%PDF-1.3 1 0 obj << /Type /Catalog /Outlines 2 0 R /Pages 3 0 R >> endobj 2 0 obj << /Type /Outlines /Count 0 >> endobj 3 0 obj << /Type /Pages /Kids [6 0 R 68 0 R 90 0 R 123 0 R 197 0 R 217 0 R 219 0 R ] /Count 7 /Resources << /ProcSet 4 0 R /Font << /F1 8 0 R /F2 9 0 R /F3 10 0 R /F4 11 0 R >> /XObject << /I1 12 0 R /I2 13 0 R /I3 74 0 R /I4 77 0 R /I5 102 0 R >> >> /MediaBox [0.000 0.000 612.000 792.000] >> endobj 4 0 obj [/PDF /Text /ImageC ] endobj 5 0 obj << /Creator (DOMPDF) /CreationDate (D:20180721214926+00'00') /ModDate (D:20180721214926+00'00') /Title (A Health System Approach to All-Hazards Disaster Management: A Systematic Review PLOS Currents Disasters) >> endobj 6 0 obj << /Type /Page /Parent 3 0 R /Annots [ 14 0 R 16 0 R 18 0 R 20 0 R 22 0 R 24 0 R 26 0 R 28 0 R 30 0 R 32 0 R 34 0 R 36 0 R 38 0 R 40 0 R 42 0 R 44 0 R 46 0 R 48 0 R 50 0 R 52 0 R 54 0 R 56 0 R 58 0 R 60 0 R 62 0 R 64 0 R 66 0 R ] /Contents 7 0 R >> endobj 7 0 obj << /Length 21746 >> stream q 375.000 0 0 39.000 222.000 738.000 cm /I2 Do Q q 15.000 684.354 577.500 53.646 re W n 0.267 0.267 0.267 rg BT 15.000 718.042 Td /F2 21.0 Tf [(A Health System Approach to All-Hazards Disaster )] TJ ET BT 15.000 693.094 Td /F2 21.0 Tf [(Management: A Systematic Review)] TJ ET Q 0.271 0.267 0.267 rg BT 15.000 675.088 Td /F3 9.8 Tf [(August 22, 2012)] TJ ET BT 83.523 675.088 Td /F3 9.8 Tf [()] TJ ET 0.267 0.267 0.267 rg BT 88.398 675.088 Td /F3 9.8 Tf [(Research Article)] TJ ET BT 26.250 663.247 Td /F1 9.8 Tf [(Dr Claire Bayntun)] TJ ET 0.271 0.267 0.267 rg BT 26.250 651.342 Td /F1 9.8 Tf [(Bayntun C. A Health System Approach to All-Hazards Disaster Management: A Systematic Review. PLOS Currents Disasters. )] TJ ET BT 26.250 639.438 Td /F1 9.8 Tf [(2012 Aug 22 . Edition 1. doi: 10.1371/50081cad5861d.)] TJ ET q 15.000 29.530 577.500 607.527 re W n 0.271 0.267 0.267 rg BT 26.250 610.335 Td /F4 12.0 Tf [(Abstract)] TJ ET BT 26.250 590.381 Td /F1 9.8 Tf [(AIM This review aims to develop disaster management practice using a health system strengthening approach through two )] TJ ET BT 26.250 578.476 Td /F1 9.8 Tf [(objectives. Firstly, to review the disaster management literature to test the hypothesis that a holistic health system approach has )] TJ ET BT 26.250 566.571 Td /F1 9.8 Tf [(not been established in practice or evaluated in the core literature. Secondly, to collate the worldwide experience of disaster )] TJ ET BT 26.250 554.667 Td /F1 9.8 Tf [(management found in the core literature according to the components of a health system.)] TJ ET BT 26.250 535.262 Td /F1 9.8 Tf [(METHOD A systematic review was conducted of the core literature published between January 2000 and November 2011 on )] TJ ET BT 26.250 523.357 Td /F1 9.8 Tf [(the MEDLINE and Embase databases. Search terms combined the WHOs descriptors for a health system with disaster terms. )] TJ ET BT 26.250 511.452 Td /F1 9.8 Tf [(Non-restrictive inclusion criteria were applied. Papers were assessed using a quality appraisal tool. Content analysis identified )] TJ ET BT 26.250 499.548 Td /F1 9.8 Tf [(the disaster management components discussed within the context of the health system.)] TJ ET BT 26.250 480.143 Td /F1 9.8 Tf [(RESULTS The search yielded 143 relevant disaster management documents for collation. The review found that none of these )] TJ ET BT 26.250 468.238 Td /F1 9.8 Tf [(publications described a holistic health system approach to disaster management, and none evaluated such an approach.)] TJ ET BT 26.250 448.833 Td /F1 9.8 Tf [(CONCLUSION The findings of this review demonstrate that a holistic health system approach to disaster management has not )] TJ ET BT 26.250 436.929 Td /F1 9.8 Tf [(been established in practice or evaluated in the core literature. Important lessons identified through the collation and analyses of )] TJ ET BT 26.250 425.024 Td /F1 9.8 Tf [(isolated disaster-related experience require further research to incorporate them within a holistic health system approach. This )] TJ ET BT 26.250 413.119 Td /F1 9.8 Tf [(approach, supported by the resolution passed at the World Health Assembly in 2011, aims to build health system resilience to )] TJ ET BT 26.250 401.214 Td /F1 9.8 Tf [(protect immediate and long-term population health in the face of all-hazards disasters.)] TJ ET BT 26.250 381.810 Td /F1 9.8 Tf [(Citation: Bayntun C. A health system approach to all-hazards disaster management: A systematic review. PLOS Currents )] TJ ET BT 26.250 369.905 Td /F1 9.8 Tf [(Disasters. 2012 Aug 22. doi: 10.1371/50081cad5861d.)] TJ ET BT 26.250 333.302 Td /F4 12.0 Tf [(Introduction)] TJ ET BT 26.250 313.348 Td /F1 9.8 Tf [(Disasters cause devastation for populations and can limit a health systems progress for years ahead. In spite of funds being )] TJ ET BT 26.250 301.443 Td /F1 9.8 Tf [(invested in disaster management in many countries, a comprehensive health system approach to build resilience in the face of )] TJ ET BT 26.250 289.539 Td /F1 9.8 Tf [(disasters is still lacking. As a result, populations can suffer unnecessarily during and in the aftermath of disasters.)] TJ ET BT 26.250 270.134 Td /F1 9.8 Tf [(A resolution advocating a health system approach to disaster management was adopted at the World Health Assembly in May )] TJ ET BT 26.250 258.229 Td /F1 9.8 Tf [(2011, aiming to promote resilience and efficient recovery in the face of all-hazards disasters )] TJ ET 0.267 0.267 0.267 rg BT 424.001 259.736 Td /F4 8.7 Tf [(1)] TJ ET 0.271 0.267 0.267 rg BT 428.820 258.229 Td /F1 9.8 Tf [( . The health system can be )] TJ ET BT 26.250 246.324 Td /F1 9.8 Tf [(defined as the structured and interrelated work of all agencies contributing to health within a country and includes efforts to )] TJ ET BT 26.250 234.420 Td /F1 9.8 Tf [(influence determinants of health as well as more direct health-improving activities )] TJ ET 0.267 0.267 0.267 rg BT 382.252 235.927 Td /F4 8.7 Tf [(2)] TJ ET 0.271 0.267 0.267 rg BT 387.070 234.420 Td /F1 9.8 Tf [( . The WHO describes it as being composed )] TJ ET BT 26.250 222.515 Td /F1 9.8 Tf [(of six building blocks 1\) service delivery, 2\) health workers, 3\) health information, 4\) medical products, technology and )] TJ ET BT 26.250 210.610 Td /F1 9.8 Tf [(vaccines, 5\) health finance, and 6\) governance and leadership )] TJ ET 0.267 0.267 0.267 rg BT 297.768 212.117 Td /F4 8.7 Tf [(2)] TJ ET 0.271 0.267 0.267 rg BT 302.587 210.610 Td /F1 9.8 Tf [( , which were originally derived from the World Health Report )] TJ ET BT 26.250 198.705 Td /F1 9.8 Tf [(2000 )] TJ ET 0.267 0.267 0.267 rg BT 50.645 200.213 Td /F4 8.7 Tf [(3)] TJ ET 0.271 0.267 0.267 rg BT 55.463 198.705 Td /F1 9.8 Tf [( . These health system components will be described as levers to better represent the dynamic, inter-dependent nature )] TJ ET BT 26.250 186.801 Td /F1 9.8 Tf [(of the components.)] TJ ET BT 26.250 167.396 Td /F1 9.8 Tf [(WHO asks member states to prepare for all-hazards disasters, whether natural or man-made. Historically, different aspects of )] TJ ET BT 26.250 155.491 Td /F1 9.8 Tf [(disaster management have been considered and described in isolation. However, the all-hazards approach to disaster )] TJ ET BT 26.250 143.586 Td /F1 9.8 Tf [(management suggests that a health system needs resilience built into its structure across all levers. In this way, the health )] TJ ET BT 26.250 131.682 Td /F1 9.8 Tf [(system can be strengthened to respond better to the challenges presented by any disaster.)] TJ ET BT 26.250 112.277 Td /F1 9.8 Tf [(The objective of this review is to use a health system approach to collate the worldwide experience of disasters, an initial step )] TJ ET BT 26.250 100.372 Td /F1 9.8 Tf [(toward assessing the implementation of the World Health Assembly resolution of May 2011 )] TJ ET 0.267 0.267 0.267 rg BT 421.827 101.879 Td /F4 8.7 Tf [(4)] TJ ET 0.271 0.267 0.267 rg BT 426.646 100.372 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 63.770 Td /F4 12.0 Tf [(Methods)] TJ ET BT 26.250 43.815 Td /F1 9.8 Tf [(This systematic review has been developed and written in light of the Preferred Reporting Items for Systematic Reviews and )] TJ ET Q q 15.000 684.354 577.500 53.646 re W n 0.267 0.267 0.267 rg BT 15.000 718.042 Td /F2 21.0 Tf [(A Health System Approach to All-Hazards Disaster )] TJ ET BT 15.000 693.094 Td /F2 21.0 Tf [(Management: A Systematic Review)] TJ ET Q 0.271 0.267 0.267 rg BT 15.000 675.088 Td /F3 9.8 Tf [(August 22, 2012)] TJ ET BT 83.523 675.088 Td /F3 9.8 Tf [()] TJ ET 0.267 0.267 0.267 rg BT 88.398 675.088 Td /F3 9.8 Tf [(Research Article)] TJ ET BT 26.250 663.247 Td /F1 9.8 Tf [(Dr Claire Bayntun)] TJ ET 0.271 0.267 0.267 rg BT 26.250 651.342 Td /F1 9.8 Tf [(Bayntun C. A Health System Approach to All-Hazards