Table 4 Data extracted and results of all the four studies
Study no. | Author | CCAT Score (/40) | Study design and methods (design & research type) | Title | Aims (phenomenon of interest) | Study area and year (sample) | Objective | Health system building block(s) | Key findings (evaluation) |
|---|---|---|---|---|---|---|---|---|---|
1 | Alexander et al. | 16 | Review of literature on the challenges and opportunities that led to the Ebola outbreak. | What Factors Might Have Led to the Emergence of Ebola in West Africa? | Review the sociological, ecological and environmental drivers that might have influenced the emergence of Ebola in this region of Africa and its spread throughout the region. The paper also offers recommendations that might support enhanced country level preparedness in Africa. | Guinea, Liberia, Sierra Leone - 2015 | Impacts the Ebola outbreak brought about on the existing health systems in Guinea, | Health workforce | * Ebola jeopardised the reputation of staff as they were harshly stigmatized and rejected by their communities and families. This made the community turn against seeking health from fear of contracting Ebola from staff. * By September 2014, in the West African outbreak, 10% of who died were health staff. Lack of health staff in hospitals made other staff work longer and harder leading to exhaustion and increased potential for fatal mistakes. |
2 | Buseh et al. | 22 | Review. Our approach is guided by the use of literature in peer-reviewed journals on disease burden and health system reforms in developing countries, specifically in sub-Saharan West African countries. Periodicals released by international organizations, including the United Nations Development Program, WHO, United States Agency for International Development, and the World Bank, on global health challenges were also relied on to critically examine the health, socio-political, and economic conditions and to identify the priority and policy areas discussed in this article. We extrapolated from these the studies to critically examine the challenges and opportunities that, if understood and addressed, can effectively contribute to halting the spread of Ebola and potential infectious diseases specific to the West African setting. | The Ebola epidemic in West Africa: challenges, opportunities, and policy priority areas | (a) critically examine the socio-political and economic conditions that created the environment for the Ebola epidemic to occur, (b) identify challenges to and opportunities for the prevention and control of Ebola and future outbreaks, (c) Discuss policy recommendations and priority areas for addressing the Ebola epidemic and future outbreaks in West Africa. | Guinea, Liberia, Sierra Leone - 2015 | Effects the health systems in Guinea, Liberia and Sierra Leone had on the management of the Ebola outbreak | Medical products and technology/service delivery | * Due to lack of proper transportation and ambulances, access to supportive medical needs and primary care services was compromised. * There was a severe lack of medical equipment (PPE) and supplies. Equipment were used more than once and this led to more infection transmission between health personnel and increase in comorbidities. * There is also a shortage in technologies used for diagnosis and disease management. * There is also poor road networks, lack of electricity, no medical records and poor information and technologies for rapid access to medical services. |
Information and research | * Disease surveillance is very limited in West Africa and health centres face logistical issues on a regular basis. * African traditional healer are the first point of access for health services in rural areas. This happened due to the lack of adequate treatments for patients. (Clash of Ethno-medicine with Biomedicine) | ||||||||
Health workforce | * The three countries are emerging from civil wars and this deprived them from properly trained and competent enough healthcare workers. Prior to Ebola, democracy was still taking place and the countries’ health staff were trying to serve the population’s health needs in-spite the slow economic growth and development of these countries. | ||||||||
Health financing | Severe shortage of funds for the purchase of supplies and the investment in the infrastructure. | ||||||||
Impacts the Ebola outbreak brought about on the existing health systems in Guinea, Liberia and Sierra Leone | Health workforce | * Staff that were experienced in prevention and treatment of infectious diseases were the frontline victims in this outbreak while they were trying to treat the cases. This caused a deprivation in health workforce in the already weak health system. * Ebola took the motivation of nurses to work and the lives of prominent doctors and nurses depriving the countries from the experienced and dedicated medical teams. | |||||||
3 | Gostin et al. | 16 | A review and analysis on the health system problems in West Africa. The papers offers recommendation for policy reforms | A retrospective and prospective analysis of the west African Ebola virus disease epidemic: robust national health systems at the foundation and an empowered WHO at the apex | Suggest leadership innovative reforms to transform the worldwide health system into a purposeful organised one. | Guinea, Liberia, Sierra Leone - 2015 | Effects the health systems in Guinea, Liberia and Sierra Leone had on the management of the Ebola outbreak | Health workforce | There was a huge gap in the health workforce involved in the outbreak control and human resources response required and international action. Apart from international support, there was still shortages in health workforce supply at the Ebola treatment centres despite the Ebola cases rising in December in Sierra Leone. The UN estimated that more than 1000 international staff are still needed. |
4 | Trad et al. | 10 | Review of pervious literature on technological approaches to link patients with health care facility. The paper proposes an SMS approach to link patients with health facilities. | Guiding Ebola patients to suitable health facilities: an SMS-based approach | SMS based approach to help map closest health facilities for Ebola patients | Guinea, Liberia, Sierra Leone - 2015 | Effects the health systems in Guinea, Liberia and Sierra Leone had on the management of the Ebola outbreak | Medical products and technologies | * Patients had the problem of finding the closest health facilities with adequate supplies and resources. They were also confused to whom to report the cases. |