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Identifying vulnerabilities in essential health services: Analysing the effects of system shocks on childhood vaccination delivery in Lebanon

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  • Ismail, Sharif A.
  • Tomoaia-Cotisel, Andrada
  • Noubani, Aya
  • Fouad, Fouad M.
  • Trogrlić, Robert Šakić
  • Bell, Sadie
  • Blanchet, Karl
  • Borghi, Josephine

Abstract

Shocks effects are under-theorised in the growing literature on health system resilience. Existing work has focused on the effects of single shocks on discrete elements within the health system, typically at national level. Using qualitative system dynamics, we explored how effects of multiple shocks interacted across system levels and combined with existing vulnerabilities to produce effects on essential health services delivery, through the prism of a case study on childhood vaccination in Lebanon. Lebanon has experienced a series of shocks in recent years, including large-scale refugee arrivals from neighbouring Syria, the COVID-19 pandemic and a political-economic crisis. We developed a causal loop diagram (CLD) to explore the effects of each shock individually, and in combination. The CLD was developed and validated using qualitative data from interviews with 38 stakeholders working in Lebanon's vaccination delivery system, in roles ranging from national level policy to facility-level service delivery, conducted between February 2020 and January 2022.

Suggested Citation

  • Ismail, Sharif A. & Tomoaia-Cotisel, Andrada & Noubani, Aya & Fouad, Fouad M. & Trogrlić, Robert Šakić & Bell, Sadie & Blanchet, Karl & Borghi, Josephine, 2024. "Identifying vulnerabilities in essential health services: Analysing the effects of system shocks on childhood vaccination delivery in Lebanon," Social Science & Medicine, Elsevier, vol. 358(C).
    • Handle: RePEc:eee:socmed:v:358:y:2024:i:c:s0277953624007147
    DOI: 10.1016/j.socscimed.2024.117260
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    1. Melanie Kappes & Margreth Keiler & Kirsten Elverfeldt & Thomas Glade, 2012. "Challenges of analyzing multi-hazard risk: a review," Natural Hazards: Journal of the International Society for the Prevention and Mitigation of Natural Hazards, Springer;International Society for the Prevention and Mitigation of Natural Hazards, vol. 64(2), pages 1925-1958, November.
    2. McGovern, Mark E. & Canning, David, 2015. "Vaccination and All Cause Child Mortality 1985-2011: Global Evidence from the Demographic and Health Surveys," Working Paper 227741, Harvard University OpenScholar.
    3. Yearworth, Mike & White, Leroy, 2013. "The uses of qualitative data in multimethodology: Developing causal loop diagrams during the coding process," European Journal of Operational Research, Elsevier, vol. 231(1), pages 151-161.
    4. Andrada Tomoaia‐Cotisel & Samuel D. Allen & Hyunjung Kim & David Andersen & Zaid Chalabi, 2022. "Rigorously interpreted quotation analysis for evaluating causal loop diagrams in late‐stage conceptualization," System Dynamics Review, System Dynamics Society, vol. 38(1), pages 41-80, January.
    5. Jakob Zscheischler & Seth Westra & Bart J. J. M. Hurk & Sonia I. Seneviratne & Philip J. Ward & Andy Pitman & Amir AghaKouchak & David N. Bresch & Michael Leonard & Thomas Wahl & Xuebin Zhang, 2018. "Future climate risk from compound events," Nature Climate Change, Nature, vol. 8(6), pages 469-477, June.
    6. Jakob Zscheischler & Seth Westra & Bart J. J. M. Hurk & Sonia I. Seneviratne & Philip J. Ward & Andy Pitman & Amir AghaKouchak & David N. Bresch & Michael Leonard & Thomas Wahl & Xuebin Zhang, 2018. "Author Correction: Future climate risk from compound events," Nature Climate Change, Nature, vol. 8(8), pages 750-750, August.
    7. Gianluca Pescaroli & David Alexander, 2018. "Understanding Compound, Interconnected, Interacting, and Cascading Risks: A Holistic Framework," Risk Analysis, John Wiley & Sons, vol. 38(11), pages 2245-2257, November.
    8. Hugo Jose Herrera de Leon & Birgit Kopainsky, 2019. "Do you bend or break? System dynamics in resilience planning for food security," System Dynamics Review, System Dynamics Society, vol. 35(4), pages 287-309, October.
    9. Angela Chang & Carlos Riumallo-Herl & Nicole Perales & Samantha Clark & Andrew Clark & Dagna Constenla & Tini Garske & Michael Jackson & Kévin Jean & Mark Jit & Edward Jones & Xi Li & Chutima Suraratd, 2018. "The Equity Impact Vaccines May Have On Averting Deaths And Medical Impoverishment In Developing Countries," Post-Print hal-03200172, HAL.
    10. Chang, Angela Y. & Ogbuoji, Osondu & Atun, Rifat & Verguet, Stéphane, 2017. "Dynamic modeling approaches to characterize the functioning of health systems: A systematic review of the literature," Social Science & Medicine, Elsevier, vol. 194(C), pages 160-167.
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