Evidence map›Paper›PMID 38084479›Full record

ArticleBMJ global health2023

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Yazan Douedari, Mervat Alhaffar, Ahmad Khanshor, Omar Alrashid Alhiraki, Manar Marzouk, Natasha Howard

Abstract read
In one paragraph

Article in BMJ global health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Yazan DouedariDepartment of Global Health and Development, London School of Hygiene & Tropical Medicine Faculty of Public Health and Policy, London, UK Yazan.Douedari@lshtm.ac.uk.ORCID 0000-0001-7964-9408
Mervat AlhaffarDepartment of Global Health and Development, London School of Hygiene & Tropical Medicine Faculty of Public Health and Policy, London, UK.ORCID 0000-0002-3737-8790
Ahmad KhanshorSyria Research Group, London School of Hygiene & Tropical Medicine and NUS Saw Swee Hock School of Public Health, London, UK.
Omar Alrashid AlhirakiSyria Research Group, London School of Hygiene & Tropical Medicine and NUS Saw Swee Hock School of Public Health, London, UK.
Manar MarzoukDepartment of Global Health and Development, London School of Hygiene & Tropical Medicine Faculty of Public Health and Policy, London, UK.
Natasha HowardDepartment of Global Health and Development, London School of Hygiene & Tropical Medicine Faculty of Public Health and Policy, London, UK.ORCID 0000-0003-4174-7349

Funding

Medical Research Council MR/S013121/1
6 · The paper itself

Abstract

introductionGovernance of COVID-19 responses has been challenging for all countries. Syria has been particularly challenged due to protracted multiparty conflict and debilitated health systems fragmented across different areas of control. To improve response governance, better understanding of frontline response policy implementation across the country is needed. This study thus explored perspectives of COVID-19 response governance among frontline healthcare providers over time and across major areas of control.

methodsWe used a qualitative longitudinal study design, conducting five rounds of remote semistructured interviews in Arabic (ie, approximately eight interviews each in March 2020, July 2020, September 2020, December 2020 and September 2021) with 14 purposively sampled public and private healthcare providers in the three main areas of control (ie, opposition-controlled area, Autonomous Administration-controlled area and al-Assad government-controlled area (GCA)). We conducted integrative thematic analysis in Arabic within and across geography and time.

resultsAlmost all participants across all areas and rounds expressed distrust of local health authorities and dissatisfaction with COVID-19 response governance. This was most apparent in initial rounds and in GCA. Response planning was identified as insufficient, non-participatory and non-transparent. Limited infrastructure and resources were the main challenges across time, though anticipated rapid virus spread and health systems' collapse did not occur and participant optimism increased over time. Public adherence to prevention measures varied-initially weak due to general scepticism, increasing after first cases were confirmed and then fluctuating with case numbers and challenges of insecurity and misinformation. Perceptions of COVID-19 vaccination varied, with low uptake and hesitancy attributed to misinformation, disinformation and disinterest. Suggested improvements to COVID-19 response governance focused on strengthening health systems' capacity and coordination.

conclusionThis is a unique longitudinal study of COVID-19 responses. Addressing transparency and misinformation should be a first step to improving public engagement and trust and thus response governance for health emergencies in Syria.

Indexed as

COVID-19COVID-19 VaccinesHumansLongitudinal StudiesResearch DesignSyriaCOVID-19 VaccinesCOVID-19health policyhealth systemsqualitative study

Identifiers

PMID38084479
PMCPMC10711850

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.