Hamidreza Khankeh, Samaneh Motalebi, naajmeh yazdanparast, Abbas Naboureh
Background: Over the past three decades, four international frameworks the Yokohama Strategy (1994), Hyogo Framework for Action (2005–2015), Sendai Framework (2015–2030), and WHO’s Health-EDRM Framework (2019) have shaped the disaster risk reduction (DRR) agenda. Despite advancing norms and principles, a persistent gap remains between policy commitments and implementation, particularly in integrating health systems.Methods: This study conducted a structured qualitative framework analysis of official UN and WHO documents, technical guidance, and monitoring reports. Frameworks were compared across four dimensions: governance, health system integration, monitoring and accountability, and financing/implementation guidance.Findings: Findings show a shift from state-centered governance toward multi-level, all-of-society approaches, although decision-making remains largely centralized. Health integration has progressed from minimal attention in Yokohama to explicit targets in Sendai and operational guidance in Health-EDRM; however, implementation remains fragmented. Monitoring systems have improved, particularly with Sendai’s 38 indicators, yet challenges in data quality and interoperability persist. Financing is consistently the weakest dimension, with limited guidance on sustainable funding.Conclusion: Overall, while DRR frameworks demonstrate normative and institutional progress, gaps in financing, decentralization, and alignment between Sendai monitoring and Health-EDRM implementation limit effectiveness. Future research should focus on translating global frameworks into local practice and their interaction with climate-related agreements.
Health system resilience (HSR) is essential to sustaining equitable essential functions under acute and chronic stressors in decentralized systems. We developed and validated a Brazil-tailored HSR framework that distinguishes steady-state performance from resilience-specific capacities and assigns responsibilities across federal, state, regional, and municipal levels. Using a three-phase qualitative deductive-inductive approach with 48 international and national experts, we identified nine dimensions, 18 subdimensions, and 65 indicators that prioritise governance coherence, surge workforce strategies, emergency regulation, real-time monitoring, and access to critical technologies. The framework clarifies boundaries between general health system performance and adaptive, absorptive, and transformative functions, and specifies how managers can apply it in practice through structured scoping, mapping, scoring, prioritisation, planning, and monitoring steps. Although designed for Brazil's Unified Health System (SUS), the development logic generalises to other decentralised contexts with appropriate re-allocation of responsibilities and calibration to national financing rules. This policy-facing tool supports actionable resilience strengthening in complex, multi-level systems.
Abstract Stronger health systems are better equipped to withstand shocks and continue providing quality services as response measures are implemented. We conducted a systematic review to synthesize the understanding of the concept of health system resilience from various stakeholders in Africa, focusing on definitions and attributes of a resilient health system. We conducted a search for peer-reviewed articles and grey literature, filtered for Africa, from 1980 to 2023, using the SPIDER framework. We searched four databases: PubMed, the Bielefeld Academic Search Engine, the Cumulative Index to Nursing and Allied Health Literature, and Scopus, and reviewed the websites of the World Health Organization, Africa CDC, and Ministries of Health of African countries. Articles were selected based on set inclusion and exclusion criteria. Qualitative articles were appraised using the Critical Appraisal Skills Programme, and mixed-methods articles using the Mixed Methods Appraisal Tool. We mapped the distribution of included articles by country studied; categorized the articles based on reported shock, health system building block described; and identified the definition of health system resilience, and its attributes in each article. The search yielded 4,306 relevant records, fifty-five of which were included in the study. Studies were found from 48 of the 54 African countries. Up to 75% of the articles focused on COVID-19; others were on Ebola Virus Disease, cholera, and meningitis. Service delivery and health workforce were the most frequently studied health system building blocks. In defining or describing health system resilience, the adaptive capacity (39, 65%) was most frequently mentioned, followed by absorptive capacity (17, 28%), preparedness (3, 5%), and recovery (1, 2%). Identified attributes of a resilient health system were: community engagement and involvement; leadership and governance; collaborations and partnerships; human resources for health; health education and promotion; health information systems; health service delivery; decentralization and local governance; health infrastructure and logistics; preparedness; learning and adaptation; and innovation and financing. Our review reports four core capacities that define a resilient health system: preparedness, absorptive capacity, adaptive capacity, and recovery. Essential attributes encompass community engagement, health education and promotion, leadership and governance, surveillance and laboratory capacity, innovation, service delivery, and adaptability.
