Understanding response to COVID-19. How resilient is our health system

Development and pilot testing of a tool to measure health resilience. Then a global dashboard of the various parameters of health system resilience will be developed.

The team lead is Dr. Salman Rawaf, head of the WHO collaborating Center at the Imperial College, London.

On December 21, 2019 China reported pneumonia cases with unknown etiology to WHO. The novel corona virus was isolated from sea food market in Wuhan city, China shortly afterwards. The virus spread to Thailand, Japan and Korea in January 2020, and to most countries of the world by May 2020.  COVID-19 was first detected in the EMR countries in January 29, 2020 when 4 cases were reported to WHO. By the end of February the number of cases started escalating gradually (Figure 1) and in May 13 the total number of cases reported from the 22 EMR countries are 291,444 cases. 

A review by Imperial college indicates that 0.1-27.3% of COVID-19 cases require hospitalization, while 5-70% of those require admission an intensive care unit based on the age group. Considering that there are about 300,000 cases in the EMR regions and the numbers are increasing rapidly. With the increasing number of cases in countries of the region, the health system faces a tremendous challenge in testing, tracing and tracking cases. For that reason, a new look on health systems functioning, and an understanding how the health systems in countries of the region can be resilient and responsive to this and future emergencies is needed. 

This is a multi-country study that will take place in all 22 countries of the EMR region. We will conduct a multi-phase project that will aim at:

• Develop an operational definition and a tool for health system resilience for implementation in EMR countries.
• Validate the tool for health system resilience.
• Assess health system resilience in 22 countries of the EMR region.
• Develop a monitoring scheme for health system resilience. 

Products:

• A systematic review on health system resilience.
• A concept analysis and development of tools to assess health system resilience.
• Validation of a tool to measure health system resilience.
• A report on health system resilience for EMR countries.

1. White paper on Health system resilience.

2. Free to use monitoring tool.

3.Dashboard of Health system resilience globally.

4. The improvement of services as a result of applying this solution will provide better health services and reduce interruption of medical care for those who need them most.

There is a need for this tool in the healthcare systems around the world, especially after the COVID-19 pandemic. Low and middle-income countries have taken the biggest hit without any organisation and basic foundational framework to work during an unexpected event. This all could be avoided by raising the level of resilience that is needed in every healthcare system. 

In addition, policy makers, health managers and practitioners can use the evidence for future planning. This solution will also trigger future research in the various components of the resilience, and will potentially facilitate a deeper understanding and action towards health equity and resilience. 

Also through the number of visitors on the dashboard, the impact can be viewed through needs assessments and reports done on health resilience. feedback from customers and systems. 

2021:  Development and validation of the tool 

2022:  We will start with 10 low and middle income countries  in the Eastern Mediterranean Region of WHO, (depending on the willingness and feasibility), and these include:

• Afghanistan
• Djibouti
• Egypt
• Iran (Islamic Republic of)
• Iraq
• Jordan
• Lebanon
• Libya
• Morocco
• Pakistan
• Somalia
• Sudan
• Syrian Arab Republic
• Tunisia
• Yemen

2023: The  dashboard will be expanded to the remaining countries. By the end of 2023, we shall have all the following countries included

• Afghanistan
• Bahrain
• Djibouti
• Egypt
• Iran (Islamic Republic of)
• Iraq
• Jordan
• Kuwait
• Lebanon
• Libya
• Morocco
• Oman
• Pakistan
• Qatar
• Saudi Arabia
• Somalia
• Sudan
• Syrian Arab Republic
• Tunisia
• United Arab Emirates
• Yemen

Also, the dashboard will be continuously monitored for the the number of visitors.  The impact can be viewed through needs assessments and reports done on health resilience. feedback from customers and systems. 

The indicators are: 

1. A concept analysis paper.

2. An expert consensus paper.

3. A tool for measuring resilience paper.

4. Data from at least 2-3 countries on the tool.

5. A dashboard of global indicator of health systems resilience.

6. At least 3-4 countries with plans to improve relevant health system resilience parameters.

7. Number of visitors to the dashboard.

8. Improvement of health indicators, and health care accessibility in counties that implemented the solution and acted upon it.

1. Infrastructures: For deployment, technology should be used to extend the use of the solution to various countries.

2. Expertise in multi-country tool development:  this can be solved through partnerships with experienced institutions.

3. Data visualisation and scoring: partnerships with experienced organisations in data visualisation and comparisons.

Imperial College London, Arab Public Health Association, 

IHME at the University of Washington has very good experience in developing dashboards 

American tech company SAP for the development of the global dashboard. 

For impact assessment, one potential partner is Said Business School, and the Innovation center for validation.

Funding, technical expertise in tool development and validation, deployment and data visualisation

Imperial College London, for technical research expertise.

Arab Public Health Association

IHME at the University of Washington has very good experience in developing dashboards.

American tech company SAP to assist with design, deployment and sharing the dashboard globally.