A conceptual learning analysis of paired after action and intra action reviews for health emergencies

IF 2.6 Q2 HEALTH POLICY & SERVICES Learning Health Systems Pub Date : 2024-08-29 DOI:10.1002/lrh2.10447
Elliot Brennan, Seye Abimbola
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Abstract

Background

Processes of self-reflection and the learning they allow are crucial before, during, and after acute emergencies, including infectious disease outbreaks. Tools—such as Action Reviews—offer World Health Organization (WHO) member states a platform to enhance learning. We sought to better understand the value of these tools and how they may be further refined and better used.

Methods

We searched the publicly available WHO Strategic Partnership for Health Security website for paired reports of Action Reviews, that is, reports with a comparable follow-up report. We complemented the paired action reviews, with a literature search, including the gray literature. The paired action reviews were analyzed using the “Learning Health Systems” framework.

Results

We identified three paired action reviews: Lassa Fever After Action Reviews (AARs) in Nigeria (2017 and 2018), COVID-19 Intra-Action Reviews (IARs) in Botswana (2020 and 2021), and COVID-19 IARs in South Sudan (2020 and 2021). Action Reviews allowed for surfacing relevant knowledge and, by engaging the right (in different contexts) actors, asking “are we doing things right?” (single loop learning) was evident in all the reports. Single loop learning is often embedded within examples of double loop learning (“are we doing the right things?”), providing a more transformative basis for policy change. Triple loop learning (“are we learning right”?) was evident in AARs, and less in IARs. The range of participants involved, the level of concentrated focus on specific issues, the duration available for follow through, and the pressures on the health system to respond influenced the type (i.e., loop) and the effectiveness of learning.

Conclusion

Action Reviews, by design, surface knowledge. With favorable contextual conditions, this knowledge can then be applied and lead to corrective and innovative actions to improve health system performance, and in exceptional cases, continuous learning.

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对突发卫生事件行动后和行动中的成对审查进行概念学习分析。
背景:在包括传染病爆发在内的紧急突发事件发生之前、期间和之后,自我反思过程及其所带来的学习都至关重要。行动回顾等工具为世界卫生组织(WHO)成员国提供了一个加强学习的平台。我们试图更好地了解这些工具的价值,以及如何进一步完善和更好地利用这些工具:我们在公开的世卫组织卫生安全战略伙伴关系网站上搜索了行动审查的配对报告,即带有可比后续报告的报告。我们通过文献检索(包括灰色文献)对配对行动审查报告进行了补充。我们使用 "学习型卫生系统 "框架对配对行动回顾进行了分析:我们确定了三项配对行动审查:结果:我们确定了三项配对行动审查:尼日利亚拉沙热行动后审查(AARs)(2017 年和 2018 年)、博茨瓦纳 COVID-19 行动内审查(IARs)(2020 年和 2021 年)以及南苏丹 COVID-19 行动内审查(IARs)(2020 年和 2021 年)。行动审查使相关知识浮出水面,并通过让正确的(在不同背景下的)行动者参与进来,询问 "我们做的事情是正确的吗?(单循环学习)在所有报告中都很明显。单环学习往往包含在双环学习("我们做的事情正确吗?")中,为政策变革提供了更具变革性的基础。三重循环学习("我们的学习是否正确?参与人员的范围、对具体问题的集中关注程度、可用于后续行动的时间以及卫生系统的应对压力都影响着学习的类型(即循环)和效果:结论:从设计上讲,行动审查是知识的表面化。在有利的环境条件下,这些知识可以得到应用,并导致采取纠正和创新行动,以提高卫生系统的绩效,在特殊情况下,还可以不断学习。
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来源期刊
Learning Health Systems
Learning Health Systems HEALTH POLICY & SERVICES-
CiteScore
5.60
自引率
22.60%
发文量
55
审稿时长
20 weeks
期刊最新文献
Issue Information Envisioning public health as a learning health system Thanks to our peer reviewers Learning health systems to implement chronic disease prevention programs: A novel framework and perspectives from an Australian health service The translation-to-policy learning cycle to improve public health
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