Preparedness Plans Research Articles

Lessons Learned From Local Health Departments: Updating Preparedness Plans to Address People Experiencing Homelessness During WASH-Related Emergencies.

Lessons Learned From Local Health Departments: Updating Preparedness Plans to Address People Experiencing Homelessness During WASH-Related Emergencies.

Policies for type 2 diabetes and non-communicable disease management during the COVID-19 pandemic in Kenya and Tanzania: a desk review and views of decision-makers

BackgroundThe COVID-19 pandemic caused disruptions in care that adversely affected the management of non-communicable diseases (NCDs) globally. Countries have responded in various ways to support people with NCDs during the...

Structural Analysis of Pre-hazard Preparedness Criteria in Iranian Large Cities

Studies have shown that Iranian large cities have experienced the most casualties and damages from natural hazards in 2010–2020 due to structural reasons. This research aims to extract, classify and determine the final model of drivers affecting the preparedness of these cities against natural hazards. The criteria were extracted by studying records and using the Delphi model’s opinions of 150 experts and city managers in 10 large cities. The combined output was 8 criteria and 70 sub-criteria that were assorted by considering the particular conditions of each study area. To obtain a multi-dimensional and comprehensive model, PROMETHEE and GAIA as structural methods have been used. PROMETHEE findings indicated that the most effective criteria for preparedness in large cities of Iran against natural hazards are institutional-managerial and social-citizenship. Also, based on GAIA VISUAL results, the comprehensive disaster preparedness plan and hazard mapping were identified as vital drivers and prerequisites of hazard preparedness. The output of GAIA has also shown that regarding the challenges of local government financing, the economic criteria (hazard-based investment, emergency budget and business continuity training) were the main facilitators and accelerators of the preparedness of Iranian large cities against natural hazards.

Evaluating a peer-to-peer health education program in Australian public housing communities during the COVID-19 pandemic

BackgroundThe cohealth Health Concierge program operated in Melbourne, Australia from July 2020 to 30 June 2022. It provided peer-to-peer support to culturally and linguistically diverse residents of high-rise public housing. During this time, the COVID-19 public health response changed frequently and included movement restriction, testing and vaccination. We conducted a mixed-methods evaluation to determine the Health Concierge program’s impact on residents’ engagement with health services and public health activities.MethodsThe evaluation, informed by a Project Reference Group, used the RE-AIM framework. We analysed data from 20,901 routinely collected forms describing interactions between Concierges and residents from August 2021 to May 2022. Additional evaluation-specific data were collected between March and May 2022 in four housing estates; we surveyed 301 residents and conducted 32 interviews with residents, Concierges and program stakeholders.ResultsConcierges promoted COVID-safe behaviours; linked residents with support, testing and vaccination services; and disseminated up-to-date information. Of the 20,901 recorded interactions, 8,872 (42%) included Concierges providing support around COVID-19 vaccination. Most surveyed residents (191/301, 63%) reported speaking with a Concierge in the previous six months. The self-reported two-dose COVID-19 vaccine uptake was 94% (283/301). Some residents described having meaningful, appreciated conversations with Concierges, and some described superficial interactions. While residents initially welcomed the program, many felt it failed to evolve. Poorly defined management and hiring criteria led to variable program implementation. A need for bicultural workers to continue linking residents with services was discussed.ConclusionsConcierges’ impact on residents may have contributed to high community uptake of COVID-19 testing and vaccination, and had benefits beyond the COVID-19 remit. We recommend the program be revised and continued to inform further preparedness planning and support service access generally. Program models such as this have potential to inform and reassure high-risk communities during a pandemic. In addition, such programs can help overcome vaccine hesitancy and promote protective health behaviours, regardless of whether a pandemic is currently occurring. Ensuring these programs remain responsive to the changing needs of end-users needs over time is imperative.

