Humanitarian health education and training state-of-the-art: a scoping review.

Introduction: In the past decade, humanitarian emergencies have been increasing, leading to an higher demand for humanitarian health professionalization. Education and training are critical for preparing these workers to provide effective care during crises. Understanding the current state-of-the-art in humanitarian health education is essential to inform research and development of future educational programs. This review surveys the peer-reviewed literature to provide insights into the current thinking in the field. Methods: A review was conducted in March 2023 and updated in May 2024 using PubMed, Web of Science, Scopus, and Education Resources Information Center databases for English-language peer-reviewed articles published since January 2013. The review followed the Joanna Briggs Institute methodology for scoping reviews and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Data were analyzed using qualitative content analysis and presented as a narrative descriptive summary. Results: After screening, 32 articles met the inclusion criteria. The themes of the selected articles focus on education and training frameworks, mapping, and programs. Despite the growing opportunities, most education and training programs are based in the Global North. The gaps identified include a lack of standardized curriculum or competency frameworks and evaluation frameworks to guide the development and evaluation of further standardized training programs. Interdisciplinary and collaborative partnerships, iterative design, and mixed teaching methods and modalities, including e-learning, facilitated successful training. However, logistical and technical constraints and the lack of standardized training frameworks were barriers to developing, implementing, and evaluating such training programs. Conclusion: This review provides an overview of the humanitarian health education trends over the last decade and identifies key areas for future educational development and research. The findings emphasize the importance of adapting interdisciplinary and collaborative partnerships and prioritizing the training of local staff through regional centers, local leadership, and accessible e-learning, including e-simulation. The review also highlights the need for continued research and evaluation of humanitarian health education and training programs with standardized metrics to evaluate training programs and identify areas for improvement. These steps will help ensure that humanitarian health professionals receive adequate training to provide effective healthcare in crisis situations.

Anxiety among Japanese nursing researchers before and after dispatch for COVID-19 pandemic support: Effects of anxiety-enhancing and buffering factors.

AIM: We investigated the levels of anxiety and the factors influencing it among Japanese nursing researchers before and after engaging in dispatch support activities during the COVID-19 pandemic. This study also tested the relationships between pre- and post-relief anxiety and their enhancing and buffering factors. METHODS: A web-based survey was conducted with 9832 members from the Japan Academy of Nursing Science, covering 15 items related to participant attributes such as age and disaster relief qualifications, factors affecting anxiety about support activities such as the content and duration of one activity, and the level of anxiety before and after activities. After performing multiple regression analyses on the effects of the attributes and the factors influencing anxiety before and after support activities, path analysis was conducted on the adopted independent variables to examine their influence on anxiety before and after support activities. RESULTS: Of the 886 participants, 82.3% were affiliated with educational institutions and 94.8% had no qualifications in disaster relief. Most of the support involved vaccination and activities at health centers. The relationship between pre- and post-relief activities and factors influencing anxiety constituted a high goodness-of-fit, with health center assistance being both a direct and indirect reinforcer of post-relief anxiety. CONCLUSIONS: Participants expressed anxiety enhanced by activities at the health center both before and after support activities in the wake of the COVID-19 pandemic. Intervention research should examine anxiety-buffering and -enhancing factors, and a support system to respond to rapidly increasing medical needs is necessary.

Implementing and evaluating integrated care models for non-communicable diseases in fragile and humanitarian settings.

In this commentary, we advocate for the wider implementation of integrated care models for NCDs within humanitarian preparedness, response, and resilience efforts. Since experience and evidence on integrated NCD care in humanitarian settings is limited, we discuss potential benefits, key lessons learned from other settings, and lessons from the integration of other conditions that may be useful for stakeholders considering an integrated model of NCD care. We also introduce our ongoing project in North Lebanon as a case example currently undergoing parallel tracks of program implementation and process evaluation that aims to strengthen the evidence base on implementing an integrated NCD care model in a crisis setting.

Epidemiology of asylum seekers and refugees at the Mexico-US border: a cross-sectional analysis from the migrant settlement camp in Matamoros, Mexico.

