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In 2017, the World Health Organization introduced an international standardized medical data collection tool for disasters, known as the Emergency Medical Team (EMT) Minimum Data Set (MDS). The EMT MDS was activated for the first time in 2019 in response to Cyclone Idai in Mozambique. The present study aimed to examine the daily and phase trends in acute mental health problems identified by international EMTs during their response to Cyclone Idai and reported using the EMT MDS.
Methods
Joinpoint regression analysis was used to examine daily trends in acute mental health consultations. Trends were also examined by phases, which were identified using joinpoints.
Results
During the 90-day EMT response period following Cyclone Idai, 94 acute mental health consultations were reported. The daily trend analysis showed a significant increase in the daily number and percentage of acute mental health consultations from response onset until day 13, followed by a gradual decline (P<0.05). The phase trend analysis showed a consistent decrease across the identified phases (P for trend<0.001).
Conclusions
The findings of this study provide insight into the need for mental health support in the immediate aftermath of natural disasters and how that need may change over time.
The aim of this study was to identify and prioritize strategies for strengthening public health system resilience for pandemics, disasters, and other emergencies using a scorecard approach.
Methods:
The United Nations Public Health System Resilience Scorecard (Scorecard) was applied across 5 workshops in Slovenia, Turkey, and the United States of America. The workshops focused on participants reviewing and discussing 23 questions/indicators. A Likert type scale was used for scoring with zero being the lowest and 5 the highest. The workshop scores were analyzed and discussed by participants to prioritize areas of need and develop resilience strategies. Data from all workshops were aggregated, analyzed, and interpreted to develop priorities representative of participating locations.
Results:
Eight themes emerged representing the need for better integration of public health and disaster management systems. These include: assessing community disease burden; embedding long-term recovery groups in emergency systems; exploring mental health care needs; examining ecosystem risks; evaluating reserve funds; identifying what crisis communication strategies worked well; providing non-medical services; and reviewing resilience of existing facilities, alternate care sites, and institutions.
Conclusions:
The Scorecard is an effective tool for establishing baseline resilience and prioritizing actions. The strategies identified reflect areas in most need for investment to improve public health system resilience.
COVID-19 conforms to key baseline characteristics of disaster which is defined as “a situation or event that overwhelms local capacity, necessitating a request for national or international level of assistance.” Many countries faced shortages of health workforce, maldistribution, misalignment of needs and skills of healthcare workers.
The research goal is to identify the country responses on the shortage of workforce, their best practices and the lessons learned that may help to better handle any similar crisis in the future.
Method:
The scoping review was conducted in four electronic academic databases, namely, Medline, Web of Science, EBSCO, and TRIP and 24 scientific articles were reviewed. This study is funded by the World Health Organization Centre for Health Development (WKC-HEDRM-K21001).
Results:
The main strategies implemented were a financial coordination mechanism, relaxing standards/rule, redeployment, recruiting volunteers, fast tracking medical students, and using other resources in the workforce such as: the recruitment of inactive healthcare workers, returnees whose registration has lapsed within the last 1-2 years and integration of internationally educated health professionals. All these strategies demonstrated advantages like establishing mutual support across nations, organizations, motivating healthcare workers, lessening the workload of healthcare workers, and creating a new staff model for the next pandemic. If a pandemic lasts longer, financial support mechanisms are no longer feasible and longer working hours result in burnout. Managing volunteers, including supervision of their safety and allocation to the area in need, required hard effort and high-level coordination, especially when a needs assessment is unavailable. Another problem was the absence of an available list of resources, including volunteers and retired medical personnel.
Conclusion:
To date, countries have not yet determined clear policies on how to ensure the sustainability and resilience of the workforce during major health shocks. A follow-up study investigating the strategies implemented is needed.
A prepared and well-trained workforce is essential to reducing the loss of lives from health emergencies. However, it is uncertain what should be included in the common set of core competencies for the health emergency and disaster risk management (Health EDRM) workforce. The objective of the study is to provide evidence mapping for the competencies in existing professional development programs and courses in Health EDRM.
