Challenges in Implementing the National Health Response to COVID-19 in Senegal.

Valéry Ridde, Adama Faye
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Abstract

Since the beginning of the COVID-19 pandemic in Africa, many epidemiological or anthropological studies have been published. However, few studies have yet been conducted to understand the implementation of State interventions to fight the COVID-19 pandemic. In Senegal, the national response plan was planned before the country experienced its first official case of COVID-19 on 2 March 2020. This qualitative study, conducted in March and April 2021, based on 189 interviews, aims to understand how the national response has been implemented in several regions of Senegal. Implementation of the response to the pandemic was favoured by good preparation, capacity to adapt, responsiveness of health actors, and commitment for both the political and religious authorities. The implementation response was confronted by several constraining factors such as the coercive approach, the challenges of coordinating actors, and the lack of intersectoral response. The central level has sometimes used reflexivity processes to adapt its response, but it has remained highly politicized, centralized, directive, and with little involvement of civil society. In Senegal, the response to the pandemic has been implemented in a relatively political and directive, even coercive manner, without necessarily considering prior knowledge and the need to adapt it to local contexts and to involve civil society and community actors in the process.

Supplementary information: The online version contains supplementary material available at 10.1007/s43477-022-00053-4.

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塞内加尔针对 COVID-19 实施国家卫生对策所面临的挑战。
自 COVID-19 在非洲开始流行以来,已经发表了许多流行病学或人类学研究报告。然而,很少有研究是为了了解国家为抗击 COVID-19 大流行而采取的干预措施的执行情况。塞内加尔在 2020 年 3 月 2 日出现第一例 COVID-19 正式病例之前就已制定了国家应对计划。本定性研究于 2021 年 3 月和 4 月进行,基于 189 次访谈,旨在了解塞内加尔几个地区是如何实施国家应对措施的。由于准备充分、适应能力强、卫生部门反应迅速以及政治和宗教当局的承诺,应对大流行病的工作得以顺利开展。在实施应对措施的过程中遇到了一些制约因素,如强制手段、协调行动者的挑战以及缺乏跨部门应对措施。中央一级有时会利用反思过程来调整其应对措施,但这仍然是高度政治化、集权化和指令性的,民间社会很少参与。在塞内加尔,对这一流行病的应对措施是以相对政治化和指令性,甚至是强制性的方式实施的,不一定考虑到先前的知识和根据当地情况进行调整的必要性,以及让民间社会和社区行动者参与这一过程的必要性:在线版本包含补充材料,可查阅 10.1007/s43477-022-00053-4。
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