Infrastructures of epidemic response: Mpox and everyday repair work in southwestern Nigeria.

Autor: Schmidt-Sane M; Health & Nutrition Cluster, Institute of Development Studies, University of Sussex, Library Road, Falmer, Brighton, BN1 9RE, United Kingdom. Electronic address: ms2244@sussex.ac., Adegoke O; Department of Sociology, Faculty of the Social Sciences, University of Ibadan, Ibadan, Nigeria., Abbas S; Health & Nutrition Cluster, Institute of Development Studies, University of Sussex, Library Road, Falmer, Brighton, BN1 9RE, United Kingdom., Lawanson AO; Department of Economics, University of Ibadan, Ibadan, Nigeria., Kunnuji M; Department of Sociology, University of Lagos, Akoka, Lagos, Nigeria., Jegede A; Department of Sociology, Faculty of the Social Sciences, University of Ibadan, Ibadan, Nigeria., MacGregor H; Health & Nutrition Cluster, Institute of Development Studies, University of Sussex, Library Road, Falmer, Brighton, BN1 9RE, United Kingdom.
Jazyk: angličtina
Zdroj: Social science & medicine (1982) [Soc Sci Med] 2024 Oct; Vol. 358, pp. 117246. Date of Electronic Publication: 2024 Aug 13.
DOI: 10.1016/j.socscimed.2024.117246
Abstrakt: Mpox (formerly known as monkeypox) was declared a Public Health Emergency of International Concern (PHEIC) by the World Health Organization on 23rd July 2022, however cases of the disease have been detected in Nigeria since the 1970s and more recently since it began spreading in more urban areas of the country from 2017 onward. Nigeria has a strong track record of epidemic preparedness and response, spearheaded by the Nigeria Centre for Disease Control. Despite being somewhat separate architectures on paper, epidemic response (in particular, integrated disease surveillance and response) relies on a foundation of primary health care, which is inadequately funded not only in Nigeria, but globally. Situating mpox response within this wider landscape, we draw on ethnographic research from September 2022-March 2023 in southwestern Nigeria on lived experiences of mpox and mpox response, focusing on the perspectives of frontline health workers and community-based suspected or confirmed mpox cases. We aimed to understand how prioritization and resource constraints shape mpox response at a local level, including effects on the everyday work of frontline health workers in public health and clinical care who are left to "make do." We analyze their experiences interfacing with two intersecting infrastructures, community-based surveillance and primary health care. Health workers' improvisation and "repair work," which we detail, enables the surveillance system to function in some capacity. However, health workers must regularly contend with competing priorities and routine care that may be sidelined during an outbreak or epidemic. We argue that this reveals the limitations of a global health security agenda as it materializes at a local level and the need for strengthening primary health care for longer-term sustainability.
(Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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