BRACE

brace

bolstering resilience and capacities for emergencies

WHAT IS BRACE?

CRIMEDIM has recently launched its BRACE (Bolstering Resilience and Capacities To Emergencies) initiative, a long-term project whose aim is to develop a knowledge hub focused on the World Health Organization’s Health Emergency and Disaster Risk Management (Health-EDRM) Framework. The BRACE initiative builds scholarly knowledge and fosters operational action around the Health-EDRM Framework through three activities:

  1. Assessment of compliance to the Health-EDRM Framework precepts;

  2. Identification of gaps at all levels of the health system (national, regional, local);

  3. Building an actionable road map for communities to adhere to Health-EDRM guidelines .

ONGOING Project

1 - Disaster management at the primary health care level

1.1 Primary healthcare disaster preparedness

A growing body of literature emphasizes the critical role played by primary healthcare (PHC) systems in disaster preparedness, response, and recovery. The H-EDRM Framework itself emphasises the importance of PHC in the disaster cycle and advocates for a unified strategy for disaster management that integrates all aspects of the health sector in order to build a truly resilient society. However, a clear understanding is lacking of how to translate this into practice. Exactly what constitutes PHC disaster preparedness remains undefined by international medical bodies and, therefore, difficult to put into practice. This project’s objective is to identify the most important elements needed for a PHC system to effectively respond to disasters. At a later stage these elements will contribute to inform the creation of an assessment tool to evaluate the level of compliance of primary care systems to the H-EDRM precepts, and will inform the creation of a PHC-specific disaster preparedness educational curriculum for PHC professionals.

For more information, contact the project’s coordinators: Alessandro Lamberti Castronuovo (alessandro.lamberti@uniupo.it), Martina Valente (martina.valente@uniupo.it).

1.2 Primary healthcare functioning during a disaster

PHC services are of paramount importance during disasters and should be constantly available and accessible, since the management of such chronic conditions represents as much of a major burden as the management of disaster-related acute conditions.

Assessing PHC continuity of operations during disasters can be of paramount importance. “Avoidable health conditions or events” (ACS) have been used in the literature as an indicator of PHC performance status. These are acute health events that could potentially be avoided with proper primary care. Elevated rates of ACS visits (measured at ER level) signal primary care access issues in the population or service area.

BRACE team is currently studying this phenomenon in hospitals in Italy in cooperation with other Universities as well as conducting an extensive literature review on different case studies of measurement of ACS during disasters in global context as a proxy for PHC functioning and quality of care.

For more information, contact the project’s coordinators: Alessandro Lamberti Castronuovo (alessandro.lamberti@uniupo.it), Martina Valente (martina.valente@uniupo.it).

2 - Assessing vulnerable populations’ disaster preparedness

2.1 Developing a new tool to assess the preparedness of vulnerable populations

Disasters exacerbate existing disparities in health and health care, compromising the already precarious situation of the most vulnerable people - migrants, refugees, displaced persons, socioeconomically disadvantaged - who have scarce resources to adequately prepare and protect themselves. The Covid-19 pandemic clearly showed that if it is true that disasters affect everyone, certain populations are typically impacted more than others. The objective of this research project is to develop a new assessment tool for the preparedness of vulnerable populations in the context of disasters or public health emergencies. Thanks to this tool it will be possible to assess whether there is a correspondence between the principles established by the H-EDRM framework and what vulnerable people experience when facing disasters. An overview of the existing tools that evaluate vulnerable groups’ preparedness in the event of a disaster will be given. Furthermore, a clear understanding of what elements would make the vulnerable communities prepared for disasters will emerge. The research project will adopt a bottom-up approach, involving key representatives of vulnerable communities in several high- and low-resource settings in a participatory study.

For more information, contact the project’s coordinators: Monica Trentin (monica.trentin@uniupo.it), Martina Valente (martina.valente@uniupo.it).

2.2 Continuity of PHC care for vulnerable communities: a cross-country comparison

This study aims to assess the barriers experienced by vulnerable communities in accessing primary health care services during the COVID-19 pandemic. A cross-country comparison (high-income, middle-income, low-income country) will be performed and barriers related to the implementation of the H-EDRM within the targeted countries for these communities will be identified. A mixed-method study (applying both quantitative and qualitative methods) will be used. The first phase of the study will involve in-depth interviews with vulnerable communities. Mapping of activities of different partners working under emergency response will be done during this phase and in-depth interviews will also be conducted with the representatives of partner organisations to understand barriers to implementation of health EDRM. Phase-2 will involve sharing of findings of phase-1 with the partners and policymakers to understand possible solutions to those barriers and challenges.

For more information, contact the project’s coordinators: Yasir Shafiq (yasir.shafiq@unipo.it), Martina Valente (martina.valente@uniupo.it).

Projects in the pipeline

1 -Validation of a self-assessment tool for measuring hospital preparedness in the Piedmont region

Hospitals are vital tools for communities on a daily basis as well as during emergencies, disasters, and other crises. Evidence shows that preparedness in hospitals and health systems significantly reduces related death rates. The aim of this project is to contextualize and validate a self-assessment tool to help decision makers in Piedmont region hospitals to evaluate their level of preparedness regarding disasters.

For more information, contact the project’s coordinator: Hamdi Lamine (hamdi.lamine@uniupo.it).

2 - COVID responses at the hospital level

Over the last year and a half, as knowledge about COVID has been evolving, communities around the globe have devised myriad strategies for handling the pandemic. BRACE Team’s objective is to build a comprehensive database of all case studies that describe hospital responses to COVID in Italy. The database will then be used to conduct a comparative analysis of the data and will be further developed to conduct cost-benefit analyses of hospital response strategies.

For more information, contact the project’s coordinator: Alessandro Lamberti Castronuovo (alessandro.lamberti@uniupo.it), Hamdi Lamine (hamdi.lamine@uniupo.it).

3 - Legal Research about the Health-EDRM Framework

At present, at least not to our knowledge, the EDRM Framework has not been incorporated in EU policy. Nevertheless, it is necessary to assess whether laws are in place to facilitate the recommendation put forth in the framework at European level and at the country level.

Some specific legal aspects of the Health-EDRM Framework are productive areas of research between CRIMEDIM and the UPO Faculty of Law. The main areas include the possibility to develop a methodology for assessing whether international, regional, and local laws have been harmonized with the DRR objectives laid out in the Health-EDRM Framework and an analysis of the Italian current DRR policies and legislation referring to the protection of people’s health, especially the most vulnerable.

For more information on this project contact: Stefano Saluzzo (stefano.saluzzo@uniupo.it).