BACKGROUND: The number of migrants and asylum seekers at the Mexico-US border has increased to historic levels. Our objective was to determine the medical diagnoses and treatments of migrating people seeking care in humanitarian clinics in Matamoros, Mexico. METHODS: We conducted a cross-sectional study of patient encounters by migrating people through a humanitarian clinic in Matamoros, Mexico, from November 22, 2019, to March 18, 2021. The clinics were operated by Global Response Medicine in concert with local non-governmental organizations. Clinical encounters were each coded to the appropriate ICD-10/CPT code and categorized according to organ system. We categorized medications using the WHO List of Essential Medicines and used multivariable logistic regression to determine associations between demographic variables and condition frequency. RESULTS: We found a total of 8,156 clinical encounters, which included 9,744 diagnoses encompassing 132 conditions (median age 26.8 years, female sex 58.2%). People originated from 24 countries, with the majority from Central America (n = 5598, 68.6%). The most common conditions were respiratory (n = 1466, 15.0%), musculoskeletal (n = 1081, 11.1%), and skin diseases (n = 473, 4.8%). Children were at higher risk for respiratory disease (aOR = 1.84, 95% CI: 1.61-2.10), while older adults had greater risk for joint disorders (aOR = 3.35, 95% CI: 1.73-6.02). Women had decreased risk for injury (aOR = 0.50, 95% CI: 0.40-0.63) and higher risk for genitourinary diseases (aOR = 4.99, 95% CI: 3.72-6.85) compared with men. Among 10,405 medications administered, analgesics were the most common (n = 3190, 30.7%) followed by anti-infectives (n = 2175, 21.1%). CONCLUSIONS: In this large study of a migrating population at the Mexico-US border, we found a variety of clinical conditions, with respiratory, musculoskeletal, and skin illnesses the most common in this study period which encompassed a period of restrictive immigration policy and the first year of the COVID-19 pandemic.

Refugee Health: A Global and Multidisciplinary Challenge.

The ongoing war and evolving humanitarian crisis in Ukraine have forced millions of women, children, and elderly people to flee the war zones and relocate across Poland, other European countries, and elsewhere in the world. As a result, numerous health issues have emerged in the host countries, ranging from the refugees' low immunization coverage to psychological distress and multimorbidities. Humanitarian support and multidisciplinary approach to the issues may help to improve the refugees' health and well-being. Involving relocated medics in rehabilitation and medical care of their compatriots may offer psychosocial and health benefits.

Simulation as a Teaching Method: Evaluation of the University of Minnesota Humanitarian Crisis Simulation.

OBJECTIVE: The University of Minnesota Crisis Humanitarian Simulation provides trans-disciplinary training in disaster response. The course directors wished to better understand the learning outcomes and experiences of simulation participants. METHODS: The learning outcomes and experiences of participants in the 2019 simulation were assessed using 3 modalities: 1) pre-and post-simulation test, 2) participants' self-assessment of learning, and 3) qualitative feedback via an anonymous evaluation. RESULTS: Participant scores on the knowledge survey were significantly higher after the simulation than before the simulation (mean percent correct 71% vs. 48%, P < 0.0001). A significant majority of participants who completed the assessment believed they had main gains within each learning objective. Anonymous evaluations contained both positive feedback and constructive criticism leading to plans for refinements in subsequent training events. CONCLUSIONS: The Humanitarian Crisis Simulation is an effective experiential training program that increases participants' knowledge in the field of disaster response. Participants also believed they had made gains in each learning objective. The authors' analysis of elements that have contributed to the success of the program and areas for future program growth and improvement are discussed.

Feasibility, acceptability, and effectiveness of non-pharmaceutical interventions against infectious diseases among crisis-affected populations: a scoping review.