Disaster Management: A Systematic Review. PLOS Currents Disasters. )] TJ ET BT 26.250 639.438 Td /F1 9.8 Tf [(2012 Aug 22 . Edition 1. doi: 10.1371/50081cad5861d.)] TJ ET q 15.000 29.530 577.500 607.527 re W n 0.271 0.267 0.267 rg BT 26.250 610.335 Td /F4 12.0 Tf [(Abstract)] TJ ET BT 26.250 590.381 Td /F1 9.8 Tf [(AIM This review aims to develop disaster management practice using a health system strengthening approach through two )] TJ ET BT 26.250 578.476 Td /F1 9.8 Tf [(objectives. Firstly, to review the disaster management literature to test the hypothesis that a holistic health system approach has )] TJ ET BT 26.250 566.571 Td /F1 9.8 Tf [(not been established in practice or evaluated in the core literature. Secondly, to collate the worldwide experience of disaster )] TJ ET BT 26.250 554.667 Td /F1 9.8 Tf [(management found in the core literature according to the components of a health system.)] TJ ET BT 26.250 535.262 Td /F1 9.8 Tf [(METHOD A systematic review was conducted of the core literature published between January 2000 and November 2011 on )] TJ ET BT 26.250 523.357 Td /F1 9.8 Tf [(the MEDLINE and Embase databases. Search terms combined the WHOs descriptors for a health system with disaster terms. )] TJ ET BT 26.250 511.452 Td /F1 9.8 Tf [(Non-restrictive inclusion criteria were applied. Papers were assessed using a quality appraisal tool. Content analysis identified )] TJ ET BT 26.250 499.548 Td /F1 9.8 Tf [(the disaster management components discussed within the context of the health system.)] TJ ET BT 26.250 480.143 Td /F1 9.8 Tf [(RESULTS The search yielded 143 relevant disaster management documents for collation. The review found that none of these )] TJ ET BT 26.250 468.238 Td /F1 9.8 Tf [(publications described a holistic health system approach to disaster management, and none evaluated such an approach.)] TJ ET BT 26.250 448.833 Td /F1 9.8 Tf [(CONCLUSION The findings of this review demonstrate that a holistic health system approach to disaster management has not )] TJ ET BT 26.250 436.929 Td /F1 9.8 Tf [(been established in practice or evaluated in the core literature. Important lessons identified through the collation and analyses of )] TJ ET BT 26.250 425.024 Td /F1 9.8 Tf [(isolated disaster-related experience require further research to incorporate them within a holistic health system approach. This )] TJ ET BT 26.250 413.119 Td /F1 9.8 Tf [(approach, supported by the resolution passed at the World Health Assembly in 2011, aims to build health system resilience to )] TJ ET BT 26.250 401.214 Td /F1 9.8 Tf [(protect immediate and long-term population health in the face of all-hazards disasters.)] TJ ET BT 26.250 381.810 Td /F1 9.8 Tf [(Citation: Bayntun C. A health system approach to all-hazards disaster management: A systematic review. PLOS Currents )] TJ ET BT 26.250 369.905 Td /F1 9.8 Tf [(Disasters. 2012 Aug 22. doi: 10.1371/50081cad5861d.)] TJ ET BT 26.250 333.302 Td /F4 12.0 Tf [(Introduction)] TJ ET BT 26.250 313.348 Td /F1 9.8 Tf [(Disasters cause devastation for populations and can limit a health systems progress for years ahead. In spite of funds being )] TJ ET BT 26.250 301.443 Td /F1 9.8 Tf [(invested in disaster management in many countries, a comprehensive health system approach to build resilience in the face of )] TJ ET BT 26.250 289.539 Td /F1 9.8 Tf [(disasters is still lacking. As a result, populations can suffer unnecessarily during and in the aftermath of disasters.)] TJ ET BT 26.250 270.134 Td /F1 9.8 Tf [(A resolution advocating a health system approach to disaster management was adopted at the World Health Assembly in May )] TJ ET BT 26.250 258.229 Td /F1 9.8 Tf [(2011, aiming to promote resilience and efficient recovery in the face of all-hazards disasters )] TJ ET 0.267 0.267 0.267 rg BT 424.001 259.736 Td /F4 8.7 Tf [(1)] TJ ET 0.271 0.267 0.267 rg BT 428.820 258.229 Td /F1 9.8 Tf [( . The health system can be )] TJ ET BT 26.250 246.324 Td /F1 9.8 Tf [(defined as the structured and interrelated work of all agencies contributing to health within a country and includes efforts to )] TJ ET BT 26.250 234.420 Td /F1 9.8 Tf [(influence determinants of health as well as more direct health-improving activities )] TJ ET 0.267 0.267 0.267 rg BT 382.252 235.927 Td /F4 8.7 Tf [(2)] TJ ET 0.271 0.267 0.267 rg BT 387.070 234.420 Td /F1 9.8 Tf [( . The WHO describes it as being composed )] TJ ET BT 26.250 222.515 Td /F1 9.8 Tf [(of six building blocks 1\) service delivery, 2\) health workers, 3\) health information, 4\) medical products, technology and )] TJ ET BT 26.250 210.610 Td /F1 9.8 Tf [(vaccines, 5\) health finance, and 6\) governance and leadership )] TJ ET 0.267 0.267 0.267 rg BT 297.768 212.117 Td /F4 8.7 Tf [(2)] TJ ET 0.271 0.267 0.267 rg BT 302.587 210.610 Td /F1 9.8 Tf [( , which were originally derived from the World Health Report )] TJ ET BT 26.250 198.705 Td /F1 9.8 Tf [(2000 )] TJ ET 0.267 0.267 0.267 rg BT 50.645 200.213 Td /F4 8.7 Tf [(3)] TJ ET 0.271 0.267 0.267 rg BT 55.463 198.705 Td /F1 9.8 Tf [( . These health system components will be described as levers to better represent the dynamic, inter-dependent nature )] TJ ET BT 26.250 186.801 Td /F1 9.8 Tf [(of the components.)] TJ ET BT 26.250 167.396 Td /F1 9.8 Tf [(WHO asks member states to prepare for all-hazards disasters, whether natural or man-made. Historically, different aspects of )] TJ ET BT 26.250 155.491 Td /F1 9.8 Tf [(disaster management have been considered and described in isolation. However, the all-hazards approach to disaster )] TJ ET BT 26.250 143.586 Td /F1 9.8 Tf [(management suggests that a health system needs resilience built into its structure across all levers. In this way, the health )] TJ ET BT 26.250 131.682 Td /F1 9.8 Tf [(system can be strengthened to respond better to the challenges presented by any disaster.)] TJ ET BT 26.250 112.277 Td /F1 9.8 Tf [(The objective of this review is to use a health system approach to collate the worldwide experience of disasters, an initial step )] TJ ET BT 26.250 100.372 Td /F1 9.8 Tf [(toward assessing the implementation of the World Health Assembly resolution of May 2011 )] TJ ET 0.267 0.267 0.267 rg BT 421.827 101.879 Td /F4 8.7 Tf [(4)] TJ ET 0.271 0.267 0.267 rg BT 426.646 100.372 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 63.770 Td /F4 12.0 Tf [(Methods)] TJ ET BT 26.250 43.815 Td /F1 9.8 Tf [(This systematic review has been developed and written in light of the Preferred Reporting Items for Systematic Reviews and )] TJ ET Q q 15.000 684.354 577.500 53.646 re W n 0.267 0.267 0.267 rg BT 15.000 718.042 Td /F2 21.0 Tf [(A Health System Approach to All-Hazards Disaster )] TJ ET BT 15.000 693.094 Td /F2 21.0 Tf [(Management: A Systematic Review)] TJ ET Q 0.271 0.267 0.267 rg BT 15.000 675.088 Td /F3 9.8 Tf [(August 22, 2012)] TJ ET BT 83.523 675.088 Td /F3 9.8 Tf [()] TJ ET 0.267 0.267 0.267 rg BT 88.398 675.088 Td /F3 9.8 Tf [(Research Article)] TJ ET BT 26.250 663.247 Td /F1 9.8 Tf [(Dr Claire Bayntun)] TJ ET 0.271 0.267 0.267 rg BT 26.250 651.342 Td /F1 9.8 Tf [(Bayntun C. A Health System Approach to All-Hazards Disaster Management: A Systematic Review. PLOS Currents Disasters. )] TJ ET BT 26.250 639.438 Td /F1 9.8 Tf [(2012 Aug 22 . Edition 1. doi: 10.1371/50081cad5861d.)] TJ ET q 15.000 29.530 577.500 607.527 re W n 0.271 0.267 0.267 rg BT 26.250 610.335 Td /F4 12.0 Tf [(Abstract)] TJ ET BT 26.250 590.381 Td /F1 9.8 Tf [(AIM This review aims to develop disaster management practice using a health system strengthening approach through two )] TJ ET BT 26.250 578.476 Td /F1 9.8 Tf [(objectives. Firstly, to review the disaster management literature to test the hypothesis that a holistic health system approach has )] TJ ET BT 26.250 566.571 Td /F1 9.8 Tf [(not been established in practice or evaluated in the core literature. Secondly, to collate the worldwide experience of disaster )] TJ ET BT 26.250 554.667 Td /F1 9.8 Tf [(management found in the core literature according to the components of a health system.)] TJ ET BT 26.250 535.262 Td /F1 9.8 Tf [(METHOD A systematic review was conducted of the core literature published between January 2000 and November 2011 on )] TJ ET BT 26.250 523.357 Td /F1 9.8 Tf [(the MEDLINE and Embase databases. Search terms combined the WHOs descriptors for a health system with disaster terms. )] TJ ET BT 26.250 511.452 Td /F1 9.8 Tf [(Non-restrictive inclusion criteria were applied. Papers were assessed using a quality appraisal tool. Content analysis identified )] TJ ET BT 26.250 499.548 Td /F1 9.8 Tf [(the disaster management components discussed within the context of the health system.)] TJ ET BT 26.250 480.143 Td /F1 9.8 Tf [(RESULTS The search yielded 143 relevant disaster management documents for collation. The review found that none of these )] TJ ET BT 26.250 468.238 Td /F1 9.8 Tf [(publications described a holistic health system approach to disaster management, and none evaluated such an approach.)] TJ ET BT 26.250 448.833 Td /F1 9.8 Tf [(CONCLUSION The findings of this review demonstrate that a holistic health system approach to disaster management has not )] TJ ET BT 26.250 436.929 Td /F1 9.8 Tf [(been established in practice or evaluated in the core literature. Important lessons identified through the collation and analyses of )] TJ ET BT 26.250 425.024 Td /F1 9.8 Tf [(isolated disaster-related experience require further research to incorporate them within a holistic health system approach. This )] TJ ET BT 26.250 413.119 Td /F1 9.8 Tf [(approach, supported by the resolution passed at the World Health Assembly in 2011, aims to build health system resilience to )] TJ ET BT 26.250 401.214 Td /F1 9.8 Tf [(protect immediate and long-term population health in the face of all-hazards disasters.)] TJ ET BT 26.250 381.810 Td /F1 9.8 Tf [(Citation: Bayntun C. A health system approach to all-hazards disaster management: A systematic review. PLOS Currents )] TJ ET BT 26.250 369.905 Td /F1 9.8 Tf [(Disasters. 