Evaluating urban climate plans for heat preparedness

As climate change continues to intensify temperature extremes across the world, it is critical to understand the impacts of extreme heat events and plan strategies for heat adaptation and mitigation. In this study, we evaluate and compare thirteen climate-related plans of six American cities that are not subject to the hottest climates in the US, but instead have only recently begun dealing with extreme heat: Baltimore, Boston, Chicago, Louisville, Minneapolis, and New York City. We find great variety in the quality of municipal plans for both heat mitigation and heat management in terms of the breadth and strength of relevant policies as well as implementation mechanisms. More specifically, vegetative cover, traffic reduction, and building efficiency improvements are the most frequent and thorough policies across plans, while several others are largely omitted. Furthermore, heat management measures and targeted actions to address equity and vulnerability are barely addressed in these plans. Some American cities’ climate plans set them up for success in preparing for extreme heat, but attention to health outcomes lags behind heat mitigation. Among the studied Midwest and Northeast cities, NYC leads the way.

Knowledge, Attitudes and Practices among Medical Officers on Disaster Preparedness: Study from Base Hospital Panadura (BHP) and Kethumathi Maternity Hospital (KMH), Panadura in Western Province


 
 
 Climate change is contributing to increased disasters in the world. As the disaster events are rising, health, socio-economic and political consequences are inevitable. Therefore, managing disasters to reduce the risk and impacts is given high priority in any development agendas. In this context, emergency and disaster preparedness have become a vital element in disaster management. To manage disaster induced health impacts that include deaths and injuries, hospitals play a major role. The objective of this study was to investigate the knowledge, attitudes, and practices of medical officers on disaster preparedness in two key hospitals in the country. The present study focused on the medical officers in Base Hospital Panadura (BHP) and Kethumathi Maternity Hospital (KMH) regarding disaster preparedness. Cross-sectional research was designed to collect data from the health personnel working in two hospitals through a questionnaire which was prepared and distributed online. Data were collected from 95 and 17 doctors, who were randomly chosen, from BHP and KMH respectively. The majority of the respondents (93%) stated that hospital disaster preparedness plans could assist in reducing morbidity and mortality during an event of a disaster. In both hospitals, 40% of respondents were familiar with the disaster preparedness (DP) programs and 60 % were aware that such programs exist in their hospital. Around 67% and 65% of the medical officers from BHP and KMH respectively had stated that the prior experience of the medical officers is the key to handling a post disaster health management. The statistical analysis indicated that knowledge and practices of the medical officers were significantly linked to DP while the attitudes of the participants did not demonstrate any link to the DP programs. In summary, enhancing knowledge and good practices aiming at post disaster medical care as well as enhanced disaster preparedness activities among the medical officers contribute to disaster risk reduction.
 Keywords: Disaster preparedness, Knowledge, Attitudes, Practices, Medical officers
 
 

A comparative national-level analysis of government food system resilience activities across four developed countries at varying stages of planning

BackgroundThe COVID-19 pandemic, extreme weather events, and the Russian invasion of Ukraine have highlighted global food system vulnerabilities and a lack of preparedness and prospective planning for increasingly complex disruptions. This has spurred an interest in food system resilience. Despite the elevated interest in food system resilience, there is a lack of comparative analyses of national-level food system resilience efforts. An improved understanding of the food system resilience landscape can support and inform future policies, programs, and planning.MethodsWe conducted a cross-country comparison of national-level food system resilience activities from Australia, Aotearoa New Zealand, Sweden, and the United States. We developed upon and adapted the resilience framework proposed by Harris and Spiegel to compare actions derived from thirteen national food system resilience documents. We coded the documents based on the actions taken by the governments including: the food system resilience attributes utilized, the part of the food supply chain, the specific shocks or stressors, the implementation level, the temporal focus of action, and the expected impact on food security. We analyzed and compared countries’ coded categories and subcategories, and category combinations.ResultsThe results showed that these countries are addressing some of the same issues, are using multi-pronged policy actions to address food system resilience issues, and are focused on both retrospective reviews and prospective models of disruptive events to inform their decisions. Some work has been done towards preparing for climate change and other natural disasters, and less preparing has been done for other shocks or stressors.ConclusionsThis paper develops and applies a framework rooted in literature to understand the content of national-level food system resilience documents. The analysis identified potential gaps, concentrations, and themes in national food systems resilience. The framework can be applied to augment existing policy, create new policy, as well as to supplement and complement other existing frameworks.

