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Evidence Aid Bulletin

2 March, 2022

Hello everyone

We are pleased to send you Evidence Aid’s March 2022 bulletin, containing shortened versions of three of our recent summaries relevant to resilient health systems and COVID-19. Please forward it to anyone who might be interested. Anyone who would like to receive these bulletins directly should contact Mark Gavin (info@evidenceaid.org) and questions about our work can be sent to Claire Allen (callen@evidenceaid.org). We will send you our monthly Evidence Aid newsletter in a couple of weeks’ time but if you would like to stop receiving our bulletins or newsletters, please contact Mark.

Pre-travel health advice guidelines for humanitarian workers https://tiny.one/pre-travel (from our Resilient Health Systems Collection). https://tiny.one/resilient Citation: Costa M, et al. Pre-travel health advice guidelines for humanitarian workers: a systematic review. https://tiny.one/systematic Travel Medicine and Infectious Disease. 2015;13(6):449-65. (Note: Not open access.)

Resilient health systems need to be ready and responsive to health emergencies but may still need assistance from humanitarian workers from elsewhere. This might require the provision of pre-deployment travel health advice and safety preparation for these workers. In this systematic review, the authors searched (in November 2014) for articles about pre-travel interventions and recommendations for health-preserving measures in people deploying in humanitarian relief missions and sent questionnaires to 30 aid organizations, of which 6 provided information about their pre-deployment preparation of aid workers. They included 35 articles.

What was found: High-risk hazards for aid workers are often location specific, and include travellers’ diarrhea, vector-borne infections and other infectious diseases, accidents and violence. Pre-deployment physical and mental fitness are vital for success in humanitarian missions but pre-travel medical and psychological assessments and training or education sessions are often not mandatory, and many aid workers felt inadequately prepared.

Implications: The authors of the review concluded that medical evaluation of people who are traveling to provide humanitarian assistance can identify problems or risk factors that can be exacerbated during humanitarian missions. They noted that the status of routine vaccinations can be controlled and completed, medication dispensed, targeted preventive advice given, and a mission specific first-aid kit recommended in this pre-travel setting. They proposed a shared database of relevant literature and some standardization of guidelines.

Masks and respirators to protect healthcare workers against respiratory viruses https://tiny.one/respirators (from our Resilient Health Systems Collection https://tiny.one/resilient and COVID-19 Collection). https://tiny.one/COVIDCollection Citation: Li J, et al. Protective efficient comparisons among all kinds of respirators and masks for health-care workers against respiratory viruses: A PRISMA-compliant network meta-analysis. https://tiny.one/Protective Medicine. 2021;100(34):e27026.

Masks and respirators are worn by healthcare workers to reduce the transmission of respiratory viruses. For this systematic review and network meta-analysis, the authors searched for studies of the effects of masks or respirators for protecting healthcare workers against respiratory infectious diseases in healthcare facilities. They restricted their searches to articles published in English and Chinese and included six randomized trials and 26 observational studies.

What was found: When the searches for this review were done in November 2020, there was no significant evidence of a difference between N95 respirators and medical masks for protecting healthcare workers from respiratory viruses, but low-quality evidence suggested that N95 respirators were more protective than medical masks against coronavirus infections.

Implications: The authors of the review recommended that healthcare workers wear N95 respirators in high-risk areas for coronaviruses and medical masks in low-risk areas.

Hospital disaster resilience (from our Resilient Health Systems Collection). https://tiny.one/resilient Citation: Fallah-Aliabadi S, et al. Towards developing a model for the evaluation of hospital disaster resilience: a systematic review. https://tiny.one/evaluationreview BMC Health Services Research. 2020;20:64.

Hospitals that are resilient are likely to be better able to provide essential services during and after disasters and other health emergencies. In this systematic review, the authors searched for studies of factors, indicators, variables, models, or instruments that affected the resilience of structural or non-structural systems of hospitals in the context of disasters. They did their search on 1 September 2018 and included 32 studies, from more than a dozen countries.

What was found: Non-structural components such as utilities and architectural systems account for more than 80% of the total costs of a hospital. Hospital building stability (including structural and non-structural systems and resource preparedness systems) plays a significant role in hospital performance during disasters. Comprehensive assessment of hospital disaster resilience helps find weaknesses and challenges and ways to mitigate the harmful consequences of disasters. Safety and risk reduction is mainly used to reduce the level of risk, but resilience is used to keep control of the functionality of a system when it is prone to risk.

Implications: The authors of the review concluded that tools or models can reduce the vulnerability of hospitals and improve their performance and resilience against disasters and that further studies should be done to quantify hospital resilience in different countries, using an all-hazards approach.

Mark Gavin, Administrative Assistant

Evidence Aid: Championing evidence-based humanitarian action.

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