Introduction Lassa fever remains endemic in Nigeria, yet diagnostics, treatment, and hospitalization are excluded from the National Health Insurance Scheme (NHIS), leaving most patients to cover costs out-of-pocket. With NHIS coverage below 10%, both epidemic preparedness and financial protection are compromised. The 2022 National Health Insurance Authority Act offers a policy window to integrate Lassa fever services into NHIS and advance Universal Health Coverage (UHC). Methods A systematic desk review of national health policy, epidemic preparedness, and financing documents published between 2010 and 2024 was conducted using the PRISMA framework. Key sources included the NHIS Operational Guidelines (2012), National Health Policy (2016), NHIA Act (2022), Nigeria’s UHC Roadmap (2020–2030), and NCDC Lassa fever Incident Action Plans (2023–2024). Screening identified 62 unique records, 31 full texts were assessed, and 17 documents met inclusion criteria. Thematic analysis explored gaps in benefit design, financing barriers, and the roles of the Basic Health Care Provision Fund and the COVID-19 Preparedness and Response Project funds. Results The review revealed that NHIS benefit packages omit Lassa fever services and that primary health centers in endemic states lack accreditation. Analysis of the 2023 Incident Action Plan showed that only 6 of 38 (16%) priority activities were fully implemented, 7 of 38 (18%) were partially implemented, and 25 of 38 (66%) were largely not conducted. In 2024, flexible, decentralized financing markedly improved Emergency Operations Centre activation and case reporting. Conclusion Achieving resilient and equitable outbreak response in Nigeria requires more than emergency activation—it demands structural reform. Integrating Lassa fever services into NHIS benefit packages is not just a policy option; it is a public health imperative. Strategic actions such as expanding NHIS accreditation to endemic PHCs, institutionalizing flexible subnational financing, and operationalizing joint NHIA–NCDC accountability frameworks can transform underfunded response plans into sustainable national capacity. These reforms will not only improve the execution of IAPs but also serve as a model for embedding epidemic preparedness within UHC systems across West Africa.
AbuYusuf Aminu-Ibrahim, John Chinemerem Ogbete, Obinna Chima Iwuanyanwu
National diagnostic systems form the backbone of public health surveillance, outbreak response, and routine clinical decision-making, yet they are highly vulnerable to systemic shocks during public health stress conditions such as pandemics, natural disasters, and large-scale humanitarian emergencies. This study examines infrastructure resilience planning strategies for national diagnostic systems, focusing on how physical facilities, supply chains, digital platforms, and governance mechanisms can be designed to withstand, absorb, and rapidly recover from extreme stress. Drawing on resilience engineering, public health systems theory, and lessons from recent global health crises, the paper identifies critical resilience dimensions including redundancy, flexibility, surge capacity, interoperability, and decentralization. Particular emphasis is placed on diagnostic laboratory networks, specimen transport systems, data integration platforms, and workforce continuity planning. The analysis demonstrates that centralized systems without adaptive buffers are prone to cascading failures, whereas networked, modular infrastructures enhance continuity of diagnostic services under stress. Infrastructure resilience planning is shown to improve response time, testing coverage, and data reliability during emergencies while preserving routine diagnostic functions. The study also highlights the importance of governance coordination, scenario-based preparedness planning, and real-time performance monitoring to support rapid decision-making. Investment in resilient power supply, cold-chain logistics, digital connectivity, and cross-sector partnerships is identified as a critical enabler of national diagnostic stability. A conceptual resilience planning framework is proposed, integrating technical, organizational, and policy-level interventions across preparedness, response, and recovery phases. By positioning diagnostics as a strategic national asset rather than a passive service function, resilience planning strengthens health security, equity, and trust in public health systems. The paper provides practical insights for policymakers, health infrastructure planners, and emergency preparedness agencies seeking to future-proof diagnostic capacity against increasingly frequent and complex public health shocks. Future research should empirically assess resilience indicators across countries and quantify the relationship between diagnostic system resilience, mortality reduction, and socioeconomic recovery during prolonged public health emergencies. These findings underscore the urgency of embedding resilience metrics into national health investment decisions, enabling proactive planning, transparent accountability, adaptive financing mechanisms, coordinated intergovernmental action, and sustained diagnostic readiness that supports population health protection before, during, and after crises across diverse healthcare contexts.