Enhancing Resilience through Nuclear Emergency Preparedness at El Dabaa Site

The research utilized advanced PCTRAN and RASCAL software to evaluate the potential radiological impacts of hypothetical accidents, specifically loss-of-coolant accident (LOCA) and long-term station blackout (LTSBO), at the El Dabaa Nuclear Power Plant. Over a span of ten years, comprehensive meteorological data were meticulously analyzed to assess the dispersion of radioactive substances within a 40-kilometer radius across all four seasons. The outcomes revealed that only in the case of LTSBO did the radiological levels surpass the limits set by the Environmental Protection Agency (EPA). Notably, during spring, LTSBO exhibited a maximum total effective dose equivalent (TEDE) value of 13 millisieverts (mSv) at a distance of 3.2 kilometers, and the highest thyroid dose (TD) recorded was 63 mSv at 8 kilometers. These significant findings play a crucial role in shaping strategies related to the distribution of potassium iodide (KI) and further enhance the overall preparedness and evacuation planning protocols.

Analysis and Warning Prediction of Tunnel Deformation Based on Multifractal Theory

To better analyze the fluctuation characteristics and development law of tunnel deformation data, multifractal theory is applied to tunnel deformation analysis. That is, the multifractal detrended fluctuation analysis (MF-DFA) model is first utilized to carry out the multifractal characterization of tunnel deformation data. Further, Mann–Kendall (M–K) analysis is utilized to construct the dual criterion (∆α indicator criterion and ∆f(α) indicator criterion) for the tunnel deformation early warning study. In addition, the particle swarm optimization long-short-term memory (PSO-LSTM) prediction model is used for predicting tunnel settlement. The results show that, in reference to the tunnel warning level criteria and based on the Z-value results of the indicator criterion, the warning level of all four sections is class II. At the same time, through the analysis of tunnel settlement predictions, the PSO-LSTM model has a better prediction effect and stability for tunnel settlement. The predicted results show a slow increase in tunnel settlement over the next 5 days. Finally, the tunnel warning level and the predicted results of tunnel settlement are analyzed in a comprehensive manner. The deformation will increase slowly in the future. Therefore, monitoring and measurement should be strengthened, and disaster preparedness plans should be prepared.

Stakeholder participation in the COVID-19 pandemic preparedness and response plans: A synthesis of findings from 70 countries

Stakeholder participation is a key component of a fair and equitable priority-setting in health. The COVID-19 pandemic highlighted the need for fair and equitable priority setting, and hence, stakeholder participation. To date, there is limited literature on stakeholder participation in the development of the pandemic plans (including the priority setting plans) that were rapidly developed during the pandemic.Drawing on a global study of national COVID-19 preparedness and response plans, we present a secondary analysis of COVID-19 national plans from 70 countries from the six WHO regions, focusing on stakeholder participation.We found that most plans were prepared by the Ministry of Health and acknowledged WHO guidance, however less than half mentioned that additional stakeholders were involved. Few plans described a strategy for stakeholder participation and/or accounted for public participation in the plan preparation. However, diverse stakeholders (including multiple governmental, non-governmental, and international organizations) were proposed to participate in the implementation of the plans. Overall, there was a lack of transparency about who participated in decision-making and limited evidence of meaningful participation of the community, including marginalized groups.The critical relevance of stakeholder participation in priority setting requires that governments develop strategies for meaningful participation of diverse stakeholders during pandemics such as COVID-19, and in routine healthcare priority setting.

