Impact of health systems reform on COVID-19 control in Sierra Leone: a case study

Abstract Background There are various impacts of COVID-19 on health systems of the world. The health systems of low- and middle-income countries are less developed. Therefore, they have greater tendencies to experience challenges and vulnerabilities in COVID-19 control compared to high-income countr...

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Bibliographic Details
Published in:Tropical Medicine and Health
Main Authors: Tracey Elizabeth Claire Jones-Konneh, Angella Isata Kaikai, Ibrahim Borbor Bah, Daisuke Nonaka, Rie Takeuchi, Jun Kobayashi
Format: Article in Journal/Newspaper
Language:English
Published: BMC 2023
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Online Access:https://doi.org/10.1186/s41182-023-00521-z
https://doaj.org/article/5e685f51ab0e47c5ad2aa7247a3f694d
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Summary:Abstract Background There are various impacts of COVID-19 on health systems of the world. The health systems of low- and middle-income countries are less developed. Therefore, they have greater tendencies to experience challenges and vulnerabilities in COVID-19 control compared to high-income countries. It is important to contain the spread of the virus, and likewise strengthen the capacity of health systems in order for the response to be effective and swift. The experience from 2014 to 2016 Ebola outbreak in Sierra Leone served as preparation for COVID-19 outbreak. The aim of this study is to determine how control of COVID-19 outbreak in Sierra Leone was enhanced by the lessons learned from 2014 to 2016 Ebola outbreak, and health systems reform. Methods We used data from a qualitative case study conducted in four districts in Sierra Leone through key informant interviews, focus group discussions, document, and archive record reviews. A total of 32 key informant interviews and 14 focus group discussions were conducted. A thematic analysis was used to analyze the data, and all transcripts were coded and analyzed with the aid of ATLAS.ti 9 software program. Results The six themes obtained were composed of categories that connect with each other and with codes to form networks. The analysis of the responses demonstrated that “Multisectoral Leadership and Cooperation”, “Government Collaboration among International Partners”, and “Awareness in the Community” were among the key interventions used during the control of 2014–2016 Ebola virus disease outbreak, which were applied in the control of COVID-19. An infectious disease outbreak control model was proposed based on the results obtained from the analysis of the lessons learned during the Ebola virus disease outbreak, and health systems reform. Conclusions “Multisectoral Leadership and Cooperation”, “Government Collaboration among International Partners” and “Awareness in the Community” are key strategies that enhanced the control of the COVID-19 outbreak in Sierra ...