2012 Aug 22. doi: 10.1371/50081cad5861d.)] TJ ET BT 26.250 333.302 Td /F4 12.0 Tf [(Introduction)] TJ ET BT 26.250 313.348 Td /F1 9.8 Tf [(Disasters cause devastation for populations and can limit a health systems progress for years ahead. In spite of funds being )] TJ ET BT 26.250 301.443 Td /F1 9.8 Tf [(invested in disaster management in many countries, a comprehensive health system approach to build resilience in the face of )] TJ ET BT 26.250 289.539 Td /F1 9.8 Tf [(disasters is still lacking. As a result, populations can suffer unnecessarily during and in the aftermath of disasters.)] TJ ET BT 26.250 270.134 Td /F1 9.8 Tf [(A resolution advocating a health system approach to disaster management was adopted at the World Health Assembly in May )] TJ ET BT 26.250 258.229 Td /F1 9.8 Tf [(2011, aiming to promote resilience and efficient recovery in the face of all-hazards disasters )] TJ ET 0.267 0.267 0.267 rg BT 424.001 259.736 Td /F4 8.7 Tf [(1)] TJ ET 0.271 0.267 0.267 rg BT 428.820 258.229 Td /F1 9.8 Tf [( . The health system can be )] TJ ET BT 26.250 246.324 Td /F1 9.8 Tf [(defined as the structured and interrelated work of all agencies contributing to health within a country and includes efforts to )] TJ ET BT 26.250 234.420 Td /F1 9.8 Tf [(influence determinants of health as well as more direct health-improving activities )] TJ ET 0.267 0.267 0.267 rg BT 382.252 235.927 Td /F4 8.7 Tf [(2)] TJ ET 0.271 0.267 0.267 rg BT 387.070 234.420 Td /F1 9.8 Tf [( . The WHO describes it as being composed )] TJ ET BT 26.250 222.515 Td /F1 9.8 Tf [(of six building blocks 1\) service delivery, 2\) health workers, 3\) health information, 4\) medical products, technology and )] TJ ET BT 26.250 210.610 Td /F1 9.8 Tf [(vaccines, 5\) health finance, and 6\) governance and leadership )] TJ ET 0.267 0.267 0.267 rg BT 297.768 212.117 Td /F4 8.7 Tf [(2)] TJ ET 0.271 0.267 0.267 rg BT 302.587 210.610 Td /F1 9.8 Tf [( , which were originally derived from the World Health Report )] TJ ET BT 26.250 198.705 Td /F1 9.8 Tf [(2000 )] TJ ET 0.267 0.267 0.267 rg BT 50.645 200.213 Td /F4 8.7 Tf [(3)] TJ ET 0.271 0.267 0.267 rg BT 55.463 198.705 Td /F1 9.8 Tf [( . These health system components will be described as levers to better represent the dynamic, inter-dependent nature )] TJ ET BT 26.250 186.801 Td /F1 9.8 Tf [(of the components.)] TJ ET BT 26.250 167.396 Td /F1 9.8 Tf [(WHO asks member states to prepare for all-hazards disasters, whether natural or man-made. Historically, different aspects of )] TJ ET BT 26.250 155.491 Td /F1 9.8 Tf [(disaster management have been considered and described in isolation. However, the all-hazards approach to disaster )] TJ ET BT 26.250 143.586 Td /F1 9.8 Tf [(management suggests that a health system needs resilience built into its structure across all levers. In this way, the health )] TJ ET BT 26.250 131.682 Td /F1 9.8 Tf [(system can be strengthened to respond better to the challenges presented by any disaster.)] TJ ET BT 26.250 112.277 Td /F1 9.8 Tf [(The objective of this review is to use a health system approach to collate the worldwide experience of disasters, an initial step )] TJ ET BT 26.250 100.372 Td /F1 9.8 Tf [(toward assessing the implementation of the World Health Assembly resolution of May 2011 )] TJ ET 0.267 0.267 0.267 rg BT 421.827 101.879 Td /F4 8.7 Tf [(4)] TJ ET 0.271 0.267 0.267 rg BT 426.646 100.372 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 63.770 Td /F4 12.0 Tf [(Methods)] TJ ET BT 26.250 43.815 Td /F1 9.8 Tf [(This systematic review has been developed and written in light of the Preferred Reporting Items for Systematic Reviews and )] TJ ET Q q 0.000 0.000 0.000 rg BT 291.710 19.825 Td /F1 11.0 Tf [(1)] TJ ET BT 25.000 19.825 Td /F1 11.0 Tf [(PLOS Currents Disasters)] TJ ET Q endstream endobj 8 0 obj << /Type /Font /Subtype /Type1 /Name /F1 /BaseFont /Helvetica /Encoding /WinAnsiEncoding >> endobj 9 0 obj << /Type /Font /Subtype /Type1 /Name /F2 /BaseFont /Times-Bold /Encoding /WinAnsiEncoding >> endobj 10 0 obj << /Type /Font /Subtype /Type1 /Name /F3 /BaseFont /Times-Italic /Encoding /WinAnsiEncoding >> endobj 11 0 obj << /Type /Font /Subtype /Type1 /Name /F4 /BaseFont /Helvetica-Bold /Encoding /WinAnsiEncoding >> endobj 12 0 obj << /Type /XObject /Subtype /Image /Width 500 /Height 52 /Filter /FlateDecode /DecodeParms << /Predictor 15 /Colors 1 /Columns 500 /BitsPerComponent 8>> /ColorSpace /DeviceGray /BitsPerComponent 8 /Length 144>> stream x1 0 'ݲ؎"e{dzAdzAdzAdzAdzAdzAdzAdzAdzAdzAdzAdzAtlM0\ endstream endobj 13 0 obj << /Type /XObject /Subtype /Image /Width 500 /Height 52 /SMask 12 0 R /Filter /FlateDecode /DecodeParms << /Predictor 15 /Colors 3 /Columns 500 /BitsPerComponent 8>> /ColorSpace /DeviceRGB /BitsPerComponent 8 /Length 3627>> stream x?b!/w N BU!@rܥ>L%|"ɾeB~qbϧG0 0 0 ü<,a ,a ,a /)܋( daKnW>'IR2 0x1ͽ{0 Z4= 4M޶mY}'IĖ2 0ָML}GQ48Iy>i("u>s6ne0 YfB;S}b 5ba,ZP՚ћuFڶ= 0{ǤbA!>m{wwW׵ApssDZdU,K:fs_׿___qykQbfMii{$̂>}JdB um{Lh'پy2c\ifZypE|,Uݝ,h4ڶ],R*\U-rQ9l PUUQ#G80aef_-mI*gߋlil-d:5ec]RUa0\ͼ$ ֌8jE%4BH\m=ϣfY )!vDL^)4axt=3*E<' _?>>.7DYt]׆0gqwр,ajmۢ(HMB$ [ U5;gfw`2R]u]GQD0g[Tt:a1J#,AU}0hwb>&8V~*ȀIH fuiah aMl7\:\>|,L5w(YqOFsoBy|<3^=6.ym۾%)~`XHnݰ‹IDs'oZ7In}wV|C%H{lDsDQ6]4jcЊͭ;*ٶv&A.09e(ji2btXɄy4?!ZEI"+Yɲy%'hZch@C+q,U1TA+FEe_R18;z.􃰢c ( H| $I.hy {ss&` 26:#(RuGQmZtJӅ˲csоj$}3#rl& j }>  ]x] ъ|G[1lfu ϛIaVz0-mvy2h܉ေA^XD`b"W#ֵU{(Y BAaDL]z_ex6 (nMOÈ%֐m`04Ԝ0aℓ.*"^=KeY~-'iM``v,Z꺞fRf1c+! 85BX,HeEљ @N^ԚG`5p |!L]U).?"l5eFQŞu]ɍK'eW/o҆&(i VM_ = E/J,;sqq0 W>rM=gdќ陞qѼ:2X;.˲j#Ņ뺮fbi\ו.u݋1mgXEQꋋ q@P%~VL0%b`eF4M}'@Sp8v;FߊdY]@u[5 (96 V0~1Gj Ňg֏= >\'ͪ$yX`!dhq%I0fF5x]t,hRˮb"3鈰@'5ؽE2>GI@ KȲLrÿ*1ȰT5ffܱYjuqqC3v(uEsI'c^چ#X,hAk"ZH6`XPW,>}fY6t^C8,Fi#nica Jzlf0 >سX,)m_Bs' c oN c>TT'%x&ߘ fi$W܇g[@ mDZ7]:RQjƘ.ğ$:؝, s{HzxqZKmF|Ϗ~p7@ {1$Xu}p(ĉzZaJ%i&0L@#\}GaT~tTQ,asEOxhy.?,aC9oqE=MS9I%8~WmdG:agO\\$,yHg^Ab%Ĩ7Z}џd2!YmN0X-#*ڈ/&W4MAYT?3;f udJ 6%ag9IxINlȦ|[+ ٘{R0' uT?NP%A wD&1=4L&ĵg-G)+0*V} 62T75yiۣrѰڳ>$'?B'IeY0K1WH]NkiR m<˭XF.xaijT==}~&;ہHA7| \( s\? ~_{ޒ{ O?^AVtї~g~~mVfS XtU6wMUv8|xxG-ü[A܆m!g۾勜*N5,sP=0 cibCub=2xa? 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The Statement consists of a checklist intended to standardise the reporting of )] TJ ET BT 26.250 755.571 Td /F1 9.8 Tf [(systematic reviews of randomised trials, and although it is not applicable in full to this review, it provides a useful tool to guide )] TJ ET BT 26.250 743.667 Td /F1 9.8 Tf [(the structure and content of this report in accordance with the principles of transparent, comprehensive review reporting )] TJ ET BT 26.250 731.762 Td /F1 9.8 Tf [(\(Appendix 2\).)] TJ ET BT 26.250 712.357 Td /F4 9.8 Tf [(Protocol. )] TJ ET BT 71.217 712.357 Td /F1 9.8 Tf [(Information sources.)] TJ ET BT 159.542 712.357 Td /F1 9.8 Tf [(Database searches were conducted using Embase and MEDLINE accessed via Ovid using text )] TJ ET BT 26.250 700.452 Td /F1 9.8 Tf [(words and MeSH terms \(Panel 1\). In addition to the papers identified from these sources, a further 37 papers were selected )] TJ ET BT 26.250 688.548 Td /F1 9.8 Tf [(for inclusion after being identified from the reference lists of retrieved articles and from citations.)] TJ ET BT 26.250 669.143 Td /F1 9.8 Tf [(Search limits. )] TJ ET BT 87.470 669.143 Td /F1 9.8 Tf [(Papers included were those published in peer-reviewed core clinical journals between 1 January 2000 and 18 )] TJ ET BT 26.250 657.238 Td /F1 9.8 Tf [(November 2011. Disaster management has been a rapidly evolving area over the last decade; thus this review concentrates on )] TJ ET BT 26.250 645.333 