BMJ Global Health (Oct 2020)
Systems thinking for health emergencies: use of process mapping during outbreak response
- Ambrose Talisuna,
- Mamadou Harouna Djingarey,
- Pierre Formenty,
- Adesola Yinka-Ogunleye,
- Chikwe Ihekweazu,
- Kara N Durski,
- Michael Osterholm,
- Ibrahim Mamadu,
- Sylvie Briand,
- Ibrahima-Soce Fall,
- Amara Jambai,
- Dhamari Naidoo,
- Shalini Singaravelu,
- Anita A Shah,
- James Banjura,
- Benoit Kebela,
- Womi Eteng,
- Mohamed Vandi,
- Charles Keimbe,
- Anwar Abubakar,
- Abulazeez Mohammed,
- Desmond E Williams,
- Margaret Lamunu,
- Jean Claude Changa Changa,
- Etienne Minkoulou,
- Dan Jernigan,
- Demba Lubambo,
- Asheena Khalakdina,
- Albert Mbule Kadiobo,
- Bruce Aylward
Affiliations
- Ambrose Talisuna
- 1 Emergency Preparedness and Response Cluster, WHO Regional Office for Africa, Brazzaville, Congo
- Mamadou Harouna Djingarey
- World Health Organization, Brazzaville, Republic of Congo
- Pierre Formenty
- World Health Organization, Geneve, Switzerland
- Adesola Yinka-Ogunleye
- Department of Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Nigeria
- Chikwe Ihekweazu
- Office of the Director General, Nigeria Centre for Disease Control, Abuja, Nigeria
- Kara N Durski
- World Health Organization, Geneva, Switzerland
- Michael Osterholm
- University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
- Ibrahim Mamadu
- World Health Organization Country Office for Nigeria, Abuja, Nigeria
- Sylvie Briand
- World Health Organization, Geneve, Switzerland
- Ibrahima-Soce Fall
- 7 Health Emergencies Program, World Health Organization, Geneva, Geneva, Switzerland
- Amara Jambai
- Ministry of Health and Sanitation, Government of Sierra Leone, Freetown, Western Area, Sierra Leone
- Dhamari Naidoo
- World Health Organization, Geneve, Switzerland
- Shalini Singaravelu
- World Health Organization, Geneve, Switzerland
- Anita A Shah
- World Health Organization, Geneve, Switzerland
- James Banjura
- Sierra Leone Ministry of Health and Sanitation, Freetown, Sierra Leone
- Benoit Kebela
- Ministry of Health Democratic Republic of Congo, Kinshasa, Democratic Republic of Congo
- Womi Eteng
- Nigeria Centre for Disease Control, Abuja, Nigeria
- Mohamed Vandi
- Sierra Leone Ministry of Health and Sanitation, Freetown, Sierra Leone
- Charles Keimbe
- Sierra Leone Ministry of Health and Sanitation, Freetown, Sierra Leone
- Anwar Abubakar
- Health Emergency Preparedness and Response, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
- Abulazeez Mohammed
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
- Desmond E Williams
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Margaret Lamunu
- World Health Organization, Freetown, Sierra Leone
- Jean Claude Changa Changa
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of Congo
- Etienne Minkoulou
- World Health Organization, Brazzaville, Republic of Congo
- Dan Jernigan
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Demba Lubambo
- World Health Organization, Brazzaville, Republic of Congo
- Asheena Khalakdina
- World Health Organization, Geneve, Switzerland
- Albert Mbule Kadiobo
- World Health Organization, Kinshasa, Democratic Republic of Congo
- Bruce Aylward
- World Health Organization, Geneve, Switzerland
- DOI
- https://doi.org/10.1136/bmjgh-2020-003901
- Journal volume & issue
-
Vol. 5,
no. 10
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.
