How has Guinea learnt from the response to outbreaks? A learning health system analysis

Area of Science:

• Health Systems Research
• Epidemiology
• Public Health Policy

Background:

• Learning is crucial for resilient health systems and strengthening health system performance.
• Effective learning from past outbreaks is vital for improving future responses.
• Guinea's health system has faced multiple disease outbreaks between 2014 and 2021.

Purpose of the Study:

• To analyze how Guinea's health system learned from its response to disease outbreaks from 2014 to 2021.
• To identify lessons learned, learning mechanisms, enablers, barriers, and recommendations for improving health system learning.

Main Methods:

• Retrospective longitudinal single embedded case study design.
• Mixed methods approach including a systematic review of 70 reports and an online survey.
• Analysis framework based on Sheikh and Abimbola's model for learning health systems.

Main Results:

• Key lessons from the 2014-2016 Ebola Virus Disease (EVD) response included community engagement, social mobilization, and investing in health personnel.
• Learning occurred through information, action/practice, and various loops (single, double, triple), but advanced learning aspects were limited.
• Enablers included a national health security agency and partner support; barriers were cultural, political, and funding-related.

Conclusions:

• Guinea's health system demonstrated improved outbreak response outcomes over time due to learning.
• Despite limitations in advanced learning, the system successfully controlled recent outbreaks like COVID-19 and Marburg virus disease.
• Recommendations include establishing knowledge management units, investing in human capacity, and enhancing governance.