to economic growth during pandemics.

v• Some pandemic mitigation measures can cause significant social and economic disruption.

v• In countries with weak institutions and legacies of political instability, pandemics can increase political stresses and tensions. In these contexts, outbreak response measures such as quarantines have sparked violence and tension between states and citizens.

Mitigation

• Pathogens with pandemic potential vary widely in the resources, capacities, and strategies required for mitigation. However, there are also common prerequisites for effective preparedness and response.
• The most cost-effective strategies for increasing pandemic preparedness, especially in resource- constrained settings, consist of investing to strengthen core public health infrastructure, including water and sanitation systems; increasing situational awareness; and rapidly extinguishing sparks that could lead to pandemics.
• Once a pandemic has started, a coordinated response should be implemented focusing on maintenance of situational awareness, public health messaging, reduction of transmission, and care for and treatment of the ill.
• Successful contingency planning and response require surge capacity—the ability to scale up the delivery of health interventions proportionately for the severity of the event, the pathogen, and the population at risk.
• For many poorly prepared countries, surge capacity likely will be delivered by foreign aid providers. This is a tenable strategy during localized outbreaks, but global surge capacity has limits that likely will be reached during a full-scale global pandemic as higher capacity states focus on their own populations.
• Risk transfer mechanisms, such as risk pooling and sovereign-level catastrophe insurance, provide a viable option for managing pandemic risk.

Knowledge Gaps

• Spending and costs specifically associated with pandemic preparedness and response efforts are poorly tracked.
• There is no widely accepted, consistent methodology for estimating the economic impacts of pandemics.
• Most data regarding the impacts of pandemics and the benefits and costs of mitigation measures come from high-income countries (HICs), leading to biases and potential blind spots regarding the risks, consequences, and optimal interventions specific to Low and middle-income countries (LMICs).

 

Epidemics /Pandemics Preparedness and Intervention

• Pandemic preparedness and response interventions can be classified by their timing with respect to pandemic occurrence: the pre-pandemic period, the spark period, and the spread period, as shown in the box below.

Whereas some interventions clearly fall under the purview of a single authority, responsibility for implementing and scaling up many critical aspects of preparedness and response is spread across multiple authorities, which play complementary, interlocking, and, in some cases, overlapping roles. Essentially, the process include:

Processes involve in Epidemics /Pandemics Preparedness and Intervention

üSituational Awareness: an accurate, up-to-date view of potential or ongoing infectious disease threats

üPreventing and Extinguishing Pandemic Sparks

üRisk Communications: providing information that people can use to take protective and preventive action

üReducing Pandemic Spread:

• Curtailing interactions between infected and uninfected populations
• Reducing infectiousness of symptomatic patients • Reducing susceptibility of uninfected individuals

Processes involve in Epidemics /Pandemics Preparedness and Intervention

üCare and treatment to reduce the severity of Pandemic Illness

üPotential for Scaling Up: expansion of health intervention coverage

üRisk Transfer Mechanisms: offer of an additional tool to manage this risk e.g. Insurance facilities

üAdequate documentation and dissemination of data

Conclusion

In conclusion, public and private sectors need to collaborate and find a common ground viz a viz trust-based cooperating mechanisms at local and global levels to evolve standard preparedness and response strategies adaptable to all and given nation or community in handling issues about epidemics and pandemics.

These are achievable through religious employment of primary healthcare principles including:

• Multi-sectoral approach • Appropriate technology • Focus on prevention
• Equitable distribution
• Community participation.

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