Amila S. Ratnayake, Dinesh Bagaria, April B. Llaneta, Ratrawee Pattanarattanamolee · 18 authors
Abstract Background Well-designed and functioning emergency medical service (EMS) can provide equitable access to emergency care to improve health issues, especially in low- and middle-income countries where the majority of deaths are due to conditions that could be treated with emergency care. To address this gap, this study explored the contextually appropriate development process in addition to the system architecture, which is lacking in Global South EMS research. Method This study was a thematic analysis of the development of EMS systems in six Asian countries. Experts in emergency care were selected through convenience sampling. Each country described and evaluated its EMS system using a standardized form with 102 EMS items that cover the emergency care system in terms of leadership, governance, financing, community-based activities, prehospital care, and quality assessment. From the descriptions, various themes were extracted focusing on the developmental perspective of EMS in Asia. Result The study identified the domain of the developmental focus, best practices, and future strategies for EMS in the Asian region. The identified areas for developmental focus are governance, multidisciplinary collaboration, communication/coordination, community participation, decentralization, equitable access, supply-demand balance, and quality assurance activities. Conclusion Countries under investigation achieved progress in planning, implementing, and sustaining EMS through varied strategies in the mentioned focal areas that can be emulated by other countries in this region. Further, their development levels varied according to the extent to which each country realized the development principles identified in this study.
Michelle Fernández, Marco Antônio Catussi Paschoalotto, Gabriela Lotta, Adriano Massuda
Brazil has one of the most comprehensive and largest public health systems in the world, called the Unified Health System (SUS). Despite the SUS’s great knowledge acquired in previous epidemics and primary health care (PHC) capillarity in the territory, Brazil suffered with the COVID-19 pandemic shock and the absence of federal government coordination and leadership. In this chapter we analyze the resilience of the Brazilian health system in the COVID-19 pandemic based on the public administration and health system literature. We use the health system performance assessment dimensions as a framework to analyze the SUS’s resilience - governance and leadership; financing; resources; and service delivery. Among the results, we point out that i) the federal government did not use the previous knowledge and it was absent in SUS coordination while also spreading misinformation - however, the state government assumed responsibility and created a strong partnership with the social mechanism (Conass); ii) the national congress, pressured by society, provided additional funds to the SUS response due to the federal absence; iii) previous inequalities in the SUS workforce, infrastructure and medicines and technology were evident in the COVID-19 response, affecting the most vulnerable; and iv) the SUS had still not recovered from the decrease in its procedures at the beginning of the COVID-19 pandemic in 2022. Therefore, our chapter shows that even with the federal political obstacles presented during the COVID-19 pandemic, the SUS’s decentralization and its social participation mechanisms, and the frontline health workforce spread throughout all the territory, kept the health system resilient.