BACKGROUND: Non-pharmaceutical interventions (NPIs) are a crucial suite of measures to prevent and control infectious disease outbreaks. Despite being particularly important for crisis-affected populations and those living in informal settlements, who typically reside in overcrowded and resource limited settings with inadequate access to healthcare, guidance on NPI implementation rarely takes the specific needs of such populations into account. We therefore conducted a systematic scoping review of the published evidence to describe the landscape of research and identify evidence gaps concerning the acceptability, feasibility, and effectiveness of NPIs among crisis-affected populations and informal settlements. METHODS: We systematically reviewed peer-reviewed articles published between 1970 and 2020 to collate available evidence on the feasibility, acceptability, and effectiveness of NPIs in crisis-affected populations and informal settlements. We performed quality assessments of each study using a standardised questionnaire. We analysed the data to produce descriptive summaries according to a number of categories: date of publication; geographical region of intervention; typology of crisis, shelter, modes of transmission, NPI, research design; study design; and study quality. RESULTS: Our review included 158 studies published in 85 peer-reviewed articles. Most research used low quality study designs. The acceptability, feasibility, and effectiveness of NPIs was highly context dependent. In general, simple and cost-effective interventions such as community-level environmental cleaning and provision of water, sanitation and hygiene services, and distribution of items for personal protection such as insecticide-treated nets, were both highly feasible and acceptable. Logistical, financial, and human resource constraints affected both the implementation and sustainability of measures. Community engagement emerged as a strong factor contributing to the effectiveness of NPIs. Conversely, measures that involve potential restriction on personal liberty such as case isolation and patient care and burial restrictions were found to be less acceptable, despite apparent effectiveness. CONCLUSIONS: Overall, the evidence base was variable, with substantial knowledge gaps which varied between settings and pathogens. Based on the current landscape, robust evidence-based guidance is not possible, and a research agenda is urgently required that focusses on these specific vulnerable populations. Although implementation of NPIs presents unique practical challenges in these settings, it is critical that such an agenda is put in place, and that the lessons learned from historical and present experiences are documented to build a firm evidence base.

Humanitarian Training With Virtual Simulation During a Pandemic.

There is an ongoing and established need for humanitarian training and professionalization. The coronavirus disease 2019 (COVID-19) pandemic disrupted training programs designed to accomplish this goal, including the Humanitarian Response Intensive Course, which includes a 3-d immersive simulation to prepare humanitarian workers for future field work. To provide program continuity, the 3-d simulation was quickly adapted to a virtual format using a combination of video conferencing, short messaging service, and cloud-based file storage software. Participants were geographically dispersed and participated virtually. Learning objectives were preserved, while some components not amenable to a virtual format were removed.A virtual humanitarian training simulation is a feasible, acceptable, and affordable alternative to an in-person simulation. Participants were engaged and experienced minimal technological disruptions. The majority of students believed the format met or exceeded expectations. However, feedback also emphasized the importance of providing sufficient time for team collaboration and deliverable preparation in the simulation schedule. The virtual format was more affordable than the traditional in-person simulation, and diverse expert faculty who could not have attended in-person were able to participate. This format could be used to overcome other barriers to in-person simulation training, including geographic, financial, time, or security.

Availability and Characteristics of Humanitarian Health Education and Training Programs: A Web-Based Review.

INTRODUCTION: Education and training programs are critical to achieve personnel capacity building and professionalization in the rapidly growing humanitarian health sector. Thus, this study aimed to describe the status of humanitarian health education and training programs world-wide. METHODS: A web-based analysis was conducted to identify the available humanitarian health programs. The following characteristics of the training programs were described: geographical location, target audience, prerequisite, qualification, curriculum, content, length, modality of delivery, teaching and assessment methods, and tuition fee. RESULTS: The search identified a total number of 142 training programs, most of them available in few countries of the global North. Only seven percent of the identified programs qualified for a master's degree in humanitarian health. Public health was the most identified content (47.2%). Approximately one-half of the training programs (50.7%) were delivered face-to-face. Theoretical knowledge was the most common method used for teaching and assessment. The duration of the training and tuition fees were different for different programs and qualifications, while target audience, prerequisite, and curriculum design were often vaguely described or missing. CONCLUSIONS: The study shows a global inequality in access to humanitarian health training programs due to financial and geographical constraints. The study also reveals gaps in program contents, as well as teaching and assessment methods, all issues that could be addressed by developing cost-effective e-learning and online simulation programs. Lastly, the data from this study provide a learning tool that can be used by humanitarian health educators and training centers to further define and standardize the requirements and competencies of humanitarian health professionals.

