臺灣博碩士論文加值系統

Background: With globalization and people travelling much more frequently and further distances than in the past, living in densely populated areas, and coming into closer contact with wild animals; the risk for emerging and re-emerging infectious disease to spread and cause global epidemics is a serious concern. The purpose of this study was to explore country level (Belize) preparedness for an infectious disease transmitted via rapid direct/indirect human transmission.
Methods: A convergent-parallel mixed method study design was employed where qualitative semi-structured interviews were conducted at the primary level of care and paper-filled surveys were administered at the secondary and tertiary levels of care. Data was gathered and analyzed separately. Subsequently, “mixing” of data occurred using the International Health Regulations as the “Gold Standard”.
Results: Qualitative and quantitative findings revealed that surveillance systems are in place to serve as early warning systems for outbreak detection. Both data types also revealed a lack of human resources across primary, secondary, and tertiary levels of care, as well as poor laboratory capacity. The presence of preparedness plans/manuals that are coordinated with local or regional infectious disease response plans were also noted, as well as the lack of certain material and infrastructural resources needed for outbreak response.
Conclusion: Findings provide a clear image of areas that are improving as well as areas that require further improvement. By drawing from the lessons learnt from the management of previous outbreaks, the country can strengthen current strategies without having to “learn the hard way”.

ACKNOWLEDGEMENTS..............................................i
DEDICATION...................................................ii
LIST OF ABBREVIATIONS.......................................iii
ABSTRACT......................................................v

CHAPTER I: INTRODUCTION.......................................1
1.1 BACKGROUND AND SIGNIFICANCE...............................1
1.2 AIM.......................................................4
1.3 SPECIFIC OBJECTIVES.......................................4

CHAPTER II: LITERATURE REVIEW.................................5
2.1 PREVIOUS EVALUATIONS......................................5
2.2 APPLYING LESSONS FROM THE MANAGEMENT OF SARS AND EBOLA....6
2.3 GAPS IN THE LITERATURE....................................8
2.4 BRIDGING THE GAP..........................................9

CHAPTER III: METHODOLOGY.....................................10
3.1 OVERVIEW.................................................10
3.2 STUDY SETTING............................................11
3.3 ETHICAL CONSIDERATION AND PERMISSIONS....................12
3.4 SAMPLING STRATEGY .......................................12
3.5 QUANTITATIVE METHODS.....................................13
3.5.1 OVERVIEW...............................................13
3.5.2 STUDY INSTRUMENT (QUANTITATIVE ASPECT).................13
3.5.3 STUDY PARTICIPANTS (QUANTITATIVE ASPECT)...............14
3.5.4 STUDY SETTING (QUANTITATIVE ASPECT)....................15
3.5.5 DATA MANAGEMENT AND ANALYSES (QUANTITATIVE ASPECT).....15
3.6 QUALITATIVE METHODS......................................16
3.6.1 OVERVIEW...............................................16
3.6.2 STUDY INSTRUMENT (QUALITATIVE ASPECT)..................16
3.6.3 STUDY PARTICIPANTS (QUALITATIVE ASPECT)................17
3.6.4 STUDY SETTING (QUALITATIVE ASPECT).....................18
3.6.5 DATA MANAGEMENT AND ANALYSES (QUALITATIVE ASPECT)......19

CHAPTER IV: RESULTS..........................................20
4.1 QUANTITATIVE RESULTS.....................................20
4.1.1 OVERVIEW...............................................20
4.2 QUALITATIVE RESULTS......................................29
4.2.1 OVERVIEW...............................................29

CHAPTER V: DISCUSSION........................................43

CHAPTER VII: CONCLUSION .....................................49
7.1 RECOMMENDATIONS AND POLICY IMPLICATIONS..................50

REFERENCES...................................................51

APPENDICES...................................................55
APPENDIX A: MINISTRY OF HEALTH APPROVAL......................55
APPENDIX B: INFORMED CONSENT FOR HEALTH PROFESSIONALS AT PRIMARY CARE FACILITIES......................................57
APPENDIX C: INFORMED CONSENT FOR INFECTION CONTROL COMMITTEE MEMBERS......................................................58
APPENDIX D: PLANNING AND PREPAREDNESS QUESTIONNAIRE FOR HEALTH CARE FACILITIES..............................................59
APPENDIX E: INTERVIEW GUIDE (NURSING AND MEDICAL DEPARTMENTS).................................................65
APPENDIX F: INTERVIEW GUIDE (PUBLIC HEALTH DEPARTMENT).......66
APPENDIX G: INTERVIEW GUIDE (EPIDEMIOLOGY DEPARTMENT)........67
APPENDIX H: INTERVIEW GUIDE (CENTRAL MEDICAL STORE)..........68
APPENDIX I: INTERVIEW GUIDE (CENTRAL MEDICAL LABORATORY).....69

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