Td /F1 9.8 Tf [(up-to-date information, while allowing the inclusion of materials describing a range of disasters across different continents. )] TJ ET BT 26.250 633.429 Td /F1 9.8 Tf [(Following a pilot exploration of the literature, search terms were chosen to reflect the aim to identify a broad range of document )] TJ ET BT 26.250 621.524 Td /F1 9.8 Tf [(type whilst avoiding the retrieval of an excessive number of irrelevant papers. Language restriction was not applied but all )] TJ ET BT 26.250 609.619 Td /F1 9.8 Tf [(included papers were published in English. The search was limited to the Human category. A second reviewer independently )] TJ ET BT 26.250 597.714 Td /F1 9.8 Tf [(assessed the selection of documents according to the eligibility criteria. This resulted in two discrepancies which were )] TJ ET BT 26.250 585.810 Td /F1 9.8 Tf [(considered further against objectives of the review, resulting in establishing a consensus for inclusion and exclusion.)] TJ ET BT 26.250 566.405 Td /F4 9.8 Tf [(Panel 1 Search terms, search strategy and results)] TJ ET 0.965 0.965 0.965 rg 26.250 312.024 555.000 244.500 re f 0.267 0.267 0.267 rg 0.267 0.267 0.267 RG 26.250 556.524 m 581.250 556.524 l 581.250 555.774 l 26.250 555.774 l f 26.250 312.024 m 581.250 312.024 l 581.250 312.774 l 26.250 312.774 l f q 142.500 0 0 225.000 35.250 321.774 cm /I3 Do Q 0.271 0.267 0.267 rg BT 26.250 295.000 Td /F4 9.8 Tf [(Eligibility.)] TJ ET BT 72.309 295.000 Td /F1 9.8 Tf [( Retrieved records were excluded if the paper used the terms outside the context of disaster management or were of )] TJ ET BT 26.250 283.095 Td /F1 9.8 Tf [(such a specific nature to warrant themselves inappropriate for the aims of the review \(such as a new laboratory technique to )] TJ ET BT 26.250 271.191 Td /F1 9.8 Tf [(identify a viral sub-strain\).)] TJ ET BT 26.250 251.786 Td /F1 9.8 Tf [(Thus, inclusion criteria were broad, including reports of round-table events, evaluations of simulation exercises, opinion pieces )] TJ ET BT 26.250 239.881 Td /F1 9.8 Tf [(and letters. Justification for the breadth of inclusion is that each document had value in reaching the objectives of the review )] TJ ET BT 26.250 227.976 Td /F1 9.8 Tf [(firstly to establish whether a health systems approach exists in the literature, and secondly to collate the worldwide experience )] TJ ET BT 26.250 216.072 Td /F1 9.8 Tf [(of disaster management using a health system perspective in order to develop this approach. Figure 2 outlines the search and )] TJ ET BT 26.250 204.167 Td /F1 9.8 Tf [(selection of papers.)] TJ ET 0.965 0.965 0.965 rg 26.250 -36.714 555.000 231.000 re f 0.267 0.267 0.267 rg 26.250 194.286 m 581.250 194.286 l 581.250 193.536 l 26.250 193.536 l f q 225.000 0 0 215.250 35.250 -30.714 cm /I4 Do Q q 35.250 -36.714 537.000 0.000 re W n Q Q q 15.000 -36.714 577.500 813.714 re W n 0.271 0.267 0.267 rg BT 26.250 767.476 Td /F1 9.8 Tf [(Meta-Analyses \(PRISMA\) Statement )] TJ ET 0.267 0.267 0.267 rg BT 187.174 768.983 Td /F4 8.7 Tf [(4)] TJ ET 0.271 0.267 0.267 rg BT 191.992 767.476 Td /F1 9.8 Tf [( . The Statement consists of a checklist intended to standardise the reporting of )] TJ ET BT 26.250 755.571 Td /F1 9.8 Tf [(systematic reviews of randomised trials, and although it is not applicable in full to this review, it provides a useful tool to guide )] TJ ET BT 26.250 743.667 Td /F1 9.8 Tf [(the structure and content of this report in accordance with the principles of transparent, comprehensive review reporting )] TJ ET BT 26.250 731.762 Td /F1 9.8 Tf [(\(Appendix 2\).)] TJ ET BT 26.250 712.357 Td /F4 9.8 Tf [(Protocol. )] TJ ET BT 71.217 712.357 Td /F1 9.8 Tf [(Information sources.)] TJ ET BT 159.542 712.357 Td /F1 9.8 Tf [(Database searches were conducted using Embase and MEDLINE accessed via Ovid using text )] TJ ET BT 26.250 700.452 Td /F1 9.8 Tf [(words and MeSH terms \(Panel 1\). In addition to the papers identified from these sources, a further 37 papers were selected )] TJ ET BT 26.250 688.548 Td /F1 9.8 Tf [(for inclusion after being identified from the reference lists of retrieved articles and from citations.)] TJ ET BT 26.250 669.143 Td /F1 9.8 Tf [(Search limits. )] TJ ET BT 87.470 669.143 Td /F1 9.8 Tf [(Papers included were those published in peer-reviewed core clinical journals between 1 January 2000 and 18 )] TJ ET BT 26.250 657.238 Td /F1 9.8 Tf [(November 2011. Disaster management has been a rapidly evolving area over the last decade; thus this review concentrates on )] TJ ET BT 26.250 645.333 Td /F1 9.8 Tf [(up-to-date information, while allowing the inclusion of materials describing a range of disasters across different continents. )] TJ ET BT 26.250 633.429 Td /F1 9.8 Tf [(Following a pilot exploration of the literature, search terms were chosen to reflect the aim to identify a broad range of document )] TJ ET BT 26.250 621.524 Td /F1 9.8 Tf [(type whilst avoiding the retrieval of an excessive number of irrelevant papers. Language restriction was not applied but all )] TJ ET BT 26.250 609.619 Td /F1 9.8 Tf [(included papers were published in English. The search was limited to the Human category. A second reviewer independently )] TJ ET BT 26.250 597.714 Td /F1 9.8 Tf [(assessed the selection of documents according to the eligibility criteria. This resulted in two discrepancies which were )] TJ ET BT 26.250 585.810 Td /F1 9.8 Tf [(considered further against objectives of the review, resulting in establishing a consensus for inclusion and exclusion.)] TJ ET BT 26.250 566.405 Td /F4 9.8 Tf [(Panel 1 Search terms, search strategy and results)] TJ ET 0.965 0.965 0.965 rg 26.250 312.024 555.000 244.500 re f 0.267 0.267 0.267 rg 0.267 0.267 0.267 RG 26.250 556.524 m 581.250 556.524 l 581.250 555.774 l 26.250 555.774 l f 26.250 312.024 m 581.250 312.024 l 581.250 312.774 l 26.250 312.774 l f q 142.500 0 0 225.000 35.250 321.774 cm /I3 Do Q 0.271 0.267 0.267 rg BT 26.250 295.000 Td /F4 9.8 Tf [(Eligibility.)] TJ ET BT 72.309 295.000 Td /F1 9.8 Tf [( Retrieved records were excluded if the paper used the terms outside the context of disaster management or were of )] TJ ET BT 26.250 283.095 Td /F1 9.8 Tf [(such a specific nature to warrant themselves inappropriate for the aims of the review \(such as a new laboratory technique to )] TJ ET BT 26.250 271.191 Td /F1 9.8 Tf [(identify a viral sub-strain\).)] TJ ET BT 26.250 251.786 Td /F1 9.8 Tf [(Thus, inclusion criteria were broad, including reports of round-table events, evaluations of simulation exercises, opinion pieces )] TJ ET BT 26.250 239.881 Td /F1 9.8 Tf [(and letters. Justification for the breadth of inclusion is that each document had value in reaching the objectives of the review )] TJ ET BT 26.250 227.976 Td /F1 9.8 Tf [(firstly to establish whether a health systems approach exists in the literature, and secondly to collate the worldwide experience )] TJ ET BT 26.250 216.072 Td /F1 9.8 Tf [(of disaster management using a health system perspective in order to develop this approach. Figure 2 outlines the search and )] TJ ET BT 26.250 204.167 Td /F1 9.8 Tf [(selection of papers.)] TJ ET 0.965 0.965 0.965 rg 26.250 -36.714 555.000 231.000 re f 0.267 0.267 0.267 rg 26.250 194.286 m 581.250 194.286 l 581.250 193.536 l 26.250 193.536 l f q 225.000 0 0 215.250 35.250 -30.714 cm /I4 Do Q q 35.250 -36.714 537.000 0.000 re W n Q Q q 15.000 -36.714 577.500 813.714 re W n 0.271 0.267 0.267 rg BT 26.250 767.476 Td /F1 9.8 Tf [(Meta-Analyses \(PRISMA\) Statement )] TJ ET 0.267 0.267 0.267 rg BT 187.174 768.983 Td /F4 8.7 Tf [(4)] TJ ET 0.271 0.267 0.267 rg BT 191.992 767.476 Td /F1 9.8 Tf [( . The Statement consists of a checklist intended to standardise the reporting of )] TJ ET BT 26.250 755.571 Td /F1 9.8 Tf [(systematic reviews of randomised trials, and although it is not applicable in full to this review, it provides a useful tool to guide )] TJ ET BT 26.250 743.667 Td /F1 9.8 Tf [(the structure and content of this report in accordance with the principles of transparent, comprehensive review reporting )] TJ ET BT 26.250 731.762 Td /F1 9.8 Tf [(\(Appendix 2\).)] TJ ET BT 26.250 712.357 Td /F4 9.8 Tf [(Protocol. )] TJ ET BT 71.217 712.357 Td /F1 9.8 Tf [(Information sources.)] TJ ET BT 159.542 712.357 Td /F1 9.8 Tf [(Database searches were conducted using Embase and MEDLINE accessed via Ovid using text )] TJ ET BT 26.250 700.452 Td /F1 9.8 Tf [(words and MeSH terms \(Panel 1\). In addition to the papers identified from these sources, a further 37 papers were selected )] TJ ET BT 26.250 688.548 Td /F1 9.8 Tf [(for inclusion after being identified from the reference lists of retrieved articles and from citations.)] TJ ET BT 26.250 669.143 Td /F1 9.8 Tf [(Search limits. )] TJ ET BT 87.470 669.143 Td /F1 9.8 Tf [(Papers included were those published in peer-reviewed core clinical journals between 1 January 2000 and 18 )] TJ ET BT 26.250 657.238 Td /F1 9.8 Tf [(November 2011. Disaster management has been a rapidly evolving area over the last decade; thus this review concentrates on )] TJ ET BT 26.250 645.333 Td /F1 9.8 Tf [(up-to-date information, while allowing the inclusion of materials describing a range of disasters across different continents. )] TJ ET BT 26.250 633.429 Td /F1 9.8 Tf [(Following a pilot exploration of the literature, search terms were chosen to reflect the aim to identify a broad range of document )] TJ ET BT 26.250 621.524 Td /F1 9.8 Tf [(type whilst avoiding the retrieval of an excessive number of irrelevant papers. Language restriction was not applied but all )] TJ ET BT 26.250 609.619 Td /F1 9.8 Tf [(included papers were published in English. The search was limited to the Human category. A second reviewer independently )] TJ ET BT 26.250 597.714 Td /F1 9.8 Tf [(assessed the selection of documents according to the eligibility criteria. This resulted in two discrepancies which were )] TJ ET BT 26.250 585.810 Td /F1 9.8 Tf [(considered further against objectives of the review, resulting in establishing a consensus for inclusion and exclusion.)] TJ ET BT 26.250 566.405 Td /F4 9.8 Tf [(Panel 1 Search terms, search strategy and results)] TJ ET 0.965 0.965 0.965 rg 26.250 312.024 555.000 244.500 re f 0.267 0.267 0.267 rg 0.267 0.267 0.267 RG 26.250 556.524 m 581.250 556.524 l 581.250 555.774 l 26.250 555.774 l f 26.250 312.024 m 581.250 312.024 l 581.250 312.774 l 26.250 312.774 l f q 142.500 0 0 225.000 35.250 321.774 cm /I3 Do Q 0.271 0.267 0.267 rg BT 26.250 295.000 Td /F4 9.8 Tf [(Eligibility.)] TJ ET BT 72.309 295.000 Td /F1 9.8 Tf [( Retrieved records were excluded if the paper used the terms outside the context of disaster management or were of )] TJ ET BT 26.250 283.095 Td /F1 9.8 Tf [(such a specific nature to warrant themselves inappropriate for the aims of the review \(such as a new laboratory technique to )] TJ ET BT 26.250 271.191 Td /F1 9.8 Tf [(identify a viral sub-strain\).)] TJ ET BT 26.250 251.786 Td /F1 9.8 Tf [(Thus, inclusion criteria were broad, including reports of round-table events, evaluations of simulation exercises, opinion pieces )] TJ ET BT 26.250 239.881 Td /F1 9.8 Tf [(and letters. Justification for the breadth of inclusion is that each document had value in reaching the objectives of the review )] TJ ET BT 26.250 227.976 Td /F1 9.8 Tf [(firstly to establish whether a health systems approach exists in the literature, and secondly to collate the worldwide experience )] TJ ET BT 26.250 216.072 Td /F1 9.8 Tf [(of disaster management using a health system perspective in order to develop this approach. Figure 2 outlines the search and )] TJ ET BT 26.250 204.167 Td /F1 9.8 Tf [(selection of papers.)] TJ ET 0.965 0.965 0.965 rg 26.250 -36.714 555.000 231.000 re f 0.267 0.267 0.267 rg 26.250 194.286 m 581.250 194.286 l 581.250 193.536 l 26.250 193.536 l f q 225.000 0 0 215.250 35.250 -30.714 cm /I4 Do Q q 35.250 -36.714 537.000 0.000 re W n Q Q q 142.500 0 0 225.000 35.250 321.774 cm /I3 Do Q q 225.000 0 0 215.250 35.250 -30.714 cm /I4 Do Q q 0.000 0.000 0.000 rg BT 291.710 19.825 Td /F1 11.0 Tf [(2)] TJ ET BT 25.000 19.825 Td /F1 11.0 Tf [(PLOS Currents Disasters)] TJ ET Q endstream endobj 70 0 obj << /Type /Annot /Subtype /Link /A 71 0 R /Border [0 0 0] /H /I /Rect [ 187.1738 768.1817 191.9924 777.0000 ] >> endobj 71 0 obj << /Type /Action >> endobj 72 0 obj << /Type /Annot /Subtype /Link /A 73 0 R /Border [0 0 0] /H /I /Rect [ 35.2500 321.7740 177.7500 546.7740 ] >> endobj 73 0 obj << /Type /Action /S /URI /URI (https://currents.plos.org/disasters/files/2012/07/Bayntun-Figure-1.jpg) >> endobj 74 0 obj << /Type /XObject /Subtype /Image /Width 190 /Height 300 /ColorSpace /DeviceRGB /Filter /DCTDecode /BitsPerComponent 8 /Length 23500>> stream JFIF;CREATOR: gd-jpeg v1.0 (using IJG JPEG v62), quality = 90 C     C   ," }!1AQa"q2#BR$3br %&'()*456789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz w!1AQaq"2B #3Rbr $4%&'()*56789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz ?RW<%u] E}wyō}pl!L{0:%RC1p ~U7e%.+9-E%dVbBH\w'[co X_[C{6lcydpcaIǥtj6I,[efp`.nh!Fxx>LJ7 *x0 r\v0pI'UZ>ɮ 7M{!؂ۋ˔(]nK7t' )Mb]6*7Ak[oIs}cZH.bm1"i|A V'b B돤5>gkk.))Eax#KiNI}o˻1mP{++@4,hC ' >!]#4$L-m|`mN(Xh&1:)Ady&8 oB2@~!xbiR>K؏ pr]Fh>iF:/ٓ'bFp9@7_3xfuv:j>3w32~`˂߇,k};?Ж[[chp>bJ0<\ӌ(@i>$2wz?Wm:8䷽$) RnmNϛ'rOÖ/kqJFr*⾛a}<3soWM X(FS >ҵش^Phn' "*I@~n{YiV+|*Ҵ]F4I%HkI&(f澤/dh"w2+>} 6WӤ]n7,*軆OA󏄚$%όZwBF%FNܕ$(g?._[Tjv+qg0q \u @3BQ4t͟z]j4Q*ry 9]ҿ /&@3BQ5@ NUÌ1=FZ /@3BQ55hӴ+ mn_.C8{ ?D'" 6ž.#,1Z,~S(f{:1'%xPMp^y{i<:}7]Å h$`gM[KD4vLTB8fVmK-1cc{i98=y 4z](xY"`!wƊ1(UHڥkw<_W3@eP$U\$;=tkI+K)ِؒ%- r?(x_LkmUbȤʨy m^ooZZEXP C1JO 9]t_R[ƌgFp:H6$Z>a8,\'5 o Fb'4z?7B{KMJ8$xd-f"Al V5~}M^!F2T.Tpo@" U8d8"Tl5d|+n{Iwm.U>؃,ň'ފQhc'綗MM05#0qe~/ehD=hݎksxfydDЩ2F#l9 ^ =MomnwxHYpCO,O;($2,f veݞs]J-,f&U5Ծdާ_Ys]of=RKKEҪf5:Wtl`K18߇g! 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K,J.#|$YWB̎t)=H>_XE]:zwi0D1I+6*'͸qQq\\q l-\&hpAFǑ3^}pO 61wW+2ԼY}VX)ZiŰb/Ђ24MytGc4mSOP"~uwS%*96QsmL__~F/è|H^;%SWeg!Dco.A!>Z>lUnV$%,LXnpA5^"~oYpz'o1hUI"1Y#bch2mKAſ%7&wiBX-*+ '9 9ƿƟ#E-+?>Yvȴ,;WZvJ W>5x|rvȴ~`;WZW=ڜp?<=>,;WZ_]?#E}Epg1bvȴ,;WZﺚ+?>Ο#EgşGjHҚvx{|,;WZ?vx{|PFbMA\|`eU {'!)>+qhl\q"O$ɨN0&#&=B\+-UV*p)ugh?5{BIY#p$V0b/8΅Ǜ|/j7)K&R{i}k `pOJ/ 7Q4 9 ) NQF (VW4m ̮]Czv$c6*AurU;[p_ /iY<)AdcS#U_r~^x.jRi 6(z t9 ~zUwxwm  IKU3#j1w](,w/tf"!:2(UN 7m3s^#{7L>Hc.:RO,;IW#zRZ=Cw_֗ǞxAE aI& kJGƽC~&M+EKc>1 {zOp<6QH\!d}?w@@VuI GG٬dxJY>GCRgx_< {]/Mi mragi"y 8D_Xp$com{ka[Mro nG@ 6JKhޙoqzM">K >u+ &/5]jZ}Kv_jA_ER]GԿWeƨQ/h GԿWeƨQ/(GԿWeƨR5/Yh(Q/?w}Kv_j(Q/?w}Kv_j(W<5j]k51D" *jy]E&ih%-wGAK }uڏk+';%fW8bӦS\|HYm4,LȝA " ۷ȀFFpEKҚi€ԝ){Q@j))MtQ@I- (-EPQ)M'Z;Gz()M%(R< k$xwþl4{ vIKDTUnj<^\_عV@4g] _;hMu3NחzGuwume}4̖~cD f@0,6p>ah% ^zWV3\y̹7%[w7Kc3]vK׵G^'-6Zw<9Hl@ I_m#^׾%IfV^MiIMp|m j}]-%`|FC]x^ߋbfԢ!hF͎DHhctGZ嶕k<56%$KF!--?M;hMt`|FCm.3A־7j:t 5ͭc\c aڞc9]AZן5D6ƺMg,vy[C-4ISݮ3~#8Km ?.+[} y.Q.m%CTI#-4 o4>'xK/ZD58emd|wdt?j8SeXg8#&`i`$((B ¨aOE(E%PuPQޗw4Pf 1E%h endstream endobj 78 0 obj << /Type /Annot /Subtype /Link /A 79 0 R /Border [0 0 0] /H /I /Rect [ 187.1738 768.1817 191.9924 777.0000 ] >> endobj 79 0 obj << /Type /Action >> endobj 80 0 obj << /Type /Annot /Subtype /Link /A 81 0 R /Border [0 0 0] /H /I /Rect [ 35.2500 321.7740 177.7500 546.7740 ] >> endobj 81 0 obj << /Type /Action /S /URI /URI (https://currents.plos.org/disasters/files/2012/07/Bayntun-Figure-1.jpg) >> endobj 82 0 obj << /Type /Annot /Subtype /Link /A 83 0 R /Border [0 0 0] /H /I /Rect [ 35.2500 -30.7140 260.2500 184.5360 ] >> endobj 83 0 obj << /Type /Action /S /URI /URI (https://currents.plos.org/disasters/files/2012/07/Bantuyn-figure-1.jpg) >> endobj 84 0 obj << /Type /Annot /Subtype /Link /A 85 0 R /Border [0 0 0] /H /I /Rect [ 187.1738 768.1817 191.9924 777.0000 ] >> endobj 85 0 obj << /Type /Action >> endobj 86 0 obj << /Type /Annot /Subtype /Link /A 87 0 R /Border [0 0 0] /H /I /Rect [ 35.2500 321.7740 177.7500 546.7740 ] >> endobj 87 0 obj << /Type /Action /S /URI /URI (https://currents.plos.org/disasters/files/2012/07/Bayntun-Figure-1.jpg) >> endobj 88 0 obj << /Type /Annot /Subtype /Link /A 89 0 R /Border [0 0 0] /H /I /Rect [ 35.2500 -30.7140 260.2500 184.5360 ] >> endobj 89 0 obj << /Type /Action /S /URI /URI (https://currents.plos.org/disasters/files/2012/07/Bantuyn-figure-1.jpg) >> endobj 90 0 obj << /Type /Page /Parent 3 0 R /Annots [ 92 0 R 94 0 R 96 0 R 98 0 R 100 0 R 103 0 R 105 0 R 107 0 R 109 0 R 111 0 R 113 0 R 115 0 R 117 0 R 119 0 R 121 0 R ] /Contents 91 0 R >> endobj 91 0 obj << /Length 14381 >> stream q 15.000 41.360 577.500 735.640 re W n 0.965 0.965 0.965 rg 26.250 747.845 555.000 29.155 re f 0.267 0.267 0.267 rg 0.267 0.267 0.267 RG 26.250 747.845 m 581.250 747.845 l 581.250 748.595 l 26.250 748.595 l f q 35.250 759.095 537.000 17.905 re W n 0.271 0.267 0.267 rg BT 35.250 767.476 Td /F4 9.8 Tf [(Fig. 1: Flow diagram of the search and selection of papers)] TJ ET Q BT 26.250 730.821 Td /F1 9.8 Tf [(Data collection process.)] TJ ET BT 129.746 730.821 Td /F1 9.8 Tf [( The initial piloting involved analysing 20 varied papers and confirmed the method of content analysis )] TJ ET BT 26.250 718.917 Td /F1 9.8 Tf [(using a matrix combining the WHOs six levers of health systems with components drawn from the WHOs Global Assessment )] TJ ET BT 26.250 707.012 Td /F1 9.8 Tf [(of National Health Sector Emergency Preparedness and Response)] TJ ET 0.267 0.267 0.267 rg BT 315.630 708.519 Td /F4 8.7 Tf [(6)] TJ ET BT 320.449 708.519 Td /F4 8.7 Tf [(5)] TJ ET 0.271 0.267 0.267 rg BT 325.267 707.012 Td /F1 9.8 Tf [( , the WHOs baseline survey of member states \(Matrix )] TJ ET BT 26.250 695.107 Td /F1 9.8 Tf [(Template, Appendix 