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      Integrating the social sciences in epidemic preparedness and response: A strategic framework to strengthen capacities and improve Global Health security

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          Abstract

          Background

          The importance of integrating the social sciences in epidemic preparedness and response has become a common feature of infectious disease policy and practice debates. However to date, this integration remains inadequate, fragmented and under-funded, with limited reach and small initial investments. Based on data collected prior to the COVID-19 pandemic, in this paper we analysed the variety of knowledge, infrastructure and funding gaps that hinder the full integration of the social sciences in epidemics and present a strategic framework for addressing them.

          Methods

          Senior social scientists with expertise in public health emergencies facilitated expert deliberations, and conducted 75 key informant interviews, a consultation with 20 expert social scientists from Africa, Asia and Europe, 2 focus groups and a literature review of 128 identified high-priority peer reviewed articles. We also analysed 56 interviews from the Ebola 100 project, collected just after the West African Ebola epidemic. Analysis was conducted on gaps and recommendations. These were inductively classified according to various themes during two group prioritization exercises. The project was conducted between February and May 2019. Findings from the report were used to inform strategic prioritization of global investments in social science capacities for health emergencies.

          Findings

          Our analysis consolidated 12 knowledge and infrastructure gaps and 38 recommendations from an initial list of 600 gaps and 220 recommendations. In developing our framework, we clustered these into three areas: 1) Recommendations to improve core social science response capacities, including investments in: human resources within response agencies; the creation of social science data analysis capacities at field and global level; mechanisms for operationalizing knowledge; and a set of rapid deployment infrastructures; 2) Recommendations to strengthen applied and basic social sciences, including the need to: better define the social science agenda and core competencies; support innovative interdisciplinary science; make concerted investments in developing field ready tools and building the evidence-base; and develop codes of conduct; and 3) Recommendations for a supportive social science ecosystem, including: the essential foundational investments in institutional development; training and capacity building; awareness-raising activities with allied disciplines; and lastly, support for a community of practice.

          Interpretation

          Comprehensively integrating social science into the epidemic preparedness and response architecture demands multifaceted investments on par with allied disciplines, such as epidemiology and virology. Building core capacities and competencies should occur at multiple levels, grounded in country-led capacity building. Social science should not be a parallel system, nor should it be “siloed” into risk communication and community engagement. Rather, it should be integrated across existing systems and networks, and deploy interdisciplinary knowledge “transversally” across all preparedness and response sectors and pillars. Future work should update this framework to account for the impact of the COVID-19 pandemic on the institutional landscape.

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          Most cited references39

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          Social Determinants of Health

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            A critical review of behavioral issues related to malaria control in sub-Saharan Africa: what contributions have social scientists made?

            In 1996, Social Science & Medicine published a review of treatment seeking for malaria (McCombie, 1996). Since that time, a significant amount of socio-behavioral research on the home management of malaria has been undertaken. In addition, recent initiatives such as Roll Back Malaria have emphasized the importance of social science inputs to malaria research and control. However, there has been a growing feeling that the potential contributions that social science could and should be making to malaria research and control have yet to be fully realized. To address these issues, this paper critically reviews and synthesizes the literature (published, unpublished and technical reports) pertaining to the home management of illness episodes of malaria in sub-Saharan Africa from 1996 to the end of 2000, and draws conclusions about the use of social science in malaria research and control. The results suggest that while we have amassed increasing quantities of descriptive data on treatment seeking behavior, we still have little understanding of the rationale of drug use from the patient perspective and, perhaps more importantly, barely any information on the rationale of provider behaviors. However, the results underline the dynamic and iterative nature of treatment seeking with multiple sources of care frequently being employed during a single illness episode; and highlight the importance in decision making of gender, socio-economic and cultural position of individuals within households and communities. Furthermore, the impact of political, structural and environmental factors on treatment seeking behaviors is starting to be recognised. Programs to address these issues may be beyond single sector (malaria control programme) interventions, but social science practice in malaria control needs to reflect a realistic appraisal of the complexities that govern human behavior and include critical appraisal and proposals for practical action. Major concerns arising from the review were the lack of evidence of 'social scientist' involvement (particularly few from endemic countries) in much of the published research; and concerns with methodological rigor. To increase the effective use of social science, we should focus on a new orientation for field research (including increased methodological rigor), address the gaps in research knowledge, strengthen the relationship between research, policy and practice; and concentrate on capacity strengthening and advocacy. Copyright 2003 Elsevier Ltd.
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              A new twenty-first century science for effective epidemic response

              With rapidly changing ecology, urbanization, climate change, increased travel and fragile public health systems, epidemics will become more frequent, more complex and harder to prevent and contain. Here we argue that our concept of epidemics must evolve from crisis response during discrete outbreaks to an integrated cycle of preparation, response and recovery. This is an opportunity to combine knowledge and skills from all over the world—especially at-risk and affected communities. Many disciplines need to be integrated, including not only epidemiology but also social sciences, research and development, diplomacy, logistics and crisis management. This requires a new approach to training tomorrow’s leaders in epidemic prevention and response.
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                Author and article information

                Contributors
                kbardosh@uw.edu , bardosh_kevin@hotmail.com
                d.h.devries@uva.nl
                saabramowitz@gmail.com
                athorlie@hotmail.com
                liannecremers@live.nl
                johnkinsman@hotmail.com
                darryl.stellmach@anthro.ox.ac.uk
                Journal
                Global Health
                Global Health
                Globalization and Health
                BioMed Central (London )
                1744-8603
                30 December 2020
                30 December 2020
                2020
                : 16
                : 120
                Affiliations
                [1 ]GRID grid.34477.33, ISNI 0000000122986657, Center for One Health Research, School of Public Health, , University of Washington, ; Box 357230, Seattle, WA 98195-7230 USA
                [2 ]GRID grid.450091.9, ISNI 0000 0004 4655 0462, Amsterdam Institute for Global Health and Development, ; Paasheuvelweg 25, 1105 BP Amsterdam, the Netherlands
                [3 ]Independent Consultant, Boston, USA
                [4 ]Independent Consultant, Berlin, Germany
                [5 ]Amsterdam University Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
                [6 ]GRID grid.12650.30, ISNI 0000 0001 1034 3451, Department of Epidemiology and Global Health, , Umeå University, ; Umeå, Sweden
                [7 ]GRID grid.4714.6, ISNI 0000 0004 1937 0626, Department of Public Health Sciences, Global Health (IHCAR), , Karolinska Institutet, ; Stockholm, Sweden
                [8 ]GRID grid.1013.3, ISNI 0000 0004 1936 834X, Sydney School of Public Health, Faculty of Medicine and Health, , University of Sydney, ; Edward Ford Building (A27) Fisher Road, Sydney, NSW 2006 Australia
                Author information
                http://orcid.org/0000-0003-2973-5708
                Article
                652
                10.1186/s12992-020-00652-6
                7772799
                33380341
                016ca71f-da16-454d-bc14-104c0122d7b8
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 10 October 2019
                : 14 December 2020
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100004440, Wellcome Trust;
                Award ID: N/A
                Funded by: Wellcome Trust (GB)
                Award ID: 108692/Z/15/Z
                Categories
                Research
                Custom metadata
                © The Author(s) 2020

                Health & Social care
                health emergencies,epidemics,preparedness,global health security,infectious disease,social science,anthropology,governance

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