Browsing by Person "Gooding, Kate"
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Item How can we strengthen partnership and coordination for health system emergency preparedness and response? Findings from a synthesis of experience across countries facing shocks.(2022-11-29) Gooding, Kate; Bertone, Maria Paola; Loffreda, Giulia; Witter, SophieDiscussions of health system resilience and emergency management often highlight the importance of coordination and partnership across government and with other stakeholders. However, both coordination and partnership have been identified as areas requiring further research. This paper identifies characteristics and enablers of effective coordination for emergency preparedness and response, drawing on experience from different countries with a range of shocks, including floods, drought, and COVID-19. The paper synthesises evidence from a set of reports related to research, evaluation and technical assistance projects, bringing together evidence from 11 countries in sub-Saharan Africa and South Asia. Methods for the original reports included primary data collection through interviews, focus groups and workshop discussions, analysis of secondary data, and document review. Reports were synthesised using a coding framework, and quality of evidence was considered for reliability of the findings. The reports highlighted the role played by coordination and partnership in preparedness and response, and identified four key areas that characterise and enable effective coordination. First, coordination needs to be inclusive, bringing together different government sectors and levels, and stakeholders such as development agencies, universities, the private sector, local leaders and civil society, with equitable gender representation. Second, structural aspects of coordination bodies are important, including availability of coordination structures and regular meeting fora; clear roles, mandates and sufficient authority; the value of building on existing coordination mechanisms; and ongoing functioning of coordination bodies, before and after crises. Third, organisations responsible for coordination require sufficient capacity, including staff, funding, communication infrastructure and other resources, and learning from previous emergencies. Fourth, effective coordination is supported by high-level political leadership and incentives for collaboration. Country experience also highlighted interactions between these components, and with the wider health system and governance architecture, pointing to the need to consider coordination as part of a complex adaptive system. COVID-19 and other shocks have highlighted the importance of effective coordination and partnership across government and with other stakeholders. Using country experience, the paper identifies a set of recommendations to strengthen coordination for health system resilience and emergency management. [Abstract copyright: © 2022. The Author(s).]Item The effectiveness of the Sierra Leone health sector’s response to COVID-19: a quantitative analysis(BioMed Central, 2025-03-12) Osborne, Augustus; Amara, Philip S.; M’Cormack-Hale, Fredline A.O.; Kanu, Mohamed; Kanu, Alhassan Fouard; Yillah, Regina Mamidy; Gooding, Kate; Witter, SophieBackground: The COVID-19 pandemic posed significant challenges to health systems globally, particularly in low-resource settings like Sierra Leone. Understanding the effectiveness of leadership, health workforce performance, community engagement, and service delivery during the pandemic is critical for strengthening future pandemic, preparedness and response. Methods: A cross-sectional study was conducted with 303 respondents, including stakeholders from the Ministry of Health, district health management teams, and community health workers. Data were collected using structured questionnaires and analyzed to assess perceptions of leadership, workforce performance, community participation, and disruptions to health services. Results: Leadership and governance were rated as “effective” or “very effective” by 58% of respondents, with key challenges including inadequate communication, delays in resource mobilization, and limited transparency. The health workforce demonstrated strong commitment (62%), but gaps in infection prevention and control training (48%) and shortages of personal protective equipment (39%) were significant barriers. Community engagement was moderately effective, with 54% rating it as “effective” or “very effective.” However, low trust in the health sector and misinformation hindered compliance with preventive measures. Maternal and child health services were the most disrupted, but innovative approaches such as telemedicine and mobile health units were adopted to mitigate service interruptions. Conclusion: Sierra Leone’s COVID-19 response highlighted both achievements and challenges. While leadership structures, workforce dedication, and community health worker contributions were notable strengths, gaps in communication, resource availability, and community trust limited the overall effectiveness of the response. Strengthening communication channels, investing in workforce training and resources, and enhancing community engagement strategies are critical for improving preparedness and response in future health emergencies.