Method:
A survey conducted using an online platform (Survey Monkey) was conducted from October to November 2021. Experts in the Health EDRM Research Network including experts identified for the Delphi studies were invited to join the study. Participants should be ≥ 18 years of age, and had relevant experience in Health EDRM and in disaster education and training programs. A self designed questionnaire containing 28 questions in four domains including competencies; curriculum; evidence gaps; work and personal details were used.
Results:
There were 65 respondents from 20 countries participating in the survey. Most of the respondents worked in academic institutions (60%), followed by government employees (19%), and non-governmental organizations (7%). These organizations have roles throughout the disaster cycle with 95% in the preparedness phase. For management skills, EDRM managers should be competent in planning, organizing, applying management processes, establishing effective communication systems and providing effective leadership. For technical competencies, emergency communications, hazard specific knowledge, communicable diseases were essential for frontline workers. In terms of designing the competency matrix, WHO resources were frequently used for the competencies and the curriculum design.
Conclusion:
Health EDRM managers are expected to master a large number of managerial and technical skills, including the increasingly recognized leadership and decision-making skills for effective planning and implementation. These competencies need to be established for the development of a Health EDRM workforce.
WHO Thematic Platform for Health Emergency and Disaster Risk Management Research Network (Health EDRM RN) is a global expert network, launched in 2018, aiming to strengthen the scientific evidence for managing health risks associated with all types of emergencies and disasters, and to foster global collaboration among academia, government officials and other stakeholders. The Health EDRM RN’s activities are in line with WHO Health EDRM Framework, which support Sendai Framework for Disaster Risk Reduction 2015-2030.
Method:
Health EDRM RN’s strategic direction is discussed and advised by its Core Group that consists of focal points of WHO HQ responsible unit, all six Regional Offices, WHO Center for Health Development (Secretariat), RN co-chairs, and key external stakeholders. Based on the strategic direction, the Secretariat facilitates global, regional, and local collaborative activities with the RN participants and partners. As of 2022, over 250 global experts participate in the network.
Results:
Following the results of the Core Group Meeting in 2019, 2020 and 2021, multiple activities and results were generated including the identification of five Health EDRM key research areas. WHO Guidance on Research Methods for Health EDRM developed in collaboration with over 150 global experts, initiation of the project to establish WHO Health EDRM Knowledge Hub for developing WHO Health EDRM Research Agenda and aligning with UNDRR research agenda on thematic areas including developing a special supplement on mid-term review of Sendai Framework implementation in health. The 2022 Core Group Meeting, held on October 27, 2022, agreed to promote knowledge dissemination and implementation research for better outputs for regions and countries.
Conclusion:
WHO Health EDRM RN will continue its unique function as the platform of global experts and stakeholders to produce, disseminate, and apply knowledge. Participation and engagement by more and broader experts are expected.
In order to promote useful and usable scientific evidence for health emergency and disaster risk management (Health EDRM), the World Health Organization (WHO) Health EDRM Knowledge Hub has been established as part of the WHO Thematic Platform for Health EDRM research network (Health EDRM RN). The Knowledge Hub aims to extend scientific knowledge; strengthen evidence-based practice in the management of health risks in emergencies and disasters; create and develop a competent network in the Health EDRM community; and integrate research, policy and practice.
Method:
To begin with, the Knowledge Hub has five interconnected research themes: (1) health data management; (2) psychosocial support; (3) health needs of sub-populations; (4) health workforce development; and (5) research methods. Systematic literature reviews and expert consultations have assessed current research under each theme and identified potential knowledge gaps. The work of the Knowledge Hub is advised by members of the Health EDRM RN and staff in WHO regional offices.
