WHO Health Research Articles

Qualitative multi-stakeholder evaluation of the adoption, implementation and sustainment of theschool-based dietary intervention "Jump-in".

Comprehensive school-based programs applying the WHO Health Promoting School Model have the potential to initiate and sustain behavior change and impact health. However, since they often include intervention efforts on a school's policies, physical environment, curriculum, health care and involving parents and communities, they significantly 'intrude' on a complex system that is aimed primarily at education, not health promotion. More insights into and concrete strategies are therefore needed regarding their adoption, implementation, and sustainment processes to address the challenge to sustainable implementation of HPS initiatives in a primarily educational setting. This study consequently evaluates adoption, implementation and sustainment processes of Amsterdam's Jump-in healthy nutrition HPS intervention from a multi-stakeholder perspective. We conducted semi-structured interviews and focus groups with all involved stakeholders (n = 131), i.e., Jump-in health promotion professionals (n = 5), school principals (n = 7), at-school Jump-in coordinators (n = 7), teachers (n = 20), parents (n = 50, 9 groups) and children (n = 42, 7 groups) from 10 primary schools that enrolled in Jump-in in the school year 2016-2017. Included schools had a higher prevalence of overweight and/or obesity than the Dutch average and they were all located in Amsterdam's low-SEP neighborhoods. Data were analyzed using a directed content analysis, in which the Determinants of Innovation Model was used for obtaining theory-based predetermined codes, supplemented with new codes emerging from the data. During intervention adoption, all stakeholders emphasized the importance of parental support, and accompanying workshops and promotional materials. Additionally, parents and teachers indicated that a shared responsibility for children's health and nuanced framing of health messages were important. During implementation, all stakeholders needed clear guidelines and support structures. Teachers and children highlighted the importance of peer influence, social norms, and uniform application of guidelines. School staff also found further tailoring of the intervention and dealing with financial constraints important. For long-term intervention sustainment, incorporating the intervention policies into the school statutes was crucial according to health promotion professionals. This qualitative evaluation provides valuable insights into factors influencing the adoption, implementation, and sustainment processes of dietary interventions, such as the importance of transparent and consistent intervention guidelines, clear communication regarding the rationale behind intervention guidelines, and, stakeholders' involvement in decision-making.

Catalyzing change: A framework for equitable health among MSM—insights from South Africa for developing nations

AbstractThis research paper seeks to close health disparities among MSM in developing countries by presenting a holistic framework that will ensure equal access to healthcare services. Conducted in South Africa with 25 MSM participants, employing qualitative methods and Nvivo software for analysis, the framework integrates WHO's social health determinants and systems theory principles into three dimensions: Input, process, and output. The main components are sensitization training, community engagement, MSM empowerment, health promotion coupled with the look at finances, human resources, and infrastructure. The study underlines the importance of collective action by MSM and other stakeholders for achieving health equity and offers valuable lessons for policy makers and healthcare professionals in terms of inclusiveness and equal health service delivery. It highlights the critical role of inter‐disciplinary strategy comprising of community participation and resource allocation to erase the health inequality among MSM in developing countries.

Development of indicators to measure health system capacity for quality abortion care in 10 countries: a rapid assessment of a measurement framework and indicators

IntroductionA significant gap exists in the availability of indicators and tools to monitor health system capacity for quality abortion care at input and process levels. In this paper, we describe...

Mercury biomagnification in the food chain of a piscivorous turtle species (Testudines: Chelidae: Chelus fimbriata) in the Central Amazon, Brazil.

Due to their natural history and ecological attributes, turtles are excellent organisms for studies of heavy metal contamination. Turtles have a large geographical distribution, occupy different aquatic habitats, and occupy various trophic levels. The present study investigated mercury bioaccumulation in the carnivorous chelonian Chelus fimbriata (Matamata turtle) and Hg biomagnification in relation to its aquatic food chain in the middle Rio Negro, AM-Brazil. Tissue samples of muscle, carapace and claws were collected from 26 C. fimbriata individuals, as well as collections of autotrophic energy sources found in the turtle's aquatic habitat area. The samples were collected in February-March/2014 and analyzed for THg concentrations and carbon (δ13C) and nitrogen (δ15N) stable isotopes. The highest THg levels were found in claws (3780 ng.g-1), carapace (3622 ng.g-1) and muscle (403 ng.g-1), which were found to be significantly different [F(2.73) = 49.02 p < 0.01]. However, THg concentrations in muscle tissue were below the consumption threshold indicated by the WHO and Brazilian Health Ministry. The average δ13C and δ15N values in Matamata samples were -31.7‰ and 11.9‰, respectively. The principal energy source sustaining the food chain of C. fimbriata was found to be terrestrial shrubs, with smaller contributions from emergent aquatic herbaceous plants and algae, while δ15N values showed its trophic position to be two levels above the autotrophic energy sources. There was a positive correlation between THg and turtle size, while a significant relationship was found between THg and δ15N, showing strong biomagnification in the food chain of C. fimbriata: y = 0.21x + 0.46; r2 = 0.45; p < 0.001, for which the slope presented a value of 0.21.

