Managing the COVID-19 emergency: A coordination framework to enhance response practices and actions

The COVID-19 Vaccination Rollout in Tanzania: The Role of Coordination in Its Success

Background: The national rollout of a vaccine is a complex and significant undertaking, made more challenging when the health system is experiencing shock, such as in a pandemic. Tanzania had relative success in its COVID-19 vaccination rollout compared to other African countries. Objectives: To better understand factors that contributed to this success, we examined the role of coordination (one of the six immunization system building blocks) on the outcomes of the national vaccine rollout. Methods: We obtained qualitative information from the published literature, COVID-19 vaccination program documents for Tanzania Mainland and Zanzibar, and reports from two documentation workshops with national, regional, and district stakeholders from the government, partners, academia, and civil society. Triangulating this information, we describe the COVID-19 vaccination coordination structure, the roles and responsibilities of its members, and the changes in their engagement and activities over the 18 months following the introduction of the COVID-19 vaccine. We also obtained quantitative data from the CHANJOCOVID system to analyze time trends in national COVID-19 vaccine coverage rates for the period August 2021 to December 2022. Results: We found that Tanzania had a multi-level, multi-partner integrated coordination mechanism that provided strategic direction, oversight, and guidance for the vaccination rollout. The coordination structure was initially weak but strengthened over time. Based on the level of coordination activities undertaken, we identified three periods marking different strengths of the coordination mechanisms, these corresponded with different trends in vaccination coverage in the mainland. In the first period (July-December 2021), the coordination mechanism was weak, and vaccine coverage was low, with only 3% of the target population vaccinated on the mainland. In the second period (January-May 2022), when stakeholder engagement was expanded and the coordination mechanism improved, there was a concurrent rise in vaccine coverage from 4% to 25%. In the third period (June-December 2022), coordination was further strengthened, and vaccination strategies were intensified; a corresponding increase in vaccine uptake was observed with coverage reaching 100% of the target population. Conclusions: Qualitative insights from the three time periods suggest a positive association between coordination strength and COVID-19 vaccine coverage. Coordination fostered collaboration, enhanced stakeholder engagement, and facilitated data-driven decision making. This enabled Tanzania to overcome complex challenges and achieve significant progress in vaccination coverage. Strong coordination and effective collaboration among stakeholders are essential mechanisms and processes to optimize vaccine delivery resources and ensure the equitable distribution and uptake of vaccines in Tanzania.

Developing an index for measuring gender lens investing in organizations: the GLIMETRICS framework

Introduction

The objective of this article is to develop and validate a metric for assessing gender lens investing (GLI) practices within organizations. The validation of these measurement items constitutes a methodological innovation, responding to calls in the literature for the exploration of novel approaches in comparative studies.

Methods

To achieve this objective, the development of the measurement items was informed by a comprehensive literature review, and their content validation was conducted through a Delphi study.

Results

The primary outcome of this research is the recommendation and validation of a tool designed to measure various dimensions of GLI practices, from both an academic standpoint and the perspective of expert evaluators.

Implications

The application of this tool is expected to facilitate the integration and generalization of diverse perspectives on GLI. As Investment Fund Agencies and companies increasingly invest in GLI initiatives, there is a growing demand for robust instruments to effectively assess their impact.

Stakeholders' perspectives on barriers to and facilitators of school-based HPV vaccination in the context of COVID-19 pandemic-related disruption: a qualitative mixed methods study