2\).)] TJ ET BT 26.250 675.702 Td /F1 9.8 Tf [(A quality appraisal checklist was completed for each paper. Hardens quality appraisal tool )] TJ ET 0.267 0.267 0.267 rg BT 418.034 677.210 Td /F4 8.7 Tf [(6)] TJ ET 0.271 0.267 0.267 rg BT 422.853 675.702 Td /F1 9.8 Tf [( was identified as the most suitable )] TJ ET BT 26.250 663.798 Td /F1 9.8 Tf [(for public health literature \(see Appendix 1\). Appraisal details were recorded along with additional relevant comments outlining )] TJ ET BT 26.250 651.893 Td /F1 9.8 Tf [(the relevance of each document \(Summary Table of Reviewed Paper, Appendix 2\).)] TJ ET BT 26.250 615.290 Td /F4 12.0 Tf [(Results)] TJ ET BT 26.250 595.336 Td /F1 9.8 Tf [(The search strategy and application of the exclusion criteria yielded 143 relevant disaster management documents published )] TJ ET BT 26.250 583.431 Td /F1 9.8 Tf [(between 1 January 2000 and 18 November 2011 \(Figure 1\). The review found that none of these publications described a )] TJ ET BT 26.250 571.527 Td /F1 9.8 Tf [(holistic health system approach to disaster management, and none evaluated such an approach. A large proportion of the )] TJ ET BT 26.250 559.622 Td /F1 9.8 Tf [(documents considered the importance of taking an all-hazards approach to disaster management, but described this through )] TJ ET BT 26.250 547.717 Td /F1 9.8 Tf [(the context of isolated vertical programmes, such as health professional training programmes or surge capacity development )] TJ ET BT 26.250 535.812 Td /F1 9.8 Tf [(within hospitals.)] TJ ET BT 26.250 516.408 Td /F1 9.8 Tf [(Table 1 summarises how many papers address the WHO disaster management components )] TJ ET 0.267 0.267 0.267 rg BT 428.857 517.915 Td /F4 8.7 Tf [(5)] TJ ET 0.271 0.267 0.267 rg BT 433.675 516.408 Td /F1 9.8 Tf [( within each health system lever. )] TJ ET BT 26.250 504.503 Td /F1 9.8 Tf [(While it should be expected that some areas are less well addressed by the literature, Table 1 shows that there is little coverage )] TJ ET BT 26.250 492.598 Td /F1 9.8 Tf [(of complex and crucial issues such as international cooperation and partnership. Conversely, many publications highlight )] TJ ET BT 26.250 480.693 Td /F1 9.8 Tf [(vulnerabilities in disaster management and identify lessons for the health sector plan. The Summary Table of Reviewed )] TJ ET BT 26.250 468.789 Td /F1 9.8 Tf [(Papers \(Appendix 2\) identifies which components are addressed in each publication. This enables valuable experience in )] TJ ET BT 26.250 456.884 Td /F1 9.8 Tf [(building health system resilience to be located in the literature.)] TJ ET BT 26.250 437.479 Td /F4 9.8 Tf [(Table 1 Systematic review content analysis findings: Table shows the numbers of papers addressing disaster )] TJ ET BT 26.250 425.574 Td /F4 9.8 Tf [(management components within the health system levers)] TJ ET 0.965 0.965 0.965 rg 26.250 184.693 555.000 231.000 re f 0.267 0.267 0.267 rg 0.267 0.267 0.267 RG 26.250 415.693 m 581.250 415.693 l 581.250 414.943 l 26.250 414.943 l f 26.250 184.693 m 581.250 184.693 l 581.250 185.443 l 26.250 185.443 l f q 450.000 0 0 211.500 35.250 194.443 cm /I5 Do Q 0.271 0.267 0.267 rg BT 26.250 167.670 Td /F1 9.8 Tf [(Key: Number of papers \(range\))] TJ ET BT 26.250 148.265 Td /F1 9.8 Tf [(0 blank)] TJ ET BT 26.250 128.860 Td /F1 9.8 Tf [(1-10 +)] TJ ET BT 26.250 109.455 Td /F1 9.8 Tf [(11-20 ++)] TJ ET BT 26.250 90.051 Td /F1 9.8 Tf [(21-30 +++)] TJ ET BT 26.250 70.646 Td /F1 9.8 Tf [(31-40 ++++)] TJ ET BT 26.250 51.241 Td /F1 9.8 Tf [(41-50 +++++)] TJ ET Q q 15.000 41.360 577.500 735.640 re W n 0.965 0.965 0.965 rg 26.250 747.845 555.000 29.155 re f 0.267 0.267 0.267 rg 0.267 0.267 0.267 RG 26.250 747.845 m 581.250 747.845 l 581.250 748.595 l 26.250 748.595 l f q 35.250 759.095 537.000 17.905 re W n 0.271 0.267 0.267 rg BT 35.250 767.476 Td /F4 9.8 Tf [(Fig. 1: Flow diagram of the search and selection of papers)] TJ ET Q BT 26.250 730.821 Td /F1 9.8 Tf [(Data collection process.)] TJ ET BT 129.746 730.821 Td /F1 9.8 Tf [( The initial piloting involved analysing 20 varied papers and confirmed the method of content analysis )] TJ ET BT 26.250 718.917 Td /F1 9.8 Tf [(using a matrix combining the WHOs six levers of health systems with components drawn from the WHOs Global Assessment )] TJ ET BT 26.250 707.012 Td /F1 9.8 Tf [(of National Health Sector Emergency Preparedness and Response)] TJ ET 0.267 0.267 0.267 rg BT 315.630 708.519 Td /F4 8.7 Tf [(6)] TJ ET BT 320.449 708.519 Td /F4 8.7 Tf [(5)] TJ ET 0.271 0.267 0.267 rg BT 325.267 707.012 Td /F1 9.8 Tf [( , the WHOs baseline survey of member states \(Matrix )] TJ ET BT 26.250 695.107 Td /F1 9.8 Tf [(Template, Appendix 2\).)] TJ ET BT 26.250 675.702 Td /F1 9.8 Tf [(A quality appraisal checklist was completed for each paper. Hardens quality appraisal tool )] TJ ET 0.267 0.267 0.267 rg BT 418.034 677.210 Td /F4 8.7 Tf [(6)] TJ ET 0.271 0.267 0.267 rg BT 422.853 675.702 Td /F1 9.8 Tf [( was identified as the most suitable )] TJ ET BT 26.250 663.798 Td /F1 9.8 Tf [(for public health literature \(see Appendix 1\). Appraisal details were recorded along with additional relevant comments outlining )] TJ ET BT 26.250 651.893 Td /F1 9.8 Tf [(the relevance of each document \(Summary Table of Reviewed Paper, Appendix 2\).)] TJ ET BT 26.250 615.290 Td /F4 12.0 Tf [(Results)] TJ ET BT 26.250 595.336 Td /F1 9.8 Tf [(The search strategy and application of the exclusion criteria yielded 143 relevant disaster management documents published )] TJ ET BT 26.250 583.431 Td /F1 9.8 Tf [(between 1 January 2000 and 18 November 2011 \(Figure 1\). The review found that none of these publications described a )] TJ ET BT 26.250 571.527 Td /F1 9.8 Tf [(holistic health system approach to disaster management, and none evaluated such an approach. A large proportion of the )] TJ ET BT 26.250 559.622 Td /F1 9.8 Tf [(documents considered the importance of taking an all-hazards approach to disaster management, but described this through )] TJ ET BT 26.250 547.717 Td /F1 9.8 Tf [(the context of isolated vertical programmes, such as health professional training programmes or surge capacity development )] TJ ET BT 26.250 535.812 Td /F1 9.8 Tf [(within hospitals.)] TJ ET BT 26.250 516.408 Td /F1 9.8 Tf [(Table 1 summarises how many papers address the WHO disaster management components )] TJ ET 0.267 0.267 0.267 rg BT 428.857 517.915 Td /F4 8.7 Tf [(5)] TJ ET 0.271 0.267 0.267 rg BT 433.675 516.408 Td /F1 9.8 Tf [( within each health system lever. )] TJ ET BT 26.250 504.503 Td /F1 9.8 Tf [(While it should be expected that some areas are less well addressed by the literature, Table 1 shows that there is little coverage )] TJ ET BT 26.250 492.598 Td /F1 9.8 Tf [(of complex and crucial issues such as international cooperation and partnership. Conversely, many publications highlight )] TJ ET BT 26.250 480.693 Td /F1 9.8 Tf [(vulnerabilities in disaster management and identify lessons for the health sector plan. The Summary Table of Reviewed )] TJ ET BT 26.250 468.789 Td /F1 9.8 Tf [(Papers \(Appendix 2\) identifies which components are addressed in each publication. This enables valuable experience in )] TJ ET BT 26.250 456.884 Td /F1 9.8 Tf [(building health system resilience to be located in the literature.)] TJ ET BT 26.250 437.479 Td /F4 9.8 Tf [(Table 1 Systematic review content analysis findings: Table shows the numbers of papers addressing disaster )] TJ ET BT 26.250 425.574 Td /F4 9.8 Tf [(management components within the health system levers)] TJ ET 0.965 0.965 0.965 rg 26.250 184.693 555.000 231.000 re f 0.267 0.267 0.267 rg 0.267 0.267 0.267 RG 26.250 415.693 m 581.250 415.693 l 581.250 414.943 l 26.250 414.943 l f 26.250 184.693 m 581.250 184.693 l 581.250 185.443 l 26.250 185.443 l f q 450.000 0 0 211.500 35.250 194.443 cm /I5 Do Q 0.271 0.267 0.267 rg BT 26.250 167.670 Td /F1 9.8 Tf [(Key: Number of papers \(range\))] TJ ET BT 26.250 148.265 Td /F1 9.8 Tf [(0 blank)] TJ ET BT 26.250 128.860 Td /F1 9.8 Tf [(1-10 +)] TJ ET BT 26.250 109.455 Td /F1 9.8 Tf [(11-20 ++)] TJ ET BT 26.250 90.051 Td /F1 9.8 Tf [(21-30 +++)] TJ ET BT 26.250 70.646 Td /F1 9.8 Tf [(31-40 ++++)] TJ ET BT 26.250 51.241 Td /F1 9.8 Tf [(41-50 +++++)] TJ ET Q q 15.000 41.360 577.500 735.640 re W n 0.965 0.965 0.965 rg 26.250 747.845 555.000 29.155 re f 0.267 0.267 0.267 rg 0.267 0.267 0.267 RG 26.250 747.845 m 581.250 747.845 l 581.250 748.595 l 26.250 748.595 l f q 35.250 759.095 537.000 17.905 re W n 0.271 0.267 0.267 rg BT 35.250 767.476 Td /F4 9.8 Tf [(Fig. 1: Flow diagram of the search and selection of papers)] TJ ET Q BT 26.250 730.821 Td /F1 9.8 Tf [(Data collection process.)] TJ ET BT 129.746 730.821 Td /F1 9.8 Tf [( The initial piloting involved analysing 20 varied papers and