Utilisation and barriers of social health protection program among its enrolled population of federally administrative areas, Pakistan

ObjectivesThe objective of this research is to analyse the extent of utilisation and identify the barriers faced by individuals in the Federally Administrative Area of Pakistan concerning the Social Health...

Clustering of non-communicable disease risk factors among adolescents in urban and rural Rajasthan

Background: Non communicable diseases (NCDs) are primarily driven by the modifiable risk factors that often emerge during the childhood/adolescence and contribute towards majority of premature deaths during adulthood. This study aimed to assess the prevalence of multiple NCD risk factors and the associated factors among adolescents in urban and rural areas of Rajasthan. Methods: It was a community-based cross-sectional study conducted among 430 school going adolescents. A self-administered questionnaire adapted from STEPS survey format of the WHO and indian adolescent health questionnaire was used; anthropometric measurements were taken using standard procedure. Presence of two or more risk factors in one individual was considered as clustering of NCD risk factors. Results: Prevalence of two risk factors (Dyads) was 48.8% (urban) and 33% (rural), three or more risk factors were found in about 12.1% urban and 7.9% rural adolescents. For “Dyads”, males had OR 3.58 (95% CI 1.9- 6.4) and OR 4.1 (95% CI 2.6-7.9) in urban and rural areas, respectively. The risk of clustering was higher with increasing age [Dyad: OR 1.26 (CI 1.1-5.73) in urban, OR 2.2 (CI 1.56-3.7) in rural; ≥ 3 risk factors: OR 2.3 (CI 1.98-4.11) in urban, OR 1.52 (CI 1.21-4.9)]. Conclusions: Clustering of the risk factors was prevalent among urban as well as rural adolescents emphasizing the importance of developing primary prevention strategies which can be effective across all demographic and socioeconomic backgrounds.

Sex-related inequalities in crude and age-standardized suicide rates: trends in Ghana from 2000 to 2019

BackgroundSuicide represents a major public health concern, affecting a significant portion of individuals. However, there remains a gap in understanding the age and sex disparities in the occurrence of suicide. Therefore, this study aimed to investigate the sex-related inequalities in suicide rates in Ghana from 2000 to 2019.MethodsWe utilized data from the WHO Health Equity Assessment Toolkit (HEAT) online software. We analysed sex differences in both crude and age-standardized suicide rates in Ghana spanning from 2000 to 2019. Crude and age-adjusted suicide rates were calculated based on the International Classification of Diseases (ICD) definition and coding of suicide mortality. We measured inequality in terms of sex. Two inequality indicators were used to examine the suicide rates: the difference (D) and the ratio (R).ResultsAge-standardized and crude suicide rates in Ghana were higher among men from 2000 to 2019. Between 2000 and 2007, the age-standardized suicide rate for women rose steadily and declined slightly between 2008 and 2019. Age-standardized suicide rates for men increased consistently from 2000 to 2010, then declined steadily from 2011 to 2019. The crude suicide rates among men and women followed similar patterns. The widest absolute inequality in crude suicide rates (D) was recorded in 2013 (D=-11.91), while the smallest difference was observed in 2000 (D=-7.16). We also found the greatest disparity in age-standardized rates in 2011 (D=-21.46) and the least in 2000 (D=-14.32). The crude suicide rates increased with age for both men and women aged 15–54 years and 55–85+ years respectively. However, the increased rate was higher in men than in women across all age groups surveyed. A similar pattern was observed for relative inequality in both crude and age-standardized rates of suicide.ConclusionThe suicide rate in Ghana has declined over time. Suicide is more common among older men. Inequalities in suicide rates, in both absolute and relative terms, are similar. There is a need to monitor suicide trends in Ghana, especially among older men. Moreover, the findings could serve as a basis for future studies on suicide in Ghana.