Results:
The WHO Health EDRM Knowledge Hub will be a platform for providing and exchanging up-to-date evidence. This will include information on validated methods for managing health data and identifying health needs in specific subpopulations. The Knowledge Hub will raise awareness of psychosocial support, health workforce development and research before, during and after disasters. It is targeted to policy-makers, researchers, practitioners and the broader community with the aim of accelerating evidence-informed policy and programs. This will support implementation of the Sendai Framework for Disaster Risk Reduction 2015–2030, the WHO Health EDRM Framework, and other related global, regional and national agendas.
Conclusion:
This paper introduces this new initiative and describes its objectives, design, and implementation. Additionally, it provides an overview of the Knowledge Hub and invites session participants to provide insights into their current needs and to make recommendations for improvement.
The mental health consequences of health emergencies and disasters have the potential to be sustained and severe. In recognition, the 2018 Kobe Expert Meeting on Health Emergency and Disaster Risk Management (Health EDRM), prioritized mental health as one of the key research areas of Health EDRM, to be addressed in a multi-country research project supported by WHO (Kayano et.al., 2019). As climate change, growing urbanization, population density and viral transmission generate increasingly severe hazards, attention to mental health will be critical.
Method:
The Asia Pacific Disaster Mental Health Network was established in 2020 to foster advancements in mental health research and policy in the region. Building connections between researchers, practitioners and policy makers, the Network includes broad representation from interdisciplinary scholars and organizations across eight Asian and Pacific nations. A research agenda was designed in early meetings, and collaborative research projects were established.
Results:
The Network has supported the development of innovative disaster mental health research investigating community engagement in recovery, psychosocial interventions, and evaluation frameworks. A recent multilingual systematic review of more than 200 longitudinal studies identified the long-term trajectories of post-traumatic stress symptoms, depression and anxiety following disasters and pandemics (Newnham et al., 2022). Synthesized evidence of risks related to age, gender and disaster type were determined to inform intervention targets.
Conclusion:
The Asia Pacific Disaster Mental Health Network established a platform for scholarly connection, intervention planning and knowledge dissemination. This presentation will provide an overview of the Network’s activities, and research highlights that have identified targeted points for policy and practice.
In the last ten years, Japan has experienced several large-scale earthquakes with devastating social and health impacts. Earthquakes directly and indirectly cause a variety of health problems. Further investigation is required to increase preparedness and preventive efforts. In response to the Hokkaido Eastern Iburi Earthquake on September 6, 2018, 32 Emergency Medical Teams (EMTs) employed the Japanese version of Surveillance in Post-Extreme Emergencies and Disasters (J-SPEED) as a national standard daily reporting template, gathering data on the number and type of health problems treated.
Study Objective:
The purpose of the study is to conduct a descriptive epidemiology study using the J-SPEED data to better understand the health problems during the earthquake disaster.
Methods:
Reported items in J-SPEED (Ver 1.0) form were analyzed by age, gender, and time to better understand the health issues that have arisen from the earthquake.
Results:
Most consultations (721; 97.6%) occurred between Day 1 and Day 13 of the 32-day EMT response. During the response period, disaster stress-related symptoms were the most common health event (15.2%), followed by wounds (14.5%) and skin diseases (7.0%).
Conclusion:
The most often reported health event during the response period was stress-associated illnesses related to disasters, followed by wounds and skin conditions. The health consequences of natural disasters depend on diverse local environment and population. As a result, this initial study was hard to generalize; however, it is expected that data accumulated using the J-SPEED system in the future will strengthen and extend the conclusions.
During a disaster, comprehensive, accurate, timely, and standardized health data collection is needed to improve patient care and support effective responses. In 2017, the World Health Organization (WHO) developed the Emergency Medical Team (EMT) Minimum Data Set (MDS) as an international standard for data collection in the context of disasters and public health emergencies. The EMT MDS was formally activated for the first time in 2019 during the response to Cyclone Idai in Mozambique.
Study Objective:
The aim of this study was to analyze data collected through the EMT MDS during Cyclone Idai of 2019 and to identify the benefits of and opportunities for its future use.