Kimberly DiMaria; C.S. Mott Children’s Hospital, Ann Arbor, MichiganSurvival after in-hospital cardiac arrest is associated with resuscitation team performance and adherence to American Heart Association (AHA) resuscitation algorithms. The primary aim was increased resuscitation team performance during simulation scenarios as evidenced by improved modified Clinical Performance Tool (mCPT) scores. The secondary aim was improved adherence to AHA resuscitation guidelines during actual code events. Process measures, including frequency of simulations, were used to determine proof of concept.In 2021, a review of resuscitation events in the cardiac progressive care unit (CPCU) revealed poor compliance with AHA guidelines. One of the most critical times of code performance in the CPCU is during the initial response, before code team arrival, which prompted development of a simulation intervention that focused on improving team performance during the initial stages of resuscitation. A single-center, prospective, interventional quality improvement project, First 5-Minute Drills, was developed to provide concise, repeated opportunities for CPCU team members to practice low-frequency, high-risk skills, and crisis resource management principles. Team performance during simulations was directly observed and evaluated using an mCPT score, a 20-point scoring tool that measures team performance of 10 different skills. A t test was used to compare mean mCPT scores at 3 periods. Adherence to AHA algorithms during patient codes was assessed via a retrospective review. Patient resuscitations were evaluated using a standardized scorecard comprising 10 evidence-based treatment recommendations embedded within the AHA resuscitation algorithms.Over 19 months, 48 First 5-Minute Drills were conducted and 238 team members participated. The mCPT was administered at various time points during the study, and results demonstrated a 35% improvement in code team performance. There was a statistically significant increase in mCPT scores from 14.3 to 18.3 (P = .02). Pre-post analysis of 4 actual code events demonstrated a 50% improvement in adherence to AHA algorithms. First 5-Minute Drills resulted in improved simulation resuscitation team performance and adherence to AHA algorithms during real-time code events in the CPCU. The low-cost, high-yield First 5-Minute Drills intervention is generalizable to other departments and hospitals.Eunice Santos, Jimmy Nguyen; Cedars-Sinai Medical Center, Los Angeles, CaliforniaThe rate of central line [catheter]–associated bloodstream infections (CLABSIs) with pulmonary arterial catheter (PAC) use is high. In the advanced heart failure unit (AHFU), PAC CLABSIs are associated with increase morbidity, cost, and loss of eligibility for a heart transplant. The goal for this initiative was to determine whether the optimization of a nursing maintenance bundle created in 2018 in the AHFU to reduce PAC CLABSIs sustained fewer than 3 PAC CLABSIs per year for 5 years.In the AHFU, PACs are used for heart transplant evaluation and heart transplant listing. In 2017, there were 10 PAC infections at our institution. Feedback from case reviews for PAC CLABSIs in 2017 showed problems maintaining occlusive dressings in these catheters. In 2018, a quality improvement project was implemented to address challenges associated with PAC maintenance. The project introduced new PAC dressing kits and development of education for nurses caring for PACs in the AHFU. The standard central catheter dressing kit included a single transparent bandage, a chlorhexidine gluconate (CHG) swab, sterile gloves, and tweezers. The new PAC kit included a second anchoring transparent bandage and CHG swab. All the nurses were educated on the use of the PAC dressing kit—specifically the application of 2 transparent bandages to maintain an occlusive dressing, narrow beard clipping, and CHG bathing. In 2021, introduction of weekly central catheter rounds consisted of epidemiology nurse and nursing leadership rounding on patients with PACs. Sustainment of the project included permanent changes in nursing education, dressing kits, and close monitoring by epidemiology nurses and nursing leadership.PAC CLABSI rates were analyzed using the organization’s hospital-acquired infection dashboard from January 2018 to July 2023. Results showed that the PAC nursing maintenance bundle reduced PAC CLABSIs through the 5-year study period. In 2018, the year of implementation, there were 3 PAC CLABSIs in the AHFU. There was 1 PAC CLABSI in the AHFU in each of 2019, 2020, and 2023; there were 2 CLABSIs in 2021. Implementation of the PAC nursing maintenance bundle, multidisciplinary collaborations, continued nursing education, and adherence to the PAC nursing maintenance bundle during the 5-year period accomplished organizational goals in improving CLABSI rates and improving patient outcomes.Isabel Madrigal, Melissa Parodi; Doctors Hospital, Coral Gables, FloridaCentral line [catheter]–associated bloodstream infections (CLABSIs) are among the most common hospital-acquired infections (HAIs). CLABSIs are serious infections that can result in longer hospital length of stay, increased cost, and increased risk for death. In February 2021, the critical care unit (CCU) leadership team reviewed the unit CLABSI rates of 11.33 for the third quarter (Q3) of calendar year 2020 (CY20) and 9.32 for Q4 CY20. 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Thushara Kamalrathne, Dilanthi Amaratunga, Richard Haigh
The entire world is in an unprecedented dysfunction since 11 th March 2020 when the WHO declared a global pandemic as unprecedented health and socioeconomic issues emerged with the outbreak of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and its associated 53 coronavirus diseases (COVID-19). This challenging pandemic has created a greater shock on regular activities of every social strata resulting in a significant decline in economic growth and health sector progression. A serious wearing down of infrastructure, human resources and emergency response in the public health sector was visible in many countries, irrespective of the level of economic and social development. In this backdrop, many scholars are exploring appropriate and effective resilient systems to govern pandemic risks in varied settings. It is observed that Sri Lanka's pandemic response is not properly embedded with the country's Disaster Risk Reduction (DRR) framework and in many aspects, it is heavily reliant on the public health sector authority. In further elaborating the identified gap, this study explored many possible policy amalgamations that can be considered to improve the effectiveness of pandemic response activities at sub-national levels in Sri Lanka. Many government authorities, universities, volunteer agencies including NGOs, private sector organisations and the community can be efficiently integrated into pandemic response activities, vesting necessary responsibilities and authority for contingency and financial decision making at the sub-national level. This system further ensures the unique and contextual approach in pandemic response at the Divisional Secretariat level of each sub-region, which consists of diverse cultures. A large number of public officers are employed at District Secretary (DS) level in different areas of work such as finance, statistic and information, development, public health, livelihood, legal, police, child protection and probation, social welfare, elderly care, poverty alleviation, etc. within the public administration protocol adopted in Sri Lanka. These official positions can also be effectively integrated with the pandemic preparedness and response mechanisms at sub-national level.