3D Printing Approach in Maxillofacial Surgery in Iran: An Evaluation Using the Non-Adoption, Abandonment, Scale-Up, Spread, and Sustainability (NASSS) Framework

The integration of 3D printing technology in maxillofacial surgery in Iran represents a significant advancement in medical practice, offering unprecedented precision and efficiency in surgical procedures. Employing the Non-Adoption, Abandonment, Scale-Up, Spread, and Sustainability (NASSS) framework and the WHO Health Systems Framework, this study analyzes the complex impact and challenges of 3D printing adoption within the Iranian healthcare sector. Maxillofacial surgery has seen transformative progress with 3D printing’s ability to produce accurate surgical models and customized implants. The results indicate a notable improvement in surgical precision and patient recovery times, alongside combatting identified barriers including technological access, cost, and skill acquisition. This conclusion underscores the critical need for targeted educational programs, policy support, and infrastructure development to overcome these obstacles. This paper highlights 3D printing’s potential to revolutionize maxillofacial surgery in Iran, provided that comprehensive strategies are implemented to address the current limitations and fully leverage this innovative technology’s benefits.

Getting to effective housing policy for health: a thematic synthesis of policy development and implementation

ABSTRACT Impacts of housing on health are well-recognised. Despite this, housing standards have been neglected and there are gaps in healthy housing policies, particularly in low and middle-income countries. Given the recent publication of the WHO Housing and health guidelines, and the need to implement these into policy at all scales, we carried out a focused search and thematic synthesis of available literature on the barriers and enablers to recent housing and health policy. We aimed to generate lessons of what works to support healthy housing policy development and implementation elsewhere. Twenty-three studies representing four countries were eligible for inclusion and covered housing-related risks of air quality, lead, accessible design, and housing conditions. Findings demonstrated that policy development and implementation were facilitated through awareness of housing and health, evidence of existing housing conditions and health impacts, collaborations across sectors and between residents and decision-makers and effective enforcement systems that employed incentives, tools such as certificates for compliance, and housing inspections. Concerns about economic viability and tensions between housing rights and responsibilities limited healthy housing policy for the ‘common good’. Despite limitations in the diversity of available evidence, this thematic synthesis provides a starting point for healthy and equitable housing for all.

Priorities in school eye health in low and middle-income countries a scoping review.

School eye health (SEH) has been on the global agenda for many years, and there is mounting evidence available to support that school-based visual screenings are one of the most effective and cost-efficient interventions to reach children over five years old. A scoping review was conducted in MEDLINE, Web of Science, PubMed, and CINHAL between February and June 2023 to identify current priorities in recent literature on school eye health in low- and middle-income countries (LMICs). Selection of relevant publications was performed with Covidence, and the main findings were classified according to the WHO Health Promoting Schools framework (HPS). A total of 95 articles were included: cross-sectional studies (n = 55), randomised controlled trials (n = 7), qualitative research (n = 7) and others. Results demonstrate that multi-level action is required to implement sustainable and integrated school eye health programmes in low and middle-income countries. The main priorities identified in this review are: standardised and rigorous protocols; cost-effective workforce; provision of suitable spectacles; compliance to spectacle wear; efficient health promotion interventions; parents and community engagement; integration of programmes in school health; inter-sectoral, government-owned programmes with long-term financing schemes. Even though many challenges remain, the continuous production of quality data such as the ones presented in this review will help governments and other stakeholders to build evidence-based, comprehensive, integrated, and context-adapted programmes and deliver quality eye care services to children all over the world.

IJCM_389A: A community based cross-sectional study on perception, attitude, and stigma towards mental illness among the rural community in Mangalore