Culturally sensitive palliative care in humanitarian action: Lessons from a critical interpretive synthesis of culture in palliative care literature.

OBJECTIVE: There is growing recognition of the importance of increasing preparedness for and the provision of palliative care in humanitarian crises. The primary objective of this review is to interpret the existing literature on culture and palliative care to query the recommendation that humanitarian healthcare providers, teams, and organizations integrate palliative care into their practice in ways that are attentive to and respectful of cultural differences. METHODS: A critical interpretive synthesis was applied to a systematic literature review guided by the PRISMA framework. Analysis was based on directed data extraction and was team based, to ensure rigor and consistency. RESULTS: In total, 112 articles covering 51 countries and 9 major worldviews met inclusion criteria. This literature describes culture as it influences perspectives on death and dying, expectations of palliative care, and challenges to providing culturally sensitive care. A key pattern highlighted in articles with respect to the culture and palliative care literature is that culture is invoked in this literature as a sort of catch-all for non-white, non-Christian, indigenous practices, and preferences for palliative care. It is important that humanitarian healthcare providers and organizations aiming to enact their commitment of respect for all persons through attention to potential culturally specific approaches to pain management, suffering, and dying in specific crisis settings do so without reproducing Othering and reductionistic understandings of what culturally sensitive care in humanitarian crises settings involves. SIGNIFICANCE OF RESULTS: This paper clarifies and unpacks the diverse influences of culture in palliative care with the goal of supporting the preparedness and capacity of humanitarian healthcare providers to provide palliative care. In doing so, it aids in thinking through what constitutes culturally sensitive practice when it comes to palliative care needs in humanitarian crises. Providing such care is particularly challenging but also tremendously important given that healthcare providers from diverse cultures are brought together under high stress conditions.

International cooperation of hospital ship SS HOPE in Natal (1972): health care and education / Cooperación internacional del buque hospital SS HOPE en Natal (1972): salud y educación / Cooperação internacional do navio-hospital SS HOPE em Natal (1972): assistência e educação em saúde

ABSTRACT Objective: to analyze the activities developed by hospital ship SS HOPE in Natal. Method: this is a qualitative, socio-historical study, elaborated from documentary sources and 16 interviews with health professionals. Thematic Oral History was used for data treatment and analysis. Results: the empirical material identified a wide schedule of courses and lectures as well as made it possible to elaborate the following categories: Health education on hospital ship SS HOPE; Legacy of international cooperation of hospital ship SS HOPE; Statements about the season of hospital ship SS HOPE. Final considerations: the arrival and stay of this hospital ship, for ten months, is the result of negotiations between the University, the State Government and the People to People Foundation. During their stay, education and health care actions were carried out, with the joint participation of health professionals, Potiguares and Americans.

RESUMEN Objetivo: analizar las actividades desarrolladas por el buque hospital SS HOPE en Natal. Método: estudio cualitativo, sociohistórico, basado en fuentes documentales y 16 entrevistas a profesionales de la salud. Se utilizó la Historia Oral Temática para el tratamiento y análisis de los datos. Resultados: el material empírico identificó un amplio programa de cursos y conferencias, además de posibilitar el desarrollo de las siguientes categorías: Educación para la salud en el buque hospital SS HOPE; Legado de la cooperación internacional del buque hospital SS HOPE; Declaraciones sobre la temporada del buque hospital SS HOPE. Consideraciones finales: la llegada y permanencia de este buque hospital, por diez meses, es el resultado de negociaciones entre la Universidad, el Gobierno del Estado y el People to People Foundation. Durante su estadía se realizaron acciones de educación y salud, con la participación conjunta de profesionales de la salud, potiguares y estadounidenses.