A Preventive Medicine perspective:How COVID pandemic has impacted New Zealand and their adopted policies and strategiesElimination strategyMainstays of MethodolgyCOVID situation in Iraq, Impacting the economy of a developing countryStrategic implementation of preventive measures adopted by New ZealandCovid- 19: Strategic Implementation of Policies under the guidance of IOM:Discussion: Preparing to respond to COVID-19, what Iraq could learn from New ZealandConclusion and OutlookReferencesAbstract:Background. The first cases of COVID-19 pandemic were identified in people with pneumonia in Wuhan, China, in late December 2019. It is first and foremost the most publicized pandemic, which has taken the lives of many people. It has thrown everyone into doubt and has created a collective moment of contemplation about the future. The clinical enlistment organization MedWorld of New Zealand offered for resigned and low maintenance specialists to help endeavors by the health care division and Government to battle the spread of COVID-19, in New Zealand. (11“COVID-19 Pandemic in New Zealand.”) Starting in April, more than 20,000 tests have been done in Iraq in general (counting the Kurdistan Region), with 1202 of them turning out positive. Of those tests, half of the,m were finished by the Kurdish Ministry of Health, which implies that the other tests were finished by the Iraqi Ministry of Health. (22“COVID-19 Pandemic in Iraq.”) While KRG populace has been tried, just 0.05% of the remainder of the nation has been tried, along these lines featuring the conceivable difference between absolute positive case numbers between locales. Iraq is considered ”particularly powerless against the plague due to being desolated” – by war and United Nations sanctions, and by partisan clash in the course of recent decades. This paper primarily focuses on analyzing the accessible information through research papers, peer- reviewed and non-peer reviewed to understand the pandemic affecting two different countries like New Zealand- a developed country and Iraq- a developing country.1.2. Aim: The aim of this study is to provide information and access the current status of medical management in a developed country like New Zealand and a developing country like Iraq, based on current medical literature available. 1.3. Material used: The following review paper has considered published peer- reviewed papers and non peer-reviewed pre-print manuscripts on COVID-19 and related aspects with primary focus on preventive medicine. 1.4. Study Methodology: This retrospective view focuses on understanding the different preventive strategies implemented by the countries with different socio-economical backgrounds. 1.5. Preliminary thesis: The review paper focuses on comparing the strategic management and elimination of COVID-19, in the two countries, i.e. New Zealand and Iraq, in a public health and preventive medicine perspective.Introduction- 2.1. What is corona virus? Coronaviridae is a large family of viruses that cause mild to moderate upper-respiratory tract illnesses like the common cold. They are named for the crown-like spikes on their surfaces as seen on the electron microscope. In some cases these viruses infect the humans, which is called a spillover event and can cause several diseases. The international committee for the taxonomy of viruses has approved the naming of more than 40 corona viruses, majority of which infect animals, and lead to human transmission. The COVID-19 outbreak has brought the number of identified corona viruses that can infect humans to seven, out of which, four are community acquired. The other three are SARS-CoV, MERS-CoV and SARV-CoV-2, which has resulted in the highest mortality rate. Covid-19 or previously known as Novel corona virus is a new strain of coronavirus that first emerged in Hubei provenience in China in the late 2019. It is predominantly spread by respiratory droplets and from contact to contaminated surfaces. The spread is similar to that of influenza virus, so practicing same precautions as to prevent the influenza virus can provide protection against Covid-19. The most common symptoms are cough, severe dyspnea, fever, chills, myalgia, sore throat, congestion or runny nose. Majority of the cases have milder diseases with few having severe diseases which lead to pneumonia and respiratory failure. Deaths have generally occurred in older population, and in patients having underlining health conditions. Reports of severe cases in children are uncommon. Currently the treatment is supportive, but severe cases may require intensive care. (33Cui, Li, and Shi, “Origin and Evolution of Pathogenic Coronaviruses.”)