Introduction: Mental disorder is a behavioral pattern which causes either suffering or poor ability to function in ordinary life. According to WHO health report 2022, 970 million people suffer from mental illness globally. 80% people with mental illness live in low and middle-income countries, which is a matter of concern for India being the most populated country in the world. This study aims to assess the attitude and perception of people towards mental illness and to identify the presence of stigma towards mental illness in the community. Methodology: This cross-sectional study was conducted among 320 individuals aged above 18 years from Jeppinamogaru, Boloor, Shiv Nagar and Neermarga of Mangalore. Data was collected using a pretested semi-structured questionnaire of the CAMI scale rates a total of 40 items on a 5-point Likert scale (1 = strongly agree to 5 = strongly disagree) and analyzed using SPSS version 25. Results were expressed as proportions using appropriate tables and graphs. P&lt; 0.05 was considered as statistically significant. Results: Out of 320 individuals assessed, 73.1% were females, with 50% aged over 45 years. The lower middle class constituted 35.3%, while only 0.6% belonged to the lower class. Awareness of mental illnesses was low, with only 42 individuals (13%) are knowledgeable. Most relied on behavior to identify mental illness, and 54.1% favored hospital treatment. 31.6% believed mental illness was genetically inherited as it is running through families. Medium stigma was prevalent across all domains of the CAMI scale, with the least stigma observed among the upper class. Conclusions: The study revealed low to medium level of stigma toward mental illness among lower and upper middle-class SEC individuals, alongside insufficient knowledge about mental health issues. Addressing these gaps, necessitates community awareness campaigns, enhanced education in schools, and increased accessibility to community-based mental health services and health camps.

"My Health, My Right:" There Is More to It than Meets the Eye.

The WHO's World Health Day 2024 slogan, "My health, my right," has been unpacked through the lens of an evolving social epidemiological understanding. The operative part of the theme merely reiterates international positions that have been established for a long and is unable to adequately incorporate advances in the understanding of the central role that structural determinants play in the production of ill-health. Given the urgency of addressing Sustainable Development Goal and Universal Health Coverage goals, the reduction of health inequities through the promotion of social justice is as much a governance imperative as moral.

The impact of devolution on local health systems: Evidence from Greater Manchester, England

Devolution and decentralisation policies involving health and other government sectors have been promoted with a view to improve efficiency and equity in local service provision. Evaluations of these reforms have focused on specific health or care measures, but little is known about their full impact on local health systems. We evaluated the impact of devolution in Greater Manchester (England) on multiple outcomes using a whole system approach.We estimated the impact of devolution until February 2020 on 98 measures of health system performance, using the generalised synthetic control method and adjusting for multiple hypothesis testing. We selected measures from existing monitoring frameworks to populate the WHO Health System Performance Assessment framework. The included measures captured information on health system functions, intermediatory objectives, final goals, and social determinants of health. We identified which indicators were targeted in response to devolution from an analysis of 170 health policy intervention documents.Life expectancy (0.233 years, S.E. 0.012) and healthy life expectancy (0.603 years, S.E. 0.391) increased more in GM than in the estimated synthetic control group following devolution. These increases were driven by improvements in public health, primary care, hospital, and adult social care services as well as factors associated with social determinants of health, including a reduction in alcohol-related admissions (−110.1 admission per 100,000, S.E. 9.07). In contrast, the impact on outpatient, mental health, maternity, and dental services was mixed.Devolution was associated with improved population health, driven by improvements in health services and wider social determinants of health. These changes occurred despite limited devolved powers over health service resources suggesting that other mechanisms played an important role, including the allocation of sustainability and transformation funding and the alignment of decision-making across health, social care, and wider public services in the region.

Artificial Neural Network Prediction Model for Maternal Health Services Quality in Nigeria

This study presents an innovative approach in predicting the quality of maternal health services in Nigeria using artificial neural networks (ANNs). It focuses on a binary classification task in categorizing maternal health services facilities into "High_Quality" and "Low_Quality" classes. Dataset was collected from diverse healthcare facilities in Nigeria through a WHO Health Resources and Services Availability Monitoring System (HeRAMS) cross sectional-survey report. The collected data was preprocessed; the ANN architecture was developed and trained using back-propagation method. The network was modeled using feed-forward modeling approach with 16 variables at the input layer, 2 hidden layers of 65 and 55 neurons each, and an output of 2 neurons. Hence, 87.17% accuracy with only 2.48% deviation at the 50 epoch was achieved. The model's performance was evaluated using standard metrics of accuracy (87%), precision (88%), recall (89%), and F1-score (88%) to assess its ability to accurately classify maternal health services facilities. The findings of the study can have significant implications to policymakers, healthcare providers, and maternal health advocates to optimize healthcare resources and achieve better maternal health outcomes in Nigeria. Data availability, potential biases in the data, and the subjective nature of some quality-related indicators were acknowledged as limitations. However, despite these challenges, the ANN classification model remains a valuable tool for supporting decision-making in maternal healthcare facility delivery service in Nigeria. Artificial neural network, Binary classification, Health services, Maternal health, Predictive modeling

Learning from the End of the Public-Private Partnership for Lesotho's National Referral Hospital Network.