RESUMO Objetivo: analisar as atividades desenvolvidas pelo navio-hospital SS HOPE em Natal. Método: estudo qualitativo, sócio-histórico, elaborado a partir de fontes documentais e da realização de 16 entrevistas com profissionais de saúde. Utilizou-se a História Oral Temática para o tratamento e a análise dos dados. Resultados: o material empírico identificou uma vasta programação de cursos e palestras, assim como possibilitou a elaboração das seguintes categorias: Educação em saúde no navio-hospital SS HOPE; Legado da cooperação internacional do navio-hospital SS HOPE; Enunciados sobre a temporada do navio-hospital SS HOPE. Considerações finais: a vinda e permanência desse navio-hospital, por dez meses, é fruto da negociação entre a Universidade, o Governo do estado e a People to People Foundation. Durante sua estadia, foram realizadas ações de educação e assistência à saúde, com a participação conjunta de profissionais de saúde, potiguares e estadunidenses.

Cultural Sources of Strength and Resilience: A Case Study of Holistic Wellness Boxes for COVID-19 Response in Indigenous Communities.

The COVID-19 pandemic has had disproportionately severe impacts on Indigenous peoples in the United States compared to non-Indigenous populations. In addition to the threat of viral infection, COVID-19 poses increased risk for psychosocial stress that may widen already existing physical, mental, and behavioral health inequities experienced by Indigenous communities. In recognition of the impact of COVID-19 related psychosocial stressors on our tribal community partners, the Johns Hopkins Center for American Indian Health Great Lakes Hub began sending holistic wellness boxes to our community partners in 11 tribal communities in the Midwestern United States and Canada in summer of 2020. Designed specifically to draw on culturally relevant sources of strength and resilience, these boxes contained a variety of items to support mental, emotional, cultural, and physical wellbeing. Feedback from recipients suggest that these wellness boxes provided a unique form of COVID-19 relief. Additional Johns Hopkins Center for American Indian Health offices have begun to adapt wellness boxes for the cultural context of their regions. This case study describes the conceptualization, creation, and contents of these wellness boxes and orients this intervention within a reflection on foundations of community-based participatory research, holistic relief, and drawing on cultural strengths in responding to COVID-19.

Humanitarian aid and breastfeeding practices of displaced mothers: a qualitative study in disaster relief camps.

BACKGROUND: During disasters and displacement, affected families often receive humanitarian aid from governmental and nongovernmental organizations and donor agencies. Little information is available on the effects of humanitarian aid on the breastfeeding practices of mothers affected by disaster and displacement. AIMS: The aim of this study was to explore the effects of humanitarian aid on the breastfeeding practices of displaced mothers affected by natural disasters in Chitral, Pakistan. METHODS: This was qualitative study of residents of four villages of Chitral who had experienced a recent flood and later an earthquake. Data were collected through field observations, analysis of various documents (e.g. aid-agency documents, published reports and newspaper articles) and in-depth interviews with 18 internally displaced mothers living in disaster relief camps in Chitral. RESULTS: Three main themes developed from the data: humanitarian aid as a life saver, insufficient humanitarian aid affecting breastfeeding, and systemic injustices in the distribution of humanitarian aid. CONCLUSION: Although humanitarian aid facilitated the survival, health and well-being of the displaced mothers and their family members, there were various problems with the humanitarian aid that increased the vulnerability of the displaced mothers and negatively affected their breastfeeding practices. Humanitarian aid must be gender-sensitive, thoughtful, timely, needs-based, equitable and context-specific. A systematic process of aid allocation and restricted donation of formula milk or any other form of breast-milk substitute is recommended during disasters.

Why humility is vital to effective humanitarian aid leadership: a review of the literature.