Despite successfully implementing the Human Papilloma Virus Vaccine (HPVV) program, Saskatchewan (SK) struggled to improve HPVV uptake rates. This suboptimal uptake of HPVV with a status quo of HPV-linked cervical cancer incidence rate is mainly because HPVV's impact on cancer prevention has not been realized adequately by vaccine providers and receivers. Further exploration of determinants of HPVV uptake is required to uncover high-resolution quality improvement targets for investment and situate contextually appropriate policies to improve its uptake. The study undertook a qualitative inquiry into understanding stakeholders' perspectives on HPVV experience through school-based programmes. It collected data through semi-structured initial interviews (N = 16) and follow-up interviews (N = 10) from across Saskatchewan's four Integrated Service Areas. Document analysis was conducted on all publicly available documents that included information on HPVV from January 2015 to July 2023. Thematic analysis of the data identified that inadequate information, awareness and education about HPV infection and HPVV among several groups, especially, parents, youth and school staff, was the main barrier to optimal HPVV uptake. Vaccine-related logistics, including the technical and text-heavy vaccine information sheet, understaffing, and time constraints, were other important factors that impeded HPVV uptake. A person-centred approach could educate parents in multiple dimensions.

Managing operational resilience during the implementation of digital transformation in healthcare organisational practices

PURPOSE

The aim of this study is to investigate ways in which healthcare organisations can successfully maintain operational resilience within intricate and varied engagements during digital transformation processes.

DESIGN/METHODOLOGY/APPROACH

The present research applied cultural-historical activity theory as the theoretical framework and the ethnographic account as an approach and strategy to interpret and understand the operational resilience of digital transformation tools in daily practices. Fieldwork was based on the research technique of shadowing, whereby the researcher closely accompanied the participants to record their conduct, activities and exchanges.

FINDINGS

Research results propose that effective operational resilience management in the implementation of digital transformation projects is based on (1) identifying and interpreting internal contradictions in everyday interactions as opportunities for capability developments; (2) navigating through multiple sites in fast and improvised movements, which derives in distributed and emergent practices; (3) interplaying between dyadic interactions and networked dependencies, which is achieved through the articulation of varied interests and (4) implementing novel intermediary tools, roles and regulations that facilitate the reduction of disturbances.

ORIGINALITY/VALUE

The propositions of the present study indicate that the management of operational resilience extends beyond conventional adaptive and socio-technical models in healthcare services. The study emphasises the significance of expressing and converting differing interests into mutual advantages. It additionally demonstrates the intricacy of this obstacle, as it entails navigating through uncertain information, concealed interpretations and conflicting interests.

The influence of political disagreements and corruption on state health leader turnover during the COVID-19 pandemic in Brazil

PURPOSE

Governments faced formidable challenges in coordinating public health responses to the COVID-19 pandemic. This study aims to enhance the understanding of effective organizational leadership during crises by investigating the factors influencing the turnover of health leaders during the COVID-19 pandemic in Brazil.

DESIGN/METHODOLOGY/APPROACH

Using primary data encompassing all appointments and dismissals of federal and state health secretaries, this paper conducted a quantitative analysis of the relational and reputational factors that contributed to leader turnover during the COVID-19 pandemic. This paper also examined whether leaders' management and public health experience increase the duration of tenure.

FINDINGS

States encountered significant challenges in retaining experienced and effective leadership during the health emergency, primarily due to political conflicts in policymaking and, to a lesser extent, allegations of corruption. Furthermore, leaders with expertise in public health were found to be less likely to be removed from office. However, managerial experience did not prolong the tenure of state health secretaries during the emergency.

RESEARCH LIMITATIONS/IMPLICATIONS

Since most health leaders have public health and management experience, the contributions of each factor to the duration of a secretary's tenure are difficult to separate and analyze separately.

PRACTICAL IMPLICATIONS

This study provides empirical insights into what factors drive health leader turnover during major health emergencies.

SOCIAL IMPLICATIONS

During major health emergencies, health leaders often strongly disagree with elected officials on the response. This paper test how crisis leadership theories help explain state health leaders' duration in one of the world's largest public health systems during the COVID-19 pandemic. This paper find that policy disagreements contributed to significant turnover.

ORIGINALITY/VALUE

To the best of the authors' knowledge, this paper is the first that are aware of that uses novel primary data on public health executive leader characteristics and turnover causes in the context of the COVID-19 pandemic. It provides empirical evidence contributing to the crisis leadership literature by examining health leader turnover in one of the world's largest public health systems.