The implementation of disaster preparedness training integration model based on Public Health Nursing (ILATGANA-PHN) to increase community capacity in natural disaster-prone areas

Indonesia is at high risk of disasters. Therefore, nursing is expected to play a role in disaster risk reductions in communities. This study aimed to implement the Disaster Preparedness Training Integration Model based on Public Health Nursing (ILATGANA-PHN) to increase the Capacity of community in natural disaster-prone areas by assessing the preparedness level of families and communities in disaster-prone areas. The research method was developed in two stages, including the model preparation stage and the model implementation stage. This research was in the 2nd stage, namely the model impelementation stage. The research design, at the model implementation stage, used the one-sample pre-post test without control group design. The respondents were assessed before and after the ILATGANA-PHN training intervention. The sample size was calculated using the sample size calculation formula for the experimental research design without controls. The samples of the study were 78 people. The result of the research described the ILATGANA-PHN training concepts, including the instrument, curriculum, process, module, and maintenance patterns for the training process. The intervention had a significant effect on increasing the independent preparedness of the people in Kendeng Community, Sugih Mukti Village (ƿ 0.000 ≤ 0.005) in terms of four preparedness parameters, namely knowledge and attitudes about disasters (KA), disaster preparedness plans (PE), disaster warnings (WS), and resource mobilization community (RMC). Nurses have the opportunity to take responsibilities for empowering the community capacity in the disaster area through the implementation of ILATGANA-PHN training. The integrated training model for disaster preparedness based on Public Health Nursing (ILATGANA-PHN) is effective in increasing the community capacity, especially in disaster managements, in disaster-prone areas.

Decision-making drivers for pandemic response for Institutions of Higher Education.

The purpose of this research is to identify how decision-makers within anchor institutions, using the context of higher education, determine the course of action in response to an improbable disaster event, such as the recent coronavirus disease 2019 (COVID-19) pandemic. A survey was conducted among higher education decision-makers during spring 2020 at the moment they were adapting to COVID-19. The survey aimed to identify policies and planning measures that may help Institutions of Higher Education learn from this experience to maintain continuity of operations should similar or unanticipated events occur in the future. With this knowledge, both assets and detriments contributing to community vulnerability can be better balanced to inform decision-making. The outcomes of the analysis and shared reflections inform the development of future policy and strengthen existing processes for preparedness and mitigation planning for unexpected events.

Functional Simulation Exercise on Functionality of National Public Health Emergency Operations Centers in the African Region: Review of Strengths and Gaps.

National public health emergency operations centers (PHEOCs) serve as hubs for coordinating information and resources for effective emergency management. In the International Health Regulations (IHR 2005) Monitoring and Evaluation Framework, a simulation exercise is 1 of 4 components that can be used to test the functionality of a country's emergency response capabilities in a simulated situation. To test the functionality of PHEOCs in World Health Organization African Region member states, a regional functional exercise simulating an Ebola virus disease outbreak was conducted. The public health actions taken in response to the simulated outbreak were evaluated against the exercise objectives. Thematic analysis was conducted to summarize key strengths and areas for improvement. From December 6 to 7, 2022, more than 1,000 representatives from 36 of the 47 African Region member states participated in the exercise from their respective PHEOCs. Approximately 95% of the 461 participants polled agreed with the positive responses to the postexercise survey. More than half of the PHEOC participants were able to test their existing emergency preparedness and response plans and became familiar with the expected roles to be fulfilled during an event. Of the participants who responded to the survey, over 90% reported that the exercise helped them understand their roles during emergency management. The exercise met its objectives and provided an opportunity to test the functionality of PHEOCs using realistic scenarios, and it helped participants understand existing response systems and procedures. However, the exercise also revealed areas for improvement in terms of the timing and preparation of participants. We recommend conducting functional exercises at the regional and national levels at least once a year, early or midyear, to allow many stakeholders to take part in the exercise. Moreover, there is a need to train country-level evaluators and controllers in designing and conducting functional exercises.

Terrorist attacks against healthcare facilities involving hostages.

