Terrorist attack of 15 January 2016 in Ouagadougou: how resilient was Burkina Faso's health system?

Abstract

In Africa, health systems are often not very responsive. Their resilience is often tested by health or geopolitical crises. The Ebola epidemic, for instance, exposed the fragility of health systems, and recent terrorist attacks have required countries to respond to urgent situations. Up until 2014, Burkina Faso's health system strongly resisted these pressures and reforms had always been minor. However, since late 2014, Burkina Faso has had to contend with several unprecedented crises. In October 2014, there was a popular insurrection. Then, in September 2015, the Security Regiment of the deposed president attempted a coup d’état. Finally, on 15 January 2016, a terrorist attack occurred in the capital, Ouagadougou. These events involved significant human injury and casualties. In these crises, the Burkinabè health system was sorely tried, testing its responsiveness, resiliency and adaptability. We describe the management of the recent terrorist attack from the standpoint of health system resilience. It would appear that the multiple crises that had occurred within the previous 2 years led to appropriate management of that terrorist attack thanks to the rapid mobilisation of personnel and good communication between centres. For example, the health system had put in place a committee and an emergency response plan, adapted blood bank services and psychology services, and made healthcare free for victims. Nevertheless, the system encountered several challenges, including the development of framework documents for resources (financial, material and human) and their use and coordination in crisis situations.

Health system resilience: a literature review of empirical research

“…The provision of emergency services during a crisis is also explored in four qualitative studies. Two of these assess service provision in the context of a particular crisis: Ridde et al (2016) describe the emergency response to the Ouagadougou Terrorist attack in Burkina Faso, using a mixture of observations and expert interviews as their data source and structuring insights around Kruk et al ’s (2017) ‘resilience indicators’ framework. Landeg et al (2019) assess the emergency response to localized flooding in the UK using semi-structured interviews with decision-makers and document analysis.…”

“…Only two of these studies ( Ridde et al 2016 ; Back et al 2017 ), both using qualitative methodologies, apply a specific framework of health system resilience. All quantitative studies and one mixed methods study focus on the absorptive capacities of service delivery, while the other studies address a more varied set of resilience dimensions.…”

Addressing challenges in routine health data reporting in Burkina Faso through Bayesian spatiotemporal prediction of weekly clinical malaria incidence

“…However, it is important to stress the high uncertainty of these long-term predicted values, even if the reproduction of the median number of clinical malaria cases appears to be similar to the number of reported cases for the first 20 weeks of 2019. This highlights the significant challenges for developing prediction models in endemic settings where clinical malaria incidence depends on several observable and non-observable factors, such as the entomological inoculation rate, mosquito density and extrinsic incubation period of malaria parasites in the mosquito host, population displacements 54 , 55 and health interventions. Since our model was adjusted for temperature, distance to a waterbody, humidity and rainfall, several of these factors could be considered minimal because factors related to the cyclic pattern of disease transmission (mosquito development and bites) are affected by weather variables 41 , 56 – 59 .…”

La résilience de l’hôpital du Mali face à la COVID-19 dans un contexte de pénuries

“…En Afrique de l'Ouest et du Centre, l'épidémie d'Ebola, par exemple, a mis en évidence la fragilité des systèmes de santé [1]. En outre au Sahel, les récents attentats terroristes ont obligé les pays à réagir à des situations d'urgence, en particulier en milieu hospitalier au Burkina Faso [2]. Plus récemment, l'émergence et la diffusion rapide de la maladie à coronavirus (COVID- 19), depuis la fin de l'année 2019, a mis à rude épreuve les systèmes de santé du monde entier [3].…”