How Much Dialogic Coordination Practices Matter to Healthcare Professionals-A Delphi Approach towards a Tool for Identification and Measurement

The study of coordination practices in health policy is a central aspect. The need for further research has been recently highlighted because of COVID-19. In this sense, dialogic practices (DP) have been identified but not validated yet. The purpose of this study is to develop and validate a DP questionnaire for healthcare teams. Items were identified based on a literature review, and the content validation was carried out by means of a Delphi study. A total of 10 experts assessed the clarity and appropriateness of the items and their corresponding measurement scales. After two rounds, a high level of consensus was reached, with agreement of 90% or higher on all items, and a high degree of stability and concordance in the results. This study resulted in a questionnaire consisting of four items, one for each identified DP initially proposed to the experts, as no other practices were revealed. From a practical perspective, the validation of these items constitutes a methodological innovation that responds to the call in the literature to open new avenues for comparative studies, and the possibility of generalising the findings and bringing together different approaches to the problem of coordination, which is key in health policy where unforeseen situations emerge.

Research Progress and Improvement Ideas of Anti-Epidemic Resilience in China's Urban Communities

In the post-epidemic era, China's urban communities are at the forefront of implementing the whole chain of accurate epidemic prevention and control. However, the uncertainty of COVID-19, the loopholes in community management and people's overly optimistic judgment of the epidemic have led to the frequent rebound of the epidemic and serious consequences. Existing studies have not yet formed a panoramic framework of community anti-epidemic work under the concept of resilience. Therefore, this article first summarizes the current research progress of resilient communities from three perspectives, including ideas and perspectives, theories and frameworks and methods and means, and summarizes the gap of the current research. Then, an innovative idea on the epidemic resilience of urban communities in China is put forward: (1) the evolution mechanism of community anti-epidemic resilience is described through the change law of dynamic networks; (2) the anti-epidemic resilience of urban communities is evaluated or predicted through the measurement criteria; (3) a simulation platform based on Multi-Agent and dynamic Bayesian networks simulates the interactive relationship between "epidemic disturbance-cost constraint--epidemic resilience"; (4) the anti-epidemic strategies are output intelligently to provide community managers with decision-making opinions on community epidemic prevention and control.

Coordination and Management of COVID-19 in Africa through Health Operations and Technical Expertise Pillar: A Case Study from WHO AFRO One Year into Response

Background: following the importation of the first Coronavirus disease 2019 (COVID-19) case into Africa on 14 February 2020 in Egypt, the World Health Organisation (WHO) regional office for Africa (AFRO) activated a three-level incident management support team (IMST), with technical pillars, to coordinate planning, implementing, supervision, and monitoring of the situation and progress of implementation as well as response to the pandemic in the region. At WHO AFRO, one of the pillars was the health operations and technical expertise (HOTE) pillar with five sub-pillars: case management, infection prevention and control, risk communication and community engagement, laboratory, and emergency medical team (EMT). This paper documents the learnings (both positive and negative for consideration of change) from the activities of the HOTE pillar and recommends future actions for improving its coordination for future emergencies, especially for multi-country outbreaks or pandemic emergency responses. Method: we conducted a document review of the HOTE pillar coordination meetings’ minutes, reports, policy and strategy documents of the activities, and outcomes and feedback on updates on the HOTE pillar given at regular intervals to the Regional IMST. In addition, key informant interviews were conducted with 14 members of the HOTE sub pillar. Key Learnings: the pandemic response revealed that shared decision making, collaborative coordination, and planning have been significant in the COVID-19 response in Africa. The HOTE pillar’s response structure contributed to attaining the IMST objectives in the African region and translated to timely support for the WHO AFRO and the member states. However, while the coordination mechanism appeared robust, some challenges included duplication of coordination efforts, communication, documentation, and information management. Recommendations: we recommend streamlining the flow of information to better understand the challenges that countries face. There is a need to define the role and responsibilities of sub-pillar team members and provide new team members with information briefs to guide them on where and how to access internal information and work under the pillar. A unified documentation system is important and could help to strengthen intra-pillar collaboration and communication. Various indicators should be developed to constantly monitor the HOTE team’s deliverables, performance and its members.