The incidence of terrorist attacks against healthcare facilities has been increasing over recent years. In addition to direct attacks on physical structures, many attacks have involved taking hostages. Hospital and healthcare facilities remain historically underprepared for terrorist attacks, representing vulnerable locations. Yet, studies examining the frequency and reach of hostage-taking incidents within healthcare facilities are limited. A search of the Global Terrorism Database was performed. A total of 191,465 terrorist attacks were identified. The database search was narrowed down to healthcare-related terrorist attacks (2,322) and then manually analyzed to only include those incidents which involved hospitals and hostage-taking (64). Sixty-four attacks against hospitals involving hostage-taking were identified. A total of 91 victims were injured in these attacks, and 47 were killed. The attacks affected a total of 23 countries worldwide, conducted largely by unidentified terrorist organizations, with approximately half involving firearms. This study shows that terrorist attacks against healthcare facilities that involve -hostage-taking have increased in frequency over the past 10 years and have global reach. Systems may still be underprepared for this potentially increasing phenomenon and require preparedness plans with education and simulated practice in place. Healthcare facilities should consider mitigation strategies such as preparedness drills and additional education.

Prevalence and factors associated with mental illness symptoms among school students post lockdown of the COVID-19 pandemic in the United Arab Emirates: A cross-sectional national study.

Limited data exists on the mental health of children in the United Arab Emirates (UAE). This study aimed to fill this gap by examining the prevalence of anxiety, depression, and risk for Post-Traumatic Stress Disorder (PTSD) among school students in post-lockdown of the COVID-19 pandemic. A sample of 3,745 school students participated, responding to standardized tests (Mood and Feeling Questionnaire-Child Self-Report, Screen for Child Anxiety Related Disorders-Child Version, and Children's Revised Impact of Event Scale-8). Findings showed that the risk for PTSD was the most prevalent (40.6%), followed by symptoms of anxiety (23.3%), and depression (17.1%). For gender differences, symptoms of the three conditions (depression, anxiety, and PTSD) were higher in female students (9.2%) compared to male peers (7.7%) (p = 0.09). Moreover, symptoms of depression and anxiety were found to be higher among late adolescents (p<0.05). Further analysis revealed that having medical problems was a positive predictor for anxiety (OR = 2.0, p<0.01) and risk for PTSD (OR = 1.3, p = 0.002); similarly, witnessing the death of a close family member due to COVID-19 (OR for depression, anxiety, and PTSD = 1.7, p<0.01) were positive predictors associated with PTDS, depression, and anxiety. The study concluded that post COVID-19 lockdown, symptoms of anxiety, depression, and risk for PTSD were found to be prevalent among school students in the UAE. Researchers put forward recommendations on the initiation of a national school mental health screening program, the provision of follow-up services for vulnerable students, and the integration of a mental health support system in the disaster preparedness plans.

Management of pediatric emergencies during natural disasters: The 2023 earthquake in Turkey

The earthquake that occurred in the southeastern region of Türkiye on February 6, 2023 resulted in extensive destruction, affecting 11 provinces and causing a death toll of almost 50,000 individuals. This review emphasizes the unique vulnerabilities that children face in the aftermath of earthquakes and stresses the significance of having preparedness plans specifically tailored to their needs. It is crucial to provide immediate emotional support to children and help them restore their normal routines in order to ensure their well-being. Additionally, emergency nutrition care and mental health services play a vital role in maintaining their long-term health. The disruption of healthcare services also increases the risk of infectious diseases, underscoring the urgency of vaccination efforts. It is crucial that healthcare providers should undergo training and collaborate with each other to adopt a comprehensive approach to pediatric disaster care.

Navigating Flood Resilience: Challenges, Solutions, and Lessons Learnt from the Dominican Republic

Recent unprecedented events worldwide, such as floods in Dubai, recurring heavy rainfall in Santo Domingo, and abrupt temperature changes in the United Kingdom (UK), underscore the tangible impacts of climate change. In response to escalating threats from natural disasters, global communities prioritise resilience and effective disaster management systems. This paper addresses best practices for managing abnormal floods, laying the foundation for the next generation of preparedness and mitigation plans. Focusing on flood risk in Santo Domingo, the study employs the Community Disaster Resilience Framework, conducting a workshop with over 100 stakeholders from government, private, and academic sectors. The assessment spans physical, economic, environmental, and social aspects, revealing common challenges in infrastructure upkeep, public awareness, urban planning, drainage, and economic disparities. The paper proposes technological solutions like predictive maintenance and smart drainage systems, emphasising the potential for implementation. Recognising the importance of community involvement and preparedness, insights from the United Kingdom guide initial steps in strategy development. The conclusions advocate for collaborative efforts among government, academia, and society to navigate the complexities of disaster management and community resilience, ultimately proposing a framework to address these challenges. Further research is suggested in expanding online platforms for disaster risk reduction education in the Caribbean region.