Methods:
The EMT MDS was used for data collection. All 13 international EMTs deployed from March 27 through July 12 reported data in accordance with the EMT MDS form. The collected data were analyzed descriptively.
Results:
A total of 18,468 consultations, including delivery of 94 live births, were recorded. For children under-five and those five-years and older, the top five reasons for consultation were minor injuries (4.5% and 10.8%, respectively), acute respiratory infections ([ARI] 12.6% and 4.8%, respectively), acute watery diarrhea (18.7% and 7.7%, respectively), malaria (9.2% and 6.1%, respectively), and skin diseases (5.1% and 3.1%, respectively). Non-disaster-related health events accounted for 84.7% of the total health problems recorded. Obstetric care was among the core services provided by EMTs during the response.
Conclusion:
Despite of challenges, the EMT MDS reporting system was found to support the responses and coordination of EMTs. The role of the Mozambican Ministry of Health (MOH), its cooperation with EMTs, and the dedicated technical support of international organizations enabled its successful implementation.
Health workforce development is essential for achieving the goals of an effective health system, as well as establishing national Health Emergency and Disaster Risk Management (Health EDRM).
Study Objective:
The objective of this Delphi consensus study was to identify strategic recommendations for strengthening the workforce for Health EDRM in low- and middle-income countries (LMIC) and high-income countries (HIC).
Methods:
A total of 31 international experts were asked to rate the level of importance (one being strongly unimportant to seven being strongly important) for 46 statements that contain recommendations for strengthening the workforce for Health EDRM. The experts were divided into a LMIC group and an HIC group. There were three rounds of rating, and statements that did not reach consensus (SD ≥ 1.0) proceeded to the next round for further ranking.
Results:
In total, 44 statements from the LMIC group and 34 statements from the HIC group attained consensus and achieved high mean scores for importance (higher than five out of seven). The components of the World Health Organization (WHO) Health EDRM Framework with the highest number of recommendations were “Human Resources” (n = 15), “Planning and Coordination” (n = 7), and “Community Capacities for Health EDRM” (n = 6) in the LMIC group. “Policies, Strategies, and Legislation” (n = 7) and “Human Resources” (n = 7) were the components with the most recommendations for the HIC group.
Conclusion:
The expert panel provided a comprehensive list of important and actionable strategic recommendations on workforce development for Health EDRM.
The Asia Pacific Conference on Disaster Medicine (APCDM) started in 1988 in Osaka, Japan, and the 14th conference was held from October 16-182, 2018, in Kobe.
Aim:
To give a rundown of the 14th APCDM and a proposal for WADEM.
Methods:
Retrospective analysis of participants, the category of presentations, and deliverables.
Results:
With “Building Bridges for Disaster Preparedness and Response” as its main theme, the 14th APCDM was held near the epicenter of the 1995 Great Hanshin Earthquake in Kobe. The total number of participants was 524 from 35 countries, not only from Asia and the Pacific but also Europe and the Americas. Its program had 10 lectures by distinguished speakers such as WADEM Board members and WHO (World Health Organization), four symposia, two panel, oral and 99 poster presentations. “Preparedness” and “Education and Training” were the categories with the largest number of presentations. The presidential lecture outlined improvements made in Japan since the Great Hanshin Earthquake (disaster base hospitals, disaster medical assistance teams, emergency medical information system, and disaster medical coordinators) and emphasized the importance of standardizing components for better disaster management. This idea was echoed in symposia and round-table discussions, where experts from WHO, JICA (Japan International Cooperation Agency), and ASEAN (The Association of Southeast Asian Nations) countries discussed other components such as SPEED (Surveillance in Post Extreme Emergency and Disasters) and standardization of Emergency Medical Teams.
Discussion:
Each country in the disaster-prone Asia-Pacific region has a different disaster management system. However, participants agreed in this conference that we can cope with disasters more efficiently by sharing the standardized components, from both academic and practical points of view. APCDM must provide these deliverables to WADEM, so both conferences can cooperate and contribute to disaster preparedness and prevention in the new era.
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