Resilience in emergency management: Learning from COVID-19 in oil and gas platforms

Emergency management, both in civilian and military context, is regarded as a complex socio-technical system, whose dynamic nature and complexity require a holistic approach. Over time, scholars developed diverse strategies and methods to capture such complexity and effectively design emergency plans for more or less severe disasters scenarios. Nonetheless, planning is not always an omni-comprehensive task, pushing organizations to stretch their adaptive capacities in dynamic and challenging settings. This manuscript explores such adaptive capacity as put in place by a leading Norwegian organization in providing emergency management solutions, facing unexpected challenges (at the time of the event): handling of Covid-19 infection episodes on offshore oil platforms. The study, conducted through the Functional Resonance Analysis Method (FRAM) highlights the relevance of organizational learning which allows to handle emergencies by adapting plans to the specific context and by renewing new emergency management procedures derived from lessons learned. The study focuses on three different Covid-19 infection management cases to understand the nuances of actions and emerging adaptations that led to the development of a revised emergency plan, seen again through the lens of FRAM. While the methodological approach refers to Covid-19 infection management, we believe it can be extended into larger crisis management, providing a use case for the applicability of FRAM into emergency management scenarios.

Incentive Mechanism Design in Collaborative Management of Public Health Emergencies

Against the background of the worldwide spread of the COVID-19 pandemic, due to the lack of effective collaborative incentive mechanisms, issues of dislocation and incoordination have emerged in the public health emergency management system (PES) globally. Nevertheless, the available research rarely touches upon the incentive mechanism design for the collaborative management of PES. To alleviate these inefficiency operations problems with PES, three game-theoretical decision models, including a decentralized decision model without public governance policy incentive (GPI), a decentralized decision model with GPI, and a collaborative decision model with GPI, were developed and analyzed to explore and design the incentive mechanism of PES. Furthermore, the corresponding numerical and sensitivity analyses were conducted to validate the modelling results in the article. The research results show that: (1) the collaborative decision scenario with GPI performs best, and the decentralized decision scenario with GPI performs second-best regarding the equilibrium emergency management efforts (EMEs) and utilities in all the decision scenarios; (2) an incentive mechanism of the “carrot + Stick” can effectively enhance the collaborative management of public health emergencies and its governance-driven operational performance/efficiency; (3) strengthening the performance assessment of emergency management for relevant government departments is beneficial in improving the overall emergency management efficiency of the PES; (4) reducing the cost of EMEs and enhancing the effectiveness of EMEs are conducive to improving the overall emergency management efficiency of the PES. This research provides a novel framework for designing an effective incentive mechanism to overcome the incoordination impacts and achieve collaborative operations across the PES.

Coordination mechanisms for COVID-19 in the WHO Regional office for Africa

Aim

This study describes the coordination mechanisms that have been used for management of the COVID 19 pandemic in the WHO AFRO region; relate the patterns of the disease (length of time between onset of coordination and first case; length of the wave of the disease and peak attack rate) to coordination mechanisms established at the national level, and document best practices and lessons learned.

Method

We did a retrospective policy tracing of the COVID-19 coordination mechanisms from March 2020 (when first cases of COVID-19 in the AFRO region were reported) to the end of the third wave in September 2021. Data sources were from document and Literature review of COVID-19 response strategies, plans, regulations, press releases, government websites, grey and peer-reviewed literature. The data was extracted to Excel file database and coded then analysed using Stata (version 15). Analysis was done through descriptive statistical analysis (using measures of central tendencies (mean, SD, and median) and measures of central dispersion (range)), multiple linear regression, and thematic analysis of qualitative data.

