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Review
. 2021 Jul 1:11:05011.
doi: 10.7189/jogh.11.05011.

Macro level influences on strategic responses to the COVID-19 pandemic - an international survey and tool for national assessments

Raheelah Ahmad  1   2   3 , Rifat A Atun  1   4 , Gabriel Birgand  1   5 , Enrique Castro-Sánchez  1   2   6 , Esmita Charani  1   7   8 , Ewan B Ferlie  9 , Izhar Hussain  3 , Andrew Kambugu  10 , Jaime Labarca  11 , Gabriel Levy Hara  12 , Martin McKee  13 , Marc Mendelson  7 , Sanjeev Singh  8 , Jay Varma  14 , Nina J Zhu  1 , Walter Zingg  1   15   16 , Alison H Holmes  1 ; COMPASS (COntrol and Management of PAndemicS through Strategic analysis) study group
Affiliations
Review

Macro level influences on strategic responses to the COVID-19 pandemic - an international survey and tool for national assessments

Raheelah Ahmad et al. J Glob Health. .

Abstract

Background: Variation in the approaches taken to contain the SARS-CoV-2 (COVID-19) pandemic at country level has been shaped by economic and political considerations, technical capacity, and assumptions about public behaviours. To address the limited application of learning from previous pandemics, this study aimed to analyse perceived facilitators and inhibitors during the pandemic and to inform the development of an assessment tool for pandemic response planning.

Methods: A cross-sectional electronic survey of health and non-health care professionals (5 May - 5 June 2020) in six languages, with respondents recruited via email, social media and website posting. Participants were asked to score inhibitors (-10 to 0) or facilitators (0 to +10) impacting country response to COVID-19 from the following domains - Political, Economic, Sociological, Technological, Ecological, Legislative, and wider Industry (the PESTELI framework). Participants were then asked to explain their responses using free text. Descriptive and thematic analysis was followed by triangulation with the literature and expert validation to develop the assessment tool, which was then compared with four existing pandemic planning frameworks.

Results: 928 respondents from 66 countries (57% health care professionals) participated. Political and economic influences were consistently perceived as powerful negative forces and technology as a facilitator across high- and low-income countries. The 103-item tool developed for guiding rapid situational assessment for pandemic planning is comprehensive when compared to existing tools and highlights the interconnectedness of the 7 domains.

Conclusions: The tool developed and proposed addresses the problems associated with decision making in disciplinary silos and offers a means to refine future use of epidemic modelling.

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Conflict of interest statement

Competing interests: The authors completed the ICMJE Unified Competing Interest form (available upon request from the corresponding author), and declare no other conflicts of interest.

Figures

Figure 1
Figure 1
PESTELI domain scoring: by continent.
Figure 2
Figure 2
PESTELI domain scoring: by country. Panel A. Argentina. Panel B. China. Panel C. Colombia. Panel D. France. Panel E. Mexico. Panel F. Pakistan. Panel G. Paraguay. Panel H. South Africa. Panel I. Spain. Panel J. Thailand. Panel K. United Kingdom (UK). Panel L. United States of America (USA).
Figure 3
Figure 3
Qualitative themes in PESTELI domains.
See this image and copyright information in PMC

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