Organisational scientists are paying increasing attention to humility, following a larger trend in scholarship highlighting the relational and interdependent nature of leadership and business. A growing body of evidence identifies humility as vital to effective organisational leadership, facilitating positive organisational outcomes, such as lower voluntary turnover and greater follower job satisfaction. To date, research on the subject has focused on certain specific organisational contexts, including businesses, hospitals, and schools. This paper reviews the existing literature and explores why humility may be an especially important leader trait in international humanitarian aid organisations and relief work-a context that is not only uniquely challenging, but also one that would seemingly stand to benefit keenly from the quality. It argues that humility is essential for effective leadership because it is normative of good character, it is predictive of positive outcomes, and it corresponds to a genuine representation of the nature of humanitarian aid.

Key issues for participatory research in the design and implementation of humanitarian assistance: a scoping review.

BACKGROUND: Participatory approaches that engage affected populations are increasingly applied in humanitarian health programs in concert with emerging accountability frameworks and the rapid growth of research in these settings. Participatory initiatives within this domain appear to be largely adopted at an operational level and are infrequently reported as a component of research efforts. Yet the evidence of the benefits of research involving community members is growing worldwide. This is the first review of participatory research (PR) in humanitarian settings. OBJECTIVES: This study sought to understand the extent to which PR values and practices have been adopted in humanitarian health programs and to explore key issues in applying PR in this context. METHODS: This scoping review was based on the approach developed by Arksey and O'Malley. The search for relevant peer-reviewed articles included scientific databases, a humanitarian database, targeted journals and online resources published since 2009. Eleven articles were retrieved and reviewed to identify practices and key issues related to conducting PR in humanitarian settings. RESULTS: Four key themes were identified: building trust with local research stakeholders and participants; the importance of contextual understanding; implications of collaborating with affected populations in PR, and neutrality of researchers and Non-Governmental Organizations (NGOs). Study teams considered PR as a valued approach where there was mistrust or a need for contextualized understanding. The studies described how adaptations made during the study optimized collaboration with affected populations and how the presence of NGOs influenced the approach and results of PR. CONCLUSIONS: One of the most important contributions of humanitarian health programs is to develop 'medical practices that are better adapted to the living conditions and priorities of patients who are generally ignored'. Participatory approaches, such as PR, support the development of health-related practices that are more relevant and sustainable for affected populations.

Hospital Evacuation Assistance from Public and Private Resources: Lessons Learned from the 2018 Western Japan Floods.

During major flooding in June/July 2018, the Mabi Memorial Hospital in Kurashiki, Okayama, Japan was flooded and patients were stranded in the hospital. Peace Winds Japan, a non-governmental organization, collaborated with the Japanese Disaster Medical Assistance Team and Self-Defense Force Public to transport 8 critical patients from the hospital by helicopter. Ultimately, 54 patients and hospital staff members were safely evacuated. The evacuation was accomplished without any casualties, despite the severe conditions. Public and private organizations can work together and continue to seek ways to collaborate and cooperate in disaster settings.

Psychological and physical condition of Japan maritime self-defense force personnel who performed disaster-relief missions after the 2011 great east Japan earthquake.

The Great East Japan Earthquake, which occurred on March 11, 2011, was the most powerful earthquake ever recorded in Japan. In the present study, we examine personnel from the Japan Maritime Self-Defense Force who performed disaster relief in the earthquake's aftermath, focusing on the associated psychological and physical impacts. Overall, 8733 personnel were examined. In both July-August 2011 (M1) and July 2012 (M2), these personnel answered the Impact of Events Scale-Revised, the Kessler Psychological Distress Scale, and the Disaster Relief Questionnaire. We also analyzed the sample's physical examination records for the periods before and after the earthquake, using as controls a sample of peers who were not dispatched to the disaster area (N = 32,270). The psychological examinations showed that, in M1, holding the rank of private/sergeant (odds ratio [OR] = 2.13), performing body-recovery duties (OR = 1.94), and having disaster-affected family members (OR = 2.13) were significant risk factors for high post-traumatic stress response (PTSR). In M2, performing body-recovery duties (OR = 1.45) and having disaster-affected family members (OR = 2.60) were significant risk factors for high PTSR. Also, being woman (OR = 2.18) and having disaster-affected family members (OR = 1.68) were significant risk factors for high general psychological distress. For the physical examinations, the mean alanine transaminase in the dispatched group (31.73 ± 25.21) was significantly higher than that in the non-dispatched group (29.56 ± 21.03). These findings suggest that personnel involved in disaster relief experience psychological impacts in the subacute stage, but that these impacts attenuate one year after the event.