Results

There are three distinct layered coordination mechanisms (strategic, operational, and tactical) that were either implemented singularly or in tandem with another coordination mechanism. 87.23% (n = 41) of the countries initiated strategic coordination, and 59.57% (n = 28) initiated some form of operational coordination. Some of countries (n = 26,55.32%) provided operational coordination using functional Public Health Emergency Operation Centres (PHEOCs) which were activated for the response. 31.91% (n = 15) of the countries initiated some form of tactical coordination which involved the decentralisation of the operations at the local/grassroot level/district/ county levels. Decentralisation strategies played a key role in coordination, as was the innovative strategies by the countries; some coordination mechanisms built on already existing coordination systems and the heads of states were effective in the success of the coordination process. Financing posed challenge to majority of the countries in initiating coordination.

Conclusion

Coordinating an emergency is a multidimensional process that includes having decision-makers and institutional agents define and prioritise policies and norms that contain the spread of the disease, regulate activities and behaviour and citizens, and respond to personnel who coordinate prevention.

Investigating the role of stakeholder engagement for more resilient vaccine supply chains during COVID-19

The complexity of the supply chains and the uncertainties in the processes cause business to become more vulnerable in the face of disruptions. Pandemic situations such as COVID-19 cause sudden disruptions in supply chains, causing processes to be disrupted. Especially in multi-stakeholder supply chains, the importance of stakeholder communication, motivation, and regulations i.e. comes to the forefront in order to ensure the resilience of supply chains. As learned with the COVID-19 pandemic, vaccine supply chains are also one of the multi-stakeholder supply chains and are extremely vulnerable to disruptions. In COVID-19 times, the importance of vaccine supply chain management and the resilience in vaccine supply chains increased. To have more resilient vaccine supply chains, stakeholder engagement is an essential issue. Therefore, the Graph Theory Matrix Approach has been used to determine factors of stakeholder engagement in multi-stakeholder vaccine supply chains and to specify the relationships between the factors of project and stakeholder engagement in vaccine supply chains to increase resilience in disruption times. The aim of the study is to identify the factors of project and stakeholder engagement that are necessary to ensure the resilience of multi-stakeholder vaccine supply chains and not be affected by disruptions such as COVID-19 as it is today. As a result of the study, innovativeness of stakeholders is the most important factor of stakeholder engagement in vaccine supply chains.

Designing a drone assisted sample collection and testing system during epidemic outbreaks

Purpose

A major component in managing pandemic outbreaks involves testing the suspected individuals and isolating them to avoid transmission in the community. This requires setting up testing centres for diagnosis of the infected individuals, which usually involves movement of either patient from their residence to the testing centre or personnel visiting the patient, thus aggregating the risk of transmission to localities and testing centres. The purpose of this paper is to investigate and minimize such movements by developing a drone assisted sample collection and diagnostic system.

Design/methodology/approach

Effective control of an epidemic outbreak calls for a rapid response and involves testing suspected individuals and isolating them to avoid transmission in the community. This paper presents the problem in a two-phase manner by locating sample collection centres while assigning neighbourhoods to these collection centres and thereafter, assigning collection centres to nearest testing centres. To solve the mathematical model, this study develops a mixed-integer linear programming model and propose an integrated genetic algorithm with a local search-based approach (GA-LS) to solve the problem.

Findings

Proposed approach is demonstrated as a case problem in an Indian urban city named Kolkata. Computational results show that the integrated GA-LS approach is capable of producing good quality solutions within a short span of time, which aids to the practicality in the circumstance of a pandemic.

Social implications

The COVID-19 pandemic has shown that the large-scale outbreak of a transmissible disease may require a restriction of movement to take control of the exponential transmission. This paper proposes a system for the location of clinical sample collection centres in such a way that drones can be used for the transportation of samples from the neighbourhood to the testing centres.

