How have researchers defined institutions, politics, organizations and governance in research related to epidemic and pandemic response? A scoping review to map current concepts

Abstract

In recent years, the literature on public health interventions and health outcomes in the context of epidemic and pandemic response has grown immensely. However, relatively few of these studies have situated their findings within the institutional, political, organizational, and governmental (IPOG) context in which interventions and outcomes exist. This conceptual mapping scoping study synthesized the published literature on the impact of IPOG factors on epidemic and pandemic response and critically examined definitions and uses of the terms IPOG in this literature. This research involved a comprehensive search of four databases across the social, health, and biomedical sciences as well as multi-level eligibility screening conducted by two independent reviewers. Data on the temporal, geographic, and topical range of studies were extracted, then descriptive statistics were calculated to summarize these data. Hybrid inductive and deductive qualitative analysis of the full-text articles was conducted to critically analyze the definitions and uses of these terms in the literature. The searches retrieved 4,918 distinct articles; 65 met the inclusion criteria and were thus reviewed. These articles were published from 2004 to 2022, were mostly written about COVID-19 (61.5%), and most frequently engaged with the concept of governance (36.9%) in relation to epidemic and pandemic response. Emergent themes related to the variable use of the investigated terms, the significant increase in relevant literature published amidst the COVID-19 pandemic, as well as a lack of consistent definitions used across all four terms: institutions, politics, organizations, and governance. This study revealed opportunities for health systems researchers to further engage in interdisciplinary work with fields such as law and political science, to become more forthright in defining factors which shape responses to epidemics and pandemics, and to develop greater consistency in using these IPOG terms in order to lessen confusion among a rapidly growing body of literature.

Improving the response to future pandemics requires an improved understanding of the role played by institutions, politics, organization, and governance

“…It is our contention that COVID-19 has exposed the need to expand, deepen, and sharpen the focus of investigation to explore the intersection of all of these key contextual factors and how they combine to influence outcomes. This assertion drove the development of our IPOG analytical framework, the details of which have been published elsewhere [10]. We have applied this framework, elaborated on in Fig 1, with colleagues in multiple jurisdictions both within Canada as well as internationally.…”