confirmed the method of content analysis )] TJ ET BT 26.250 718.917 Td /F1 9.8 Tf [(using a matrix combining the WHOs six levers of health systems with components drawn from the WHOs Global Assessment )] TJ ET BT 26.250 707.012 Td /F1 9.8 Tf [(of National Health Sector Emergency Preparedness and Response)] TJ ET 0.267 0.267 0.267 rg BT 315.630 708.519 Td /F4 8.7 Tf [(6)] TJ ET BT 320.449 708.519 Td /F4 8.7 Tf [(5)] TJ ET 0.271 0.267 0.267 rg BT 325.267 707.012 Td /F1 9.8 Tf [( , the WHOs baseline survey of member states \(Matrix )] TJ ET BT 26.250 695.107 Td /F1 9.8 Tf [(Template, Appendix 2\).)] TJ ET BT 26.250 675.702 Td /F1 9.8 Tf [(A quality appraisal checklist was completed for each paper. Hardens quality appraisal tool )] TJ ET 0.267 0.267 0.267 rg BT 418.034 677.210 Td /F4 8.7 Tf [(6)] TJ ET 0.271 0.267 0.267 rg BT 422.853 675.702 Td /F1 9.8 Tf [( was identified as the most suitable )] TJ ET BT 26.250 663.798 Td /F1 9.8 Tf [(for public health literature \(see Appendix 1\). Appraisal details were recorded along with additional relevant comments outlining )] TJ ET BT 26.250 651.893 Td /F1 9.8 Tf [(the relevance of each document \(Summary Table of Reviewed Paper, Appendix 2\).)] TJ ET BT 26.250 615.290 Td /F4 12.0 Tf [(Results)] TJ ET BT 26.250 595.336 Td /F1 9.8 Tf [(The search strategy and application of the exclusion criteria yielded 143 relevant disaster management documents published )] TJ ET BT 26.250 583.431 Td /F1 9.8 Tf [(between 1 January 2000 and 18 November 2011 \(Figure 1\). The review found that none of these publications described a )] TJ ET BT 26.250 571.527 Td /F1 9.8 Tf [(holistic health system approach to disaster management, and none evaluated such an approach. A large proportion of the )] TJ ET BT 26.250 559.622 Td /F1 9.8 Tf [(documents considered the importance of taking an all-hazards approach to disaster management, but described this through )] TJ ET BT 26.250 547.717 Td /F1 9.8 Tf [(the context of isolated vertical programmes, such as health professional training programmes or surge capacity development )] TJ ET BT 26.250 535.812 Td /F1 9.8 Tf [(within hospitals.)] TJ ET BT 26.250 516.408 Td /F1 9.8 Tf [(Table 1 summarises how many papers address the WHO disaster management components )] TJ ET 0.267 0.267 0.267 rg BT 428.857 517.915 Td /F4 8.7 Tf [(5)] TJ ET 0.271 0.267 0.267 rg BT 433.675 516.408 Td /F1 9.8 Tf [( within each health system lever. )] TJ ET BT 26.250 504.503 Td /F1 9.8 Tf [(While it should be expected that some areas are less well addressed by the literature, Table 1 shows that there is little coverage )] TJ ET BT 26.250 492.598 Td /F1 9.8 Tf [(of complex and crucial issues such as international cooperation and partnership. Conversely, many publications highlight )] TJ ET BT 26.250 480.693 Td /F1 9.8 Tf [(vulnerabilities in disaster management and identify lessons for the health sector plan. The Summary Table of Reviewed )] TJ ET BT 26.250 468.789 Td /F1 9.8 Tf [(Papers \(Appendix 2\) identifies which components are addressed in each publication. This enables valuable experience in )] TJ ET BT 26.250 456.884 Td /F1 9.8 Tf [(building health system resilience to be located in the literature.)] TJ ET BT 26.250 437.479 Td /F4 9.8 Tf [(Table 1 Systematic review content analysis findings: Table shows the numbers of papers addressing disaster )] TJ ET BT 26.250 425.574 Td /F4 9.8 Tf [(management components within the health system levers)] TJ ET 0.965 0.965 0.965 rg 26.250 184.693 555.000 231.000 re f 0.267 0.267 0.267 rg 0.267 0.267 0.267 RG 26.250 415.693 m 581.250 415.693 l 581.250 414.943 l 26.250 414.943 l f 26.250 184.693 m 581.250 184.693 l 581.250 185.443 l 26.250 185.443 l f q 450.000 0 0 211.500 35.250 194.443 cm /I5 Do Q 0.271 0.267 0.267 rg BT 26.250 167.670 Td /F1 9.8 Tf [(Key: Number of papers \(range\))] TJ ET BT 26.250 148.265 Td /F1 9.8 Tf [(0 blank)] TJ ET BT 26.250 128.860 Td /F1 9.8 Tf [(1-10 +)] TJ ET BT 26.250 109.455 Td /F1 9.8 Tf [(11-20 ++)] TJ ET BT 26.250 90.051 Td /F1 9.8 Tf [(21-30 +++)] TJ ET BT 26.250 70.646 Td /F1 9.8 Tf [(31-40 ++++)] TJ ET BT 26.250 51.241 Td /F1 9.8 Tf [(41-50 +++++)] TJ ET Q q 450.000 0 0 211.500 35.250 194.443 cm /I5 Do Q q 0.000 0.000 0.000 rg BT 291.710 19.825 Td /F1 11.0 Tf [(3)] TJ ET BT 25.000 19.825 Td /F1 11.0 Tf [(PLOS Currents Disasters)] TJ ET Q endstream endobj 92 0 obj << /Type /Annot /Subtype /Link /A 93 0 R /Border [0 0 0] /H /I /Rect [ 315.6300 707.7174 320.4487 716.5358 ] >> endobj 93 0 obj << /Type /Action >> endobj 94 0 obj << /Type /Annot /Subtype /Link /A 95 0 R /Border [0 0 0] /H /I /Rect [ 320.4487 707.7174 325.2673 716.5358 ] >> endobj 95 0 obj << /Type /Action >> endobj 96 0 obj << /Type /Annot /Subtype /Link /A 97 0 R /Border [0 0 0] /H /I /Rect [ 418.0342 676.4079 422.8529 685.2262 ] >> endobj 97 0 obj << /Type /Action >> endobj 98 0 obj << /Type /Annot /Subtype /Link /A 99 0 R /Border [0 0 0] /H /I /Rect [ 428.8567 517.1132 433.6754 525.9315 ] >> endobj 99 0 obj << /Type /Action >> endobj 100 0 obj << /Type /Annot /Subtype /Link /A 101 0 R /Border [0 0 0] /H /I /Rect [ 35.2500 194.4435 485.2500 405.9435 ] >> endobj 101 0 obj << /Type /Action /S /URI /URI (https://currents.plos.org/disasters/files/2012/07/table-1.png) >> endobj 102 0 obj << /Type /XObject /Subtype /Image /Width 600 /Height 282 /Filter /FlateDecode /DecodeParms << /Predictor 15 /Colors 3 /Columns 600 /BitsPerComponent 8>> /ColorSpace /DeviceRGB /BitsPerComponent 8 /Length 5373>> stream xݽ8wPz'[.z%v^ԙ\DʉBɼæ=b 9&; 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The aim and analysis structure of this review are innovative and the outcomes have international topical )] TJ ET BT 26.250 706.515 Td /F1 9.8 Tf [(relevance and applicability, as evidenced by the recent World Health Assemblys adopted resolution on this topic )] TJ ET 0.267 0.267 0.267 rg BT 513.965 708.022 Td /F4 8.7 Tf [(1)] TJ ET 0.271 0.267 0.267 rg BT 518.783 706.515 Td /F1 9.8 Tf [( and WHO )] TJ ET BT 26.250 694.610 Td /F1 9.8 Tf [(Regional Office for Europes recent development of the WHO Toolkit for Evaluating Crisis Management )] TJ ET 0.267 0.267 0.267 rg BT 473.297 696.117 Td /F4 8.7 Tf [(12)] TJ ET 0.271 0.267 0.267 rg BT 482.935 694.610 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 675.205 Td /F1 9.8 Tf [(This work provides an initial exploration of the evidence to support the aim that disaster management may be developed across )] TJ ET BT 26.250 663.300 Td /F1 9.8 Tf [(countries using a health system approach. This paper calls for further research, or the publication of previously unpublished )] TJ ET BT 26.250 651.396 Td /F1 9.8 Tf [(data, to establish objective measures to support policy and practice in integrating disaster management across the health )] TJ ET BT 26.250 639.491 Td /F1 9.8 Tf [(system. This will contribute to sustainable health system resilience for populations in the face of all-hazards disaster.)] TJ ET BT 26.250 602.888 Td /F4 12.0 Tf [(Discussion)] TJ ET BT 26.250 582.934 Td /F1 9.8 Tf [(The review has demonstrated that a holistic health system approach to disaster management has not been described in the )] TJ ET BT 26.250 571.029 Td /F1 9.8 Tf [(core literature not as primary research, wider articles, or as a topic for review \(Panel 2\). The WHO has placed an emphasis on )] TJ ET BT 26.250 559.125 Td /F1 9.8 Tf [(health systems since the World Health Report in 2000, culminating in the 64th World Health Assembly in May 2011 adopting a )] TJ ET BT 26.250 547.220 Td /F1 9.8 Tf [(resolution on strengthening national health emergency and disaster management capacities and resilience of health systems )] TJ ET 0.267 0.267 0.267 rg BT 570.875 548.727 Td /F4 8.7 Tf [(1)] TJ ET 0.271 0.267 0.267 rg BT 26.250 535.315 Td /F1 9.8 Tf [(. This review establishes the current lack of data to support the implementation of the resolution. These collated results identify )] TJ ET BT 26.250 523.410 Td /F1 9.8 Tf [(the valuable disaster management experience found in the core literature within the context of the health system levers. These )] TJ ET BT 26.250 511.506 Td /F1 9.8 Tf [(findings can be used by researchers and practitioners to develop a holistic health system approach to disaster management, )] TJ ET BT 26.250 499.601 Td /F1 9.8 Tf [(supporting the aims of the adopted World Health Assembly resolution.)] TJ ET q 26.250 462.247 555.000 27.473 re W n 0.271 0.267 0.267 rg BT 26.250 478.731 Td /F1 9.8 Tf [(Panel 2 RESEARCH IN CONTEXT: Previous reviews do not address the need for a holistic health system approach towards )] TJ ET BT 26.250 464.995 Td /F1 9.8 Tf [(disaster management)] TJ ET Q 1.000 1.000 1.000 rg 26.250 247.356 555.000 207.391 re f 0.267 0.267 0.267 rg 26.625 453.622 554.250 0.750 re f 26.625 247.731 554.250 