Originality/value

Epidemic outbreaks have been a reason behind a major number of deaths across the world. The present study addresses the critical issue of identifying locations of temporary sample collection centres for drone assisted testing in major cities, which is by its nature unique and has not been considered by any other previous literature. The findings of this study will be of particular interest to the policy-makers to build a more robust epidemic resistance.

Strategies for Creative Tourism Activities in Pandemic Contexts: The Case of the ‘Saídas de Mestre’ Project

The development of creative tourism in small towns in rural areas has been the subject of growing interest and research from different perspectives. As part of the national CREATOUR project, which took place in Portugal over about four years, various organisations with relevant activity in the cultural aspect of creative tourism were analysed, constituting a successful reference at a national and international level. However, since mid-2020, the health crisis owing to the pandemic made it necessary to reflect and work under new circumstances for tourism, in contexts not previously planned for, and at the same time as continuing to champion sustainable development. It is in this context that the present study emerges, the aim of which is to identify organizations’ strategies for adaptation within the scope of creative tourism activities in a pandemic situation. This empirical approach is anchored in the case study of the activities of the ‘Saídas de Mestre’ project based on intangible cultural heritage, using in-depth analysis of strategies developed to mitigate the effects of supply and demand constraints. The results show that there was no disintegration of the supply structure, as planned, due to the fact that creative activities are based on the valorisation of the principles of sustainable development and, therefore, depend on endogenous resources and local agents, who remained accessible.

Digital knowledge sharing and creative performance: Work from home during the COVID-19 pandemic

The outbreak of the COVID-19 pandemic and the resulting social distancing requirements have led to major disruptions in the world of work. The outcomes of the enforced and large-scale work from home (WFH) practices are currently largely unexplored. This study aims to address this gap in the research by investigating the external and internal digital knowledge sharing (DKS) and creative performance (CP) of employees under these extraordinary circumstances. The social capital theory was utilized as the theoretical lens for examining the associations of DKS and CP with demographic, individual, and organizational factors. An online cross-sectional survey was carried out among knowledge workers based in Norway during the pandemic lockdown. The study results indicate that internal and external DKS are significant predictors of CP in the WFH context during the COVID-19 pandemic. Females and older employees are more likely to engage in external DKS than their counterparts. Furthermore, individual motivation is found to be positively associated with internal DKS, external DKS, and CP. The findings suggest that increased use of digital platforms helps increase CP in the WFH setting resulting from the pandemic. Various theoretical and practical implications are discussed, and future research avenues are proposed.

Contributions of Smart City Solutions and Technologies to Resilience against the COVID-19 Pandemic: A Literature Review

Since its emergence in late 2019, the COVID-19 pandemic has swept through many cities around the world, claiming millions of lives and causing major socio-economic impacts. The pandemic occurred at an important historical juncture when smart solutions and technologies have become ubiquitous in many cities. Against this background, in this review, we examine how smart city solutions and technologies have contributed to resilience by enhancing planning, absorption, recovery, and adaptation abilities. For this purpose, we reviewed 147 studies that have discussed issues related to the use of smart solutions and technologies during the pandemic. The results were synthesized under four themes, namely, planning and preparation, absorption, recovery, and adaptation. This review shows that investment in smart city initiatives can enhance the planning and preparation ability. In addition, the adoption of smart solutions and technologies can, among other things, enhance the capacity of cities to predict pandemic patterns, facilitate an integrated and timely response, minimize or postpone transmission of the virus, provide support to overstretched sectors, minimize supply chain disruption, ensure continuity of basic services, and offer solutions for optimizing city operations. These are promising results that demonstrate the utility of smart solutions for enhancing resilience. However, it should be noted that realizing this potential hinges on careful attention to important issues and challenges related to privacy and security, access to open-source data, technological affordance, legal barriers, technological feasibility, and citizen engagement. Despite this, this review shows that further development of smart city initiatives can provide unprecedented opportunities for enhancing resilience to the pandemic and similar future events.