The 'merciful and loving sex': Concepción Arenal's narratives on Spanish Red Cross women's war relief work in the 1870s.

Spain signed the Geneva Convention in 1864 and the Spanish Red Cross Society (SRC) was established in July of that year. Yet, only after 1870 the SRC revived and quickly expanded, forming local and provincial committees as well as ladies' sections. This revival mostly resulted from, first, the activation of humanitarian sensibilities and networks on the occasion of the Franco-Prussian war (1870-1871), and then, the general mobilization of the SRC in reaction to the Carlist war of 1872-1876. This article examines the humanitarian work of Spanish women throughout this period through the intervention of the SRC ladies' sections, especially the central one. It reveals that these women played a crucial role in organizing, deploying and sustaining its humanitarian relief to the combatants. They empowered themselves by taking advantage of, and contributing to, the spreading of a view of women - very common at the time - as having a specific gender 'instinct' that made them 'naturally' suited to charitable and compassionate tasks. Pacifism is present in the humanitarian views and practices of these women, particularly in the case of Concepción Arenal (1820-1893), a social reformer, lawyer and writer, who was fully involved with the SRC during the Carlist war.

Choosing a hospital assistance ship to fight the covid-19 pandemic / Escolha de navio de assistência hospitalar no combate à pandemia da covid-19

ABSTRACT OBJECTIVE: To apply the THOR 2 multi-criteria support system to select the Brazilian navy's most suitable hospital care vessel (NAsH) to support the fight against the covid-19 pandemic. METHODS: We used the first three stages of the Soft Systems Methodology for structuring and modeling of the problem. For the evaluation and ordering of alternatives, we used the Thor 2 multi-criteria support system, comparing four classes of NAsH in the light of their operational and hospital criteria: "Dr. Montenegro," "Soares Meirelles," "Oswaldo Cruz" and "Tenente Maximiano." The chosen ship would support the amazon hospital system, which has an increasing number of cases of covid-19. RESULTS: After the application of the methods, we analyzed three distinct scenarios of ordering the alternatives, which allowed a robust sensitivity analysis, conferring greater transparency and reliability to the decision-making process. The NAsH "Oswaldo Cruz" was selected to be used in the fight against the pandemic. CONCLUSIONS: This study brings valuable contribution to academia and society, since it represents the application of a multi-criteria decision-aid method in the state of the art to contribute to the solution of a real problem that affects millions of people in Brazil and worldwide.

RESUMO OBJETIVO: Aplicar o método multicritério THOR 2 para selecionar o navio de assistência hospitalar (NAsH) da Marinha do Brasil mais indicado para apoiar o combate à pandemia de covid-19. MÉTODOS: Para a estruturação e modelagem do problema, foram usados os três primeiros estágios da Soft Systems Methodology. Já para a avaliação e ordenação das alternativas, foi utilizado o método de análise multicritério Thor 2, comparando quatro classes de NAsH à luz de seus critérios operativos e hospitalares: "Dr. Montenegro", "Soares Meirelles", "Oswaldo Cruz" e "Tenente Maximiano". O navio escolhido apoiaria o sistema hospitalar do Amazonas, que apresenta número cada vez maior de casos de covid-19. RESULTADOS: Após a aplicação dos métodos, foi possível analisar três cenários distintos de ordenação das alternativas, o que permitiu uma análise de sensibilidade robusta, conferindo maior transparência e confiabilidade ao processo decisório. O NAsH "Oswaldo Cruz" foi selecionado para ser empregado no combate à pandemia. CONCLUSÕES: Este trabalho traz valiosa contribuição para academia e sociedade, uma vez que representa a aplicação de um método de auxílio à decisão multicritério no estado da arte para contribuir com a solução de um problema real que afeta milhões de pessoas no Brasil e no mundo.