“Wiring” Health Systems Improves Health Security. Here’s Why.

By Alex Ergo, Director, Health Systems, PSI; and Bram Piot, Sr. Surveillance and Monitoring Advisor, Asia, PSI

COVID-19 is a stark reminder: epidemics – and pandemics – start and end in the community. 

To curb disease outbreaks from the start, early detection and rapid containment are essential and require active involvement, coordination and communication across communities, and among healthcare providers and public health authorities. 

Public Health Emergency Operations Centers (PHEOCs) deliver the framework to bring this all to life.

PHEOCs are designed to support communities to monitor public health events, define policies, develop standard operating procedures (SOPs), build capacity for disease surveillance and multi-sectoral response, and coordinate any large-scale emergency response. At the operational level, subnational PHEOCs and Rapid Response Teams (RRTs) are on the frontlines of epidemic preparedness and response: even where strong central PHEOCs and state-of-the-art disease surveillance systems exist, without this first line of defense at the local level, diseases are likely to go undetected until it is too late.

As documented in our latest technical brief, “Effective Health Security Starts and Ends on the Frontline of Epidemic Preparedness and Response,” PSI brings together our established relationships with government actors, our extensive private sector footprint and our ability to continuously gather consumer and system insights critical to designing effective, tailored approaches to improving health security.

For example:

  1. In Laos, integrated disease surveillance systems that rely on both formal and informal data sources are resulting in better quality, timeliness and granularity of essential surveillance data. Strengthening the capacity of PHEOCs and RRTs on incident management systems to respond to any public health emergency, combined with the development of disease-specific emergency response plans, has improved the local response to the COVID-19 pandemic but is also increasingly supporting the country’s efforts to reach malaria elimination goals.
  2. In Myanmar, we leveraged our extensive network of private sector health care providers, combined with innovative, user-centered digital solutions to improve  surveillance and response of COVID-19 and other epidemic-prone diseases, including malaria and dengue. Community engagement is being conducted through our social franchise network of pharmacies and private clinics, but also through targeted social media behavior change campaigns for COVID-19 prevention, building in feedback loops and using audience insights to adjust messaging and targeting over time.

These examples highlight the importance of ‘wiring’ the system, or establishing robust remote engagement mechanisms with a wide range of actors at all levels of the health system, starting with the community, and to then use these mechanisms for effective two-way communication. 

But to get there, we must invest in subnational health security capacity and community-level engagement to strengthen frontline capability to detect and manage public health emergencies – and prevent future epidemics.

Our experience responding to COVID-19 and strengthening PHEOCs shows that health security work can advance the development of remote engagement mechanisms that connect communities, healthcare providers and government authorities – a critical mix for wiring, and strengthening, the mixed health systems of tomorrow.

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