Public-private partnerships (PPP) are one strategy to finance and deliver healthcare in lower-resourced settings. Lesotho's Queen 'Mamohato Memorial Hospital Integrated Network (QMMH-IN) was sub-Saharan Africa's first and largest integrated healthcare PPP. We assessed successes and challenges to performance of the QMMH-IN PPP. We conducted 26 semi-structured interviews among QMMH-IN executive leadership and staff in early 2020. Questions were guided by the WHO Health System Building Blocks Framework. We conducted a thematic analysis. Facilitators of performance included: 1) PPP leadership commitment to quality improvement supported by protocols, monitoring, and actions; 2) high levels of accountability and discipline; and 3) well-functioning infrastructure, core systems, workflows, and internal referral network. Barriers to performance included: 1) human resource management challenges and 2) broader health system and referral network limitations. Respondents anticipated the collapse of the PPP and suggested better investing in training incoming managerial staff, improving staffing, and expanding QMMH-IN's role as a training facility. The PPP contract was terminated approximately five years before its anticipated end date; in mid-2021 the government of Lesotho assumed management of QMMH-IN. Going forward, the Lesotho government and others making strategic planning decisions should consider fostering a culture of quality improvement and accountability; ensuring sustained investments in human resource management; and allocating resources in a way that recognizes the interdependency of healthcare facilities and overall system strengthening. Contracts for integrated healthcare PPPs should be flexible to respond to changing external conditions and include provisions to invest in people as substantively as infrastructure, equipment, and core systems over the full length of the PPP. Healthcare PPPs, especially in lower-resource settings, should be developed with a strong understanding of their role in the broader health system and be implemented in conjunction with efforts to ensure and sustain adequate capacity and resources throughout the health system.

‘It’s about time’: policymakers’ and health practitioners’ perspectives on implementing fertility care in the Gambian health system

BackgroundInfertility is a major health issue worldwide, yet very few examples of interventions addressing infertility in the Global South have been documented to date. In The Gambia, West Africa, infertility is recognised as a burden and the health authorities have included it in several health policies and the new National Reproductive Health Strategy however, a detailed operationalisation plan for fertility care has not yet been established. Here, we aim to understand and document the factors that influence the implementation of fertility care in The Gambia.MethodsWe conducted 46 semi-structured interviews with policymakers, implementers, and health practitioners in both the public and private sectors from July to November 2021. The interviews were transcribed, anonymised and analysed with NVivo Pro version 1.6.1. The analysis was initially inductive, with themes arising from the coding categorised according to the WHO health systems building blocks framework.ResultsThis study identified several barriers to a successful implementation of fertility care in The Gambia, including (i) a lack of routinely collected infertility data; (ii) an absence of financial protection mechanisms for patients, and/or a specific budget for infertility; (iii) limited cooperation between the public and private sectors in the provision of fertility care; and (iv) gaps in fertility care training among health practitioners. Conversely, enablers included: (i) strong national infertility leadership; and (ii) the integration of infertility care within public reproductive health services.ConclusionThe Gambian health system is not yet in the position to support a comprehensive fertility care package in its public health facilities. Several aspects of the implementation of fertility care must be considered in operationalising the health strategy including the systematic collection of infertility data, fertility awareness, and the provision of specialised fertility care training. Furthermore, a stronger partnership between the public and private sectors must be developed. Given the increasing availability of assisted reproductive technologies in the sub-Saharan Africa region, and the tendency to locate these technologies in the private sector, further research is needed to understand and identify the processes underlying the implementation of fertility care and to foster better integration with the existing health system.

What makes health systems resilient? An analytical framework drawing on European learnings from the COVID-19 pandemic based on a multitiered approach

IntroductionThe COVID-19 pandemic posed an unprecedented challenge, which caught many health systems widely unprepared. The aim of this research was to develop a comprehensive analytical framework on health system resilience...

