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Systems thinking for health emergencies: use of process mapping during outbreak response

Countries
World
Sources
BMJ
Publication date
Origin
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Kara N Durski, Dhamari Naidoo, Shalini Singaravelu, Anita A Shah, Mamadou Harouna Djingarey, Pierre Formenty, Chikwe Ihekweazu, James Banjura, Benoit Kebela, Adesola Yinka-Ogunleye, Ibrahima-Soce Fall, Womi Eteng, Mohamed Vandi, Charles Keimbe, Anwar Abubakar, Abulazeez Mohammed, Desmond E Williams, Margaret Lamunu, Sylvie Briand, Jean Claude Changa Changa, Etienne Minkoulou, Dan Jernigan, Demba Lubambo, Asheena Khalakdina, Ibrahim Mamadu, Ambrose Talisuna, Albert Mbule Kadiobo, Amara Jambai, Bruce Aylward, Michael Osterholm

Summary box

  • There is little to no published research on process mapping being conducted during health emergencies to improve the current outbreak response.

  • Our research shows that despite the chaos and complexities associated with emerging pathogen outbreaks, process mapping can address immediate response priorities while simultaneously strengthening components of a health system.

  • This methodology could be applied to any country that has an outbreak, including COVID-19 cases.

  • There is an acute need in the global health community to respond to disease outbreaks in a way that effectively uses limited resources.

  • This is a user-friendly and low-cost methodology that can be implemented during any time point of an outbreak, including during preparedness and readiness activities.

  • Future operational and implementation research focused on using process mapping and other applied system methodologies during outbreaks should be conducted

Abstract

Process mapping is a systems thinking approach used to understand, analyse and optimise processes within complex systems. We aim to demonstrate how this methodology can be applied during disease outbreaks to strengthen response and health systems. Process mapping exercises were conducted during three unique emerging disease outbreak contexts with different: mode of transmission, size, and health system infrastructure. System functioning improved considerably in each country. In Sierra Leone, laboratory testing was accelerated from 6 days to within 24 hours. In the Democratic Republic of Congo, time to suspected case notification reduced from 7 to 3 days. In Nigeria, key data reached the national level in 48 hours instead of 5 days. Our research shows that despite the chaos and complexities associated with emerging pathogen outbreaks, the implementation of a process mapping exercise can address immediate response priorities while simultaneously strengthening components of a health system.