The global pool of simulation exercise materials in health emergency preparedness and response: a scoping review with a health system perspective

McDarby, Geraldine; Reynolds, Lindy; Zibwowa, Zandile; Syed, Shams; Kelley, Ed; Saikat, Sohel

Though often not the explicit focus, all reviewed materials (n=51) tested at least one building block or an aspect of a health system building block (figure 5). A functional approach was apparent, though functions were generally tested in a narrow way both within and across relevant building blocks, rather than integrated across all relevant health system building blocks. IPC was the most commonly tested service delivery function with adherence to case management guidelines and standard operating procedures (SOP) being a frequent focus of testing. 8 The quality of health services provided in the context of the response or measures of the maintenance of essential health services were lacking. Surge capacity was the most frequently tested function of health workforce, though a narrow approach was often apparent. Exercises tested aspects of surge capacity such as staffing, however, this was not addressed within other building blocks in relation to the invariable increased demands on services and supplies. A narrow approach to health information systems was also apparent, with three materials (out of 51) focusing on surveillance systems and only limited aspects of risk communication tested. Only one identified material tested the triggering of a response plan using a surveillance system. 12 Leadership and governance (from a security perspective) was the most frequently addressed building block, with many materials testing aspects of this building block such as response plans and roles and responsibilities of responders. However, alignment with national structures and guidelines was not apparent, nor was consideration given to decision in risk identification. While access to medicines and supplies was frequently alluded to, testing of access to mechanisms or supply chain resilience was infrequent. Financing was alluded to in only 17% of materials (n=51), but testing of mechanisms to access funding in the event of PHEs was not identified.