How did European countries set health priorities in response to the COVID-19 threat? A comparative document analysis of 24 pandemic preparedness plans across the EURO region

The COVID-19 pandemic has forced governments across the world to consider how to prioritise the allocation of scarce resources. There are many tools and frameworks that have been designed to assist with the challenges of priority setting in health care. The purpose of this study was to examine the extent to which formal priority setting was evident in the pandemic plans produced by countries in the World Health Organisation's EURO region, during the first wave of the COVID-19 pandemic. This compliments analysis of similar plans produced in other regions of the world. Twenty four pandemic preparedness plans were obtained that had been published between March and September 2020. For data extraction, we applied a framework for identifying and assessing the elements of good priority setting to each plan, before conducting comparative analysis across the sample. Our findings suggest that while some pre-requisites for effective priority setting were present in many cases – including political commitment and a recognition of the need for allocation decisions – many other hallmarks were less evident, such as explicit ethical criteria, decision making frameworks, and engagement processes. This study provides a unique insight into the role of priority setting in the European response to the onset of the COVID-19 pandemic.

Pandemic storytelling and student engagement: how students imagined pandemics before COVID-19 pandemic.

Student engagement is one of the critical issues in science classes. This commentary explores the value of storytelling in microbiology education and student engagement. It is a result of an undergraduate exercise, where students were asked to draft short stories on pandemics before the COVID-19 pandemic (i.e. conducted in 2016-2019). The analysis of student writings (total of 244 short stories) aimed to understand the students' perception of pandemics, the diseases they chose to write about, and their level of knowledge of pandemics. Interestingly, 56.6% of students chose viruses to be the cause of their pandemics, 35.7% chose bacteria, 4.5% chose parasites, and a single student chose a fungus. Respiratory mode of transmission was the top pick in the stories (30%), followed by fecal-oral route, sexually transmitted, and skin-to-skin contact. Therefore, their choice of respiratory diseases as the focus of their short story may suggest their limited understanding of pandemics beyond such diseases. The varying levels of detail in the stories suggested that storytelling could be insightful in identifying knowledge gaps and engaging students. Two exciting questions remain: (1) For the students who wrote those short stories before the COVID-19 pandemic, how did they feel when it hit? (2) If the students are asked again to write a pandemic short story, what would it look like nowadays? A deeper understanding of epidemiology and the social impact of pandemics is crucial for developing effective pandemic preparedness and response plans, and undergraduate courses can play a vital role in this endeavor. Overall, this commentary highlights the value of storytelling in engaging students to assess their knowledge of specific subject matters.

Peningkatan Kapasitas Pegawai Melalui Program Hospital Disaster Plan (HDP) di RSUD dr. Loekmono Hadi Kabupaten Kudus

This research aims to see the results of employee capacity building activities through the Hospital Disaster Plan (HDP) program at RSUD dr. Loekmono Hadi Kudus Regency. Hospital preparedness plans are very important in ensuring the safety of the hospital environment and the actions that need to be taken to ensure health services remain available during a disaster situation. Dr. Hospital Loekmono Hadi needs to develop a hospital preparedness plan. The methods used in hospital employee empowerment activities include pretest-posttest, lecture-discussion, direct training/practice, observation and evaluation methods. The research results show that Disaster Management at RSUD dr. Loekmono Hadi is very important considering that Kudus Regency has a variety of potential disasters and is located in an area that has potential threats of flooding, drought, landslides and earthquakes. there was an increase in pretest and posttest results by 12.00 points. It is felt that activities to strengthen employee capacity through the Hospital Disaster Plan (HDP) program need to be developed further because hospitals need more preparedness capacity in facing disasters or emergency situations and can support home accreditation.