Overcoming Operational Challenges to Ebola Case Investigation in Sierra Leone
| Autor: | Allison Connolly, Adam Hoar, Samuel T Boland, Tom Sesay, Erin Polich, Anh-Minh A Tran |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Process management
media_common.quotation_subject Culture Social Stigma 030231 tropical medicine Transportation Disease Outbreaks Sierra Leone Sierra leone 03 medical and health sciences 0302 clinical medicine Mentorship Information system Humans Medicine 030212 general & internal medicine Personal protective equipment media_common Data collection Operationalization business.industry Management science Communication Politics General Medicine Hemorrhagic Fever Ebola Payment Port (computer networking) Population Surveillance Original Article business Public Health Administration |
| Zdroj: | Global Health: Science and Practice |
| ISSN: | 2169-575X |
| Popis: | Deficiencies in transportation and communication, low frontline staff morale, and mistrust among communities, among other operational challenges, greatly limited Ebola case investigation in Sierra Leone. Recommendations for future outbreaks: (1) timely compensation for frontline staff, (2) context-appropriate transportation and communication resources, (3) systematic data collection, storage, and retrieval systems, (4) sound linkages between frontline staff and communities, (5) daily meetings between frontline staff and epidemiologists, (6) clear and appropriate operational chain of command, and (7) political and funding support to operational agencies. The Ebola virus disease (EVD) epidemic that hit West Africa in 2013 was the worst outbreak of EVD in recorded history. While much has been published regarding the international and national-level EVD responses, there is a dearth of literature on district-level coordination and operational structures, successes, and failures. This article seeks to understand how the EVD response unfolded at the district level, namely the challenges to operationalizing EVD surveillance over the course of the outbreak in Port Loko and Kambia districts of Sierra Leone. We present here GOAL Global's understanding of the fundamental challenges to case investigation operations during the EVD response, including environmental and infrastructural, sociocultural, and political and organizational challenges, with insight complemented by a survey of 42 case investigators. Major challenges included deficiencies in transportation and communication resources, low morale and fatigue among case investigators, mismanagement of data, mistrust among communities, and leadership challenges. Without addressing these operational challenges, technical surveillance solutions are difficult to implement and hold limited relevance, due to the poor quality and quantity of data being collected. The low prioritization of operational needs came at a high cost. To mediate this, GOAL addressed these operational challenges by acquiring critical transportation and communication resources to facilitate case investigation, including vehicles, boats, fuel, drivers, phones, and closed user groups; addressing fatigue and low morale by hiring more case investigators, making timely payments, arranging for time off, and providing meals and personal protective equipment; improving data tracking efforts through standard operating procedures, training, and mentorship to build higher-quality case histories and make it easier to access information; strengthening trust in communities by ensuring familiarity and consistency of case investigators; and improving operational leadership challenges through meetings and regular coordination, establishing an active surveillance strategy in Port Loko, and conducting an after-action review. Resolving or addressing these challenges was of primary importance, and requisite for the implementation of technical epidemiological complements to EVD case investigation. |
| Databáze: | OpenAIRE |
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