(44Masters, “The Molecular Biology of Coronaviruses.”) Impact of corona virus pandemic on New Zealand: New Zealand recorded its first day of no new instances of coronavirus infection 2019 (COVID-19), more than a month after its severe lockdown started. New Zealand had recorded from less than 1200 affirmed instances of COVID-19, 20 deaths. On March 23, a month to the first case reported, New Zealand focused on a disposal system. A couple of days afterward, Prime Minister Jacinda Ardern declared a public lockdown at the point when it just had 102 cases and zero deaths. Her quick decision won universal recognition, including from WHO. New Zealand’s choice to seek after an end approach was a diverse way to deal with regular pandemic arranging, which has generally been in light of an alleviation model and centers around postponing the appearance of the infection, trailed by a scope of measures to level the bend of cases and passings. Michael Baker, teacher at the College of Otago’s specialty of general healthcare in Wellington, who has been exhorting the New Zealand Government on its reaction. ”The two greatest advantages of seeking after a disposal system is that you have barely any cases and hardly any deaths and you can get business back fully operational. The elective was that we are left with the infection and stuck between relief furthermore, concealment. Concealment is lovely terrible .” (55“Coronavirus Outbreak: Live Updates on COVID-19.”) While the methodology has had its experts, for Baker, the proof was overpowering that end could be accomplished. The full lockdown permitted the nation to get the major frameworks up and rushing to viably oversee fringes, furthermore, to do contact tracing, testing, and observation. Since January, more than half a million individuals have been tried in a nation of only 5 million. Testing has been centered around individuals who have presenting symptoms, with following of both close contacts and easygoing contacts. But currently, more broad testing has being presented. The Ministry of Health is in conversation with regions to organize testing of explicit networks who are at higher danger of gaining the infection such as human services laborers. Testing tests from sewerage is additionally being thought of to screen control and disposal. The reaction has additionally been one that set science, authority, and cautious language at the front line. Ardern has consistently showed up on online media, grinning and sharing parts of her own life under lockdown yet without underplaying the earnestness of the circumstance, which has served to construct open trust. Travelers from abroad are to be isolated as a major aspect of endeavors to forestall transmission in New Zealand. As New Zealand currently facilitates its limitations and its economy gradually resumes, there are conversations about how it can open up its fringes while guaranteeing that everybody is ensured, especially vulnerable populations. (66“(PDF) Coronavirus-19 Intervention Approach in New Zealand.”) Impact of corona virus pandemic on Iraq: On 31 December 2019, a group of pneumonia of obscure beginning was accounted for in Wuhan City, Hubei Province of the People’s Republic of China. On 11 March 2020, the World Health Organization’s (WHO) declared that the microorganism known as the Coronavirus Disease 2019 (COVID-19), established a pandemic. By 13 March, WHO announced that the expansion in instances of COVID-19 in the Eastern Mediterranean locale, including Iraq was ”of specific and incredible concern”. Starting at 20 April 2020, there were 1,539 affirmed instances of COVID-19 and 82 deaths in Iraq with the quantity of affirmed cases detailed expanding. The COVID-19 episode took steps to weaken the effectively delicate framework and effect the numerous networks who are as yet defenseless and recuperating from the Islamic State in Iraq and the Levant (ISIL) emergency and ensuing monetary downturn. The center public capacities with regards to anticipation, readiness and reaction, limit with regards to general wellbeing, and the medicinal services framework has been debilitated by years of contention, sanctions, helpless administration and low interests in wellbeing. There was an absence of wellbeing workforce across various units, with many having fled Iraq, and deficiencies in basic drugs and gear. The absence of open administrations, including medicinal services, were among the variables driving distress all through 2018, especially in the southern