Exploring how non-clinical factors in childbirth care shape users’ experiences in public health facilities in rural Chiapas, Mexico: a qualitative study using the WHO health systems responsiveness framework

IntroductionMany Mexicans face barriers to receive delivery care from qualified professionals, especially indigenous and poor sectors of the population, which represent most of the population in the state of Chiapas. When access to institutional delivery care is an option, experiences with childbirth care are often poor. This underscores the need for evidence to improve the quality of services from the user’s perspective. The present study was conceived with the objective of understanding how non-clinical aspects of care shape women’s birthing experiences in public health institutions in Chiapas.MethodsWe conducted an exploratory qualitative study. Data collection consisted in 20 semi-structured interviews to women who had delivered in a public health facility in Chiapas during the last six months prior to the interview. For the design of the interview guide we used the WHO health system responsiveness framework, which focus on the performance of the health system in terms of the extent to which it delivers services according to the “universally legitimate expectations of individuals” and focuses on the non-financial and non-clinical qualities of care. The resulting data were analyzed using thematic analysis methodology.ResultsWe identified a total of 16 themes from the data, framed in eight categories which followed the eight domains of the WHO health systems responsiveness framework: Choice of the provider and the facility, prompt attention, quality of basic amenities, access to social support, respectful treatment, privacy, involvement in decisions, and communication. We shed light on the barriers women face in receiving prompt care, aspects of health facilities that impact women’s comfort, the relevance of being provided with adequate food and drink during institutional delivery, how accompaniment contributes positively to the birthing experience, the aspects of childbirth that women find important to decide on, and how providers’ interpersonal behaviors affect the birthing experience.ConclusionsWe have identified non-clinical aspects of childbirth care that are important to the user experience and that are not being satisfactorily addressed by public health institutions in Chiapas. This evidence constitutes a necessary first step towards the design of strategies to improve the responsiveness of the Chiapas health system in childbirth care.

Mapping study for health emergency and disaster risk management competencies and curricula: literature review and cross-sectional survey

BackgroundWith the increasing threat of hazardous events at local, national, and global levels, an effective workforce for health emergency and disaster risk management (Health EDRM) in local, national, and international communities is urgently needed. However, there are no universally accepted competencies and curricula for Health EDRM. This study aimed to identify Health EDRM competencies and curricula worldwide using literature reviews and a cross-sectional survey.MethodsLiterature reviews in English and Japanese languages were performed. We searched MEDLINE, EMBASE, CINAHL (English), and the ICHUSHI (Japanese) databases for journal articles published between 1990 and 2020. Subsequently, a cross-sectional survey was sent to WHO Health EDRM Research Network members and other recommended experts in October 2021 to identify competency models and curricula not specified in the literature search.ResultsNineteen studies from the searches were found to be relevant to Health EDRM competencies and curricula. Most of the competency models and curricula were from the US. The domains included knowledge and skills, emergency response systems (including incident management principles), communications, critical thinking, ethical and legal aspects, and managerial and leadership skills. The cross-sectional survey received 65 responses with an estimated response rate of 25%. Twenty-one competency models and 20 curricula for managers and frontline personnel were analyzed; managers' decision-making and leadership skills were considered essential.ConclusionAn increased focus on decision-making and leadership skills should be included in Health EDRM competencies and curricula to strengthen the health workforce.

Politics and implications on the health systems preparedness to COVID-19 pandemic response: The Malawian experience.

The spread of the COVID-19 disease to Africa has raised concerns around the resultant effects on the fragile and non-resilient health systems. Malawi reported its first COVID-19 cases in early April 2020 at the time of the country's political turmoil, as the courts ruled for a re-run of presidential elections in July 2020 due to irregularities observed in the May 2019 elections. Therefore, assessing the implications of politics on the COVID-19 health systems preparedness is critical to design health systems strengthening efforts during the pandemic. We applied the WHO health systems framework to assess the implications of politics on the COVID-19 on the Malawi health systems preparedness. There was the population's lack of trust in government hampering government efforts, which posed as a huge concern for Malawi to navigate through the pandemic including the health systems preparedness for the pandemic. This, coupled with mass demonstrations by the public disagreeing with the Lockdown and health service providers put across their COVID-19 related demands. The political environment and the trust people have in the government determines a country's response to a pandemic. In a pandemic situation like COVID-19, the government's ability to coordinate the various key stakeholders while instilling trust in people remain critical in strengthening health systems to contain and mitigate the pandemic. However, the Malawi political turmoil highlighted in this paper derailed the process and efforts to contain the and timely prepare the health systems to manage the pandemic whilst maintaining its core functions of delivering essential health services. Therefore, governments should consider the effects of political challenges in supporting a country's health system to prepare for pandemics.