The contribution of community health systems to resilience

Case study of the response to the drought in Ethiopia

Bibliographic Data

ID19552347
AuthorsAngeli Rawat (0000-0002-1313-2796, Health & Life (Taiwan), corresponding author), Jonas Karlström (0000-0002-7279-428X, United Nations Children's Fund), Agazi Ameha (Health & Life (Taiwan)), Macoura Oulare (0000-0002-5220-4393, Government of Ethiopia), Mohamed Diaaeldin Omer (Government of Ethiopia), Hentsa Haddush Desta (Government of Ethiopia), Shalini Bahuguna (Government of Ethiopia), Katrina Hsu (0000-0002-8380-5415, Providence Health Care), Nathan P Miller (0000-0002-0500-1913, Health & Life (Taiwan)), Gemu Tiru Bati (0000-0003-4255-3618, Federal Ministry of Health), Kumanan Rasanathan (0000-0001-9347-1765, Health & Life (Taiwan))
Year2022
Volume12
Pages14001-14001
Publication date2022-10-23
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueJournal of Global Health (JOURNAL)
Journal identifiersISSN: 2047-2978 • E-ISSN: 2047-2986
PublisherInternational Society of Global Health (PUBLISHER • GB)
DOI10.7189/jogh.12.14001
PMID36273279
OpenAlexW4307099970
LanguageEN
Citations received8
References cited36

Background: Ethiopia's exposure to the El Niño drought (2015-2016) resulted in high malnutrition, internally displaced people, and epidemics of communicable diseases, all of which strained the health system. The drought was especially challenging for mothers and children. We aimed to identify salient factors that can improve health system resilience by exploring the successes and challenges experienced by a community-based health system during the drought response. Methods: We collected data via key informant interviews and focus group discussions to capture diverse perspectives across the health system (eg, international, national, district, facility, and community perspectives). Data were collected from communities in drought-affected regions of: 1) Somali, Sitti Zone, 2) Hawassa, Southern Nations, Nationalities, and Peoples' Region (SNNPR), and 3) Tigray, Eastern Zone. Data were analysed using a deductive-inductive approach using thematic content analysis applied to a conceptual framework. Results: A total of 94 participants were included (71 from the communities and 23 from other levels). Key themes included the importance of: 1) organized community groups linked to the health system, 2) an effective community health workforce within strong health systems, 3) adaptable human resource structures and service delivery models, 4) training and preparedness, and 5) strong government leadership with decentralized decision making. Conclusions: The results of this study provide insights from across the health system into the successes and challenges of building resilience in community-based health systems in Ethiopia during the drought. As climate change exacerbates extreme weather events, further research is needed to understand the determinants of building resilience from a variety of shocks in multiple contexts, especially focusing on harnessing the power of communities as reservoirs of resilience

Community health · Community resilience · Environmental health · Environmental resource management · Focus group · Geography · Political science · Preparedness · Psychological resilience · Public health · Qualitative research · Social science · Socioeconomics · Sociology · Thematic analysis · Workforce · Climate Change and Health Impacts · Global Maternal and Child Health · Medicine · Nursing · Psychology · Viral Infections and Outbreaks Research