Optimizing Pandemic Preparedness and Response Through Health Information Systems: Lessons Learned From Ebola to COVID-19

Abstract

Strengthening health systems and maintaining essential service delivery during health emergencies response is critical for early detection and diagnosis, prompt treatment, and effective control of pandemics, including the novel coronavirus disease (COVID-19). Health information systems (HIS) developed during recent Ebola outbreaks in West Africa and the Democratic Republic of the Congo (DRC) provided opportunities to collect, analyze, and distribute data to inform both day-to-day and long-term policy decisions on outbreak preparedness. As COVID-19 continues to sweep across the globe, HIS and related technological advancements remain vital for effective and sustained data sharing, contact tracing, mapping and monitoring, community risk sensitization and engagement, preventive education, and timely preparedness and response activities. In reviewing literature of how HIS could have further supported mitigation of these Ebola outbreaks and the ongoing COVID-19 pandemic, three key areas were identified: governance and coordination, health systems infrastructure and resources, and community engagement. In this concept paper, we outline scalable HIS lessons from recent Ebola outbreaks and early COVID-19 responses along these three domains, synthesizing recommendations to offer clear, evidence-based approaches on how to leverage HIS to strengthen the current pandemic response and foster community health systems resilience moving forward.

A cross-sectional survey of COVID-19 preparedness in governmental hospitals of North-West Ethiopia

“…From previous pandemic experience, governance and coordination, health system infrastructure, and community engagement were important to reduce the damage from pandemic. 26 …”

Fragmented health systems in COVID-19: rectifying the misalignment between global health security and universal health coverage

“… 10 Each state funds and operates its own systems for public health and surveillance, and the nation has been reluctant to build a unified health system that is publicly funded. 11 , 12 This absence of clear coordination, a crucial IHR core capacity, has so far hindered the country's ability to accurately estimate and forecast the effect of COVID-19, resulting in delayed response activities, including testing and contact tracing. 10 Additionally, the scarcity of centralised funding has led to chronic misuse and underuse of human and financial resources.…”

“…37 Taiwan's 99·9% coverage of national health insurance enabled comprehensive epidemic prevention, integrated medical data, unified information platforms, and safety nets for vulnerable populations. 12 , 38 Advancements in UHC helped Vietnam to safeguard the government–citizen cooperation that was needed to foster a culture of surveillance and comprehensive contact tracing where mass testing was improbable. 39 Singapore leveraged public health infrastructure, innovative diagnostics, PHC physicians who were trained for outbreaks, and no-cost screening, testing, and treatment.…”

“… 5 It is well understood that the skills and infrastructure needed for the two systems are mutually reinforcing; an opportunity exists to re-examine obvious areas, such as fortifying the national surge capacity of the health workforce as a connection between prevention and health-care delivery or integrating emergency health-information systems with routine surveillance networks and other national databases. 4 , 12 , 56 …”

“…The COVID-19 response has emphasised the glaring absence of social determinants of health and meaningful community engagement from major frameworks for health emergencies, such as the IHR. 12 , 63 Moving forward, a unified GHS–UHC agenda should be built with intersectional equity at the centre. Incorporating the vision of fostering healthy populations (as advocated for by WHO, the Healthier Societies for Healthy Populations Group, and other stakeholders) with a political economy approach that considers “competing interests, institutions, and ideas”, 48 , 64 can safeguard UHC and GHS in a global economic downturn.…”