governorates. The exhibitions and related political flimsiness brought about the abdication of the Prime Minister. At the local and worldwide level, there are proceeded and rising strains among US and Iranian intermediaries; and ISIL have additionally expressed their expectation to abuse the current emergency, which could be especially horrendous for regular citizens seeking after an arrival to normalcy. Lengthy and permeable fringes aggravate the test of overseeing dangers related with human portability and episodes; Iraq has long land and ocean fringes with Iran, Jordan, Kuwait, Saudi Arabia, Syria and Turkey, with 26 Points of Entry (PoE), including five air terminals, six ports and 15 ground intersections that convey worldwide traffic. Iraq is a country with many travelers and hence a significant number of whom are trapped in emergency and in considerably more dubious conditions. Iraq additionally has hundreds of thousands of south Asian, southeast Asian and African traveler laborers utilized in the residential, development also, administration divisions, prone to disproportionally affected by the wellbeing emergency, financial downturn and travel limitations. Travelers and evacuees in Iraq, incorporating those in outcast camps who may have residency and money related status issues, are at uplifted hazard, especially with regards to air terminal terminations, travel limitations, the stopping of worldwide resettlement program and failure to execute helped willful return and reintegration (AVRR) programming. To help stop transmission, the Government of Iraq (GoI) including the Kurdistan Regional Government (KRG) have progressively implemented bans on travelers from countries with significant COVID-19 outbreaks from entering the country, quarantine requirements and closures of the main airports in Baghdad and Erbil. (77“WHO | Iraq Health Situation Reports.”)A Preventive Medicine perspective:How COVID pandemic has impacted New Zealand and their adopted policies and strategies: 3.1.1 Elimination strategy in New Zealand: The Government’s health policy methodology in regard of the COVID-19 pandemic influencing New Zealand is elimination. That is, to apply a scope of control measures all together to stop the transmission of COVID-19 in New Zealand. Disposal doesn’t mean annihilating the infection forever from New Zealand; rather it is being certain we have disposed of chains of transmission in our locale for at any rate 28 days and can successfully contain any future imported cases from abroad. It is acknowledged that this methodology will be required in the drawn out i.e., for a long time or more, contingent upon the developing the study of disease transmission and proof around the sickness and its the executives and progress with creating protected and powerful medicines and additionally antibodies. 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Cardiac arrests claim millions of lives each year. The condition can often be treated with a de\nfibrillator,buttimeisaverycriticalfactor. Asaconsequence,survivalratesarelow.\nRecent developments in drone technology have made civilian drones both cheap, easy to\noperate, and reliable. This paper looks into opportunities to use drones to deliver defibrilla\ntors to cardiac arrest victims faster than an ambulance, and focuses on unifying the needs of\nemergencyresponsewiththerulesandregulationsrequiredtooperatethedronessafely.\nThe study is performed as a literature study combined with interviews. The primary stake\nholderswereidentifiedasemergencyresponseandtheCivilianAviationAuthority.\nThe results showed that there was both a perceived use for ambulance drones and a way to\nlegally use them. The suggested approach involves using ambulance drones at sporting events\nsuch as "Birkebeinerrennet" as a proof of concept, before more advanced or permanent pro\ngramsareconsidered.
To contain the escalating cost of health care, a prospective payment system is being introduced into the military. The authors propose a proactive approach to this change in health care financing by evaluating the experiences of nurses to a similar change in the civilian sector. These approaches are presented as nine interrelated lessons: responding optimistically; shifting into a business mode; valuing clinical nursing experts; understanding the implications for documentation; moving to decentralized management; changing outpatient care delivery; considering the effects on job satisfaction; evaluating the relationship between costs and nursing resource consumption; and basing nursing practice in science.