0.750 re f 26.625 247.731 0.750 206.641 re f 580.125 247.731 0.750 206.641 re f 0.271 0.267 0.267 rg BT 31.875 443.767 Td /F1 9.8 Tf [(Further searches for relevant reviews were conducted on MEDLINE, Embase, PubMed, Database of Abstracts of Reviews of )] TJ ET BT 31.875 436.136 Td /F1 9.8 Tf [(Effects \(DARE\) and The Cochrane Library databases. None of the searches identified papers describing the need for a )] TJ ET BT 31.875 428.505 Td /F1 9.8 Tf [(holistic health system approach to developing disaster management practice.)] TJ ET BT 31.875 413.374 Td /F1 9.8 Tf [(Other disaster-related reviews:)] TJ ET BT 31.875 405.742 Td /F1 9.8 Tf [( Savoia et al. reviewed the public health system research for emergency preparedness literature in the USA only. Their )] TJ ET BT 31.875 398.111 Td /F1 9.8 Tf [(findings highlight the lack of any previous reviews in this area and the paucity of rigorous research in spite of the emergency )] TJ ET BT 31.875 388.119 Td /F1 9.8 Tf [(preparedness literature having grown by about 33% per year since 2001 )] TJ ET 0.267 0.267 0.267 rg BT 346.195 388.568 Td /F4 8.7 Tf [(7)] TJ ET 0.271 0.267 0.267 rg BT 351.014 388.119 Td /F1 9.8 Tf [(.)] TJ ET BT 31.875 379.898 Td /F1 9.8 Tf [( Revere et al. reviewed 25 communication systems and tools for health-related emergency preparedness and response in )] TJ ET BT 31.875 372.267 Td /F1 9.8 Tf [(the USA. They found this component of disaster management under-developed in the literature and the appropriate )] TJ ET BT 31.875 362.275 Td /F1 9.8 Tf [(evaluation of the effectiveness of the systems absent )] TJ ET 0.267 0.267 0.267 rg BT 263.291 362.724 Td /F4 8.7 Tf [(8)] TJ ET 0.271 0.267 0.267 rg BT 268.110 362.275 Td /F1 9.8 Tf [(.)] TJ ET BT 31.875 354.053 Td /F1 9.8 Tf [( Potter et al.s review of the literature on emergency preparedness training effectiveness for the CDC was commissioned as )] TJ ET BT 31.875 346.422 Td /F1 9.8 Tf [(a result of the increase in disaster management training opportunities but lack of a mechanism to objectively assess the )] TJ ET BT 31.875 338.791 Td /F1 9.8 Tf [(effectiveness of training. They identify the need for evaluations of training, and that this should be based on performance )] TJ ET BT 31.875 328.799 Td /F1 9.8 Tf [(improvement assessed through field exercises )] TJ ET 0.267 0.267 0.267 rg BT 235.075 329.248 Td /F4 8.7 Tf [(9)] TJ ET 0.271 0.267 0.267 rg BT 239.893 328.799 Td /F1 9.8 Tf [(.)] TJ ET BT 31.875 320.578 Td /F1 9.8 Tf [( Auf der Heide highlights the importance of drawing on actual disaster experiences from the field to develop disaster )] TJ ET BT 31.875 312.946 Td /F1 9.8 Tf [(management practice, identifying a series of disaster myths to demonstrate the impact of failing to incorporate learning from )] TJ ET BT 31.875 302.955 Td /F1 9.8 Tf [(real disaster experiences )] TJ ET 0.267 0.267 0.267 rg BT 142.957 303.404 Td /F4 8.7 Tf [(10)] TJ ET 0.271 0.267 0.267 rg BT 152.594 302.955 Td /F1 9.8 Tf [(.)] TJ ET BT 31.875 287.233 Td /F1 9.8 Tf [(In summary, this review provides an important overview of disaster management from 2000 to 2011, collating evidence from )] TJ ET BT 31.875 279.602 Td /F1 9.8 Tf [(the core literature at a time when this issue is receiving increased international attention. WHO member states and )] TJ ET BT 31.875 271.971 Td /F1 9.8 Tf [(researchers are yet to adequately respond to the World Health Assemblys 2011 resolution to build health system resilience )] TJ ET BT 31.875 261.979 Td /F1 9.8 Tf [(to disasters )] TJ ET 0.267 0.267 0.267 rg BT 84.437 262.428 Td /F4 8.7 Tf [(1)] TJ ET 0.271 0.267 0.267 rg BT 89.256 261.979 Td /F1 9.8 Tf [(. This review progresses that agenda; it identifies the lack of comprehensive disaster management )] TJ ET BT 31.875 253.757 Td /F1 9.8 Tf [(implementation across health systems and the need for objective measures to be developed.)] TJ ET BT 26.250 192.832 Td /F1 9.8 Tf [(As a review of current experience, this work provides a platform for further qualitative analysis to identify the emerging themes )] TJ ET BT 26.250 180.928 Td /F1 9.8 Tf [(and deliver practical, translatable evidence for multi-professional teams to build resilience across the health system in the face )] TJ ET BT 26.250 169.023 Td /F1 9.8 Tf [(of all-hazards. For example, further qualitative analyses of these publications, not reported here, have been used to )] TJ ET BT 26.250 157.118 Td /F1 9.8 Tf [(complement the WHO Toolkit on Evaluating Crisis Management for the WHO Regional Office of Europe )] TJ ET 0.267 0.267 0.267 rg BT 475.998 158.625 Td /F4 8.7 Tf [(11)] TJ ET BT 485.635 158.625 Td /F4 8.7 Tf [(12)] TJ ET 0.271 0.267 0.267 rg BT 495.273 157.118 Td /F1 9.8 Tf [(. This recently )] TJ ET BT 26.250 145.213 Td /F1 9.8 Tf [(developed tool aims to progress a health systems approach to disaster management)] TJ ET 0.267 0.267 0.267 rg BT 390.959 146.721 Td /F4 8.7 Tf [(1)] TJ ET BT 395.777 146.721 Td /F4 8.7 Tf [(12)] TJ ET 0.271 0.267 0.267 rg BT 405.415 145.213 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 125.809 Td /F4 9.8 Tf [(Strengths of this design and method.)] TJ ET BT 198.523 125.809 Td /F1 9.8 Tf [( The reviewed literature embodied a vast amount of information. A separate content )] TJ ET BT 26.250 113.904 Td /F1 9.8 Tf [(matrix was originally completed on every paper reviewed, providing detail that can be used to guide disaster management from )] TJ ET BT 26.250 101.999 Td /F1 9.8 Tf [(planning to acute response, recovery and rebuilding health systems post-disaster. The analysis and collation of this evidence )] TJ ET BT 26.250 90.094 Td /F1 9.8 Tf [(within the context of health system levers would allow a holistic approach to disaster management to be progressed.)] TJ ET BT 26.250 70.690 Td /F4 9.8 Tf [(Limitations.)] TJ ET BT 80.967 70.690 Td /F1 9.8 Tf [( The variety of papers analysed meant that some quality appraisal categories were not applicable for all )] TJ ET BT 26.250 58.785 Td /F1 9.8 Tf [(documents; it was thus not appropriate to assign a numerical value to the quality appraisal. Qualitative comments were )] TJ ET BT 26.250 46.880 Td /F1 9.8 Tf [(recorded for each paper to account for this issue. The Summary Table of Reviewed Papers \(Appendix 2\) presents comments )] TJ ET Q q 15.000 32.594 577.500 744.406 re W n 0.271 0.267 0.267 rg BT 26.250 750.278 Td /F4 12.0 Tf [(Conclusion)] TJ ET BT 26.250 730.324 Td /F1 9.8 Tf [(This review analyses and collates the worldwide experience of disasters found in the core literature within the context of health )] TJ ET BT 26.250 718.419 Td /F1 9.8 Tf [(system levers. The aim and analysis structure of this review are innovative and the outcomes have international topical )] TJ ET BT 26.250 706.515 Td /F1 9.8 Tf [(relevance and applicability, as evidenced by the recent World Health Assemblys adopted resolution on this topic )] TJ ET 0.267 0.267 0.267 rg BT 513.965 708.022 Td /F4 8.7 Tf [(1)] TJ ET 0.271 0.267 0.267 rg BT 518.783 706.515 Td /F1 9.8 Tf [( and WHO )] TJ ET BT 26.250 694.610 Td /F1 9.8 Tf [(Regional Office for Europes recent development of the WHO Toolkit for Evaluating Crisis Management )] TJ ET 0.267 0.267 0.267 rg BT 473.297 696.117 Td /F4 8.7 Tf [(12)] TJ ET 0.271 0.267 0.267 rg BT 482.935 694.610 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 675.205 Td /F1 9.8 Tf [(This work provides an initial exploration of the evidence to support the aim that disaster management may be developed across )] TJ ET BT 26.250 663.300 Td /F1 9.8 Tf [(countries using a health system approach. This paper calls for further research, or the publication of previously unpublished )] TJ ET BT 26.250 651.396 Td /F1 9.8 Tf [(data, to establish objective measures to support policy and practice in integrating disaster management across the health )] TJ ET BT 26.250 639.491 Td /F1 9.8 Tf [(system. This will contribute to sustainable health system resilience for populations in the face of all-hazards disaster.)] TJ ET BT 26.250 602.888 Td /F4 12.0 Tf [(Discussion)] TJ ET BT 26.250 582.934 Td /F1 9.8 Tf [(The review has demonstrated that a holistic health system approach to disaster management has not been described in the )] TJ ET BT 26.250 571.029 Td /F1 9.8 Tf [(core literature not as primary research, wider articles, or as a topic for review \(Panel 2\). The WHO has placed an emphasis on )] TJ ET BT 26.250 559.125 Td /F1 9.8 Tf [(health systems since the World Health Report in 2000, culminating in the 64th World Health Assembly in May 2011 adopting a )] TJ ET BT 26.250 547.220 Td /F1 9.8 Tf [(resolution on strengthening national health emergency and disaster management capacities and resilience of health systems )] TJ ET 0.267 0.267 0.267 rg BT 570.875 548.727 Td /F4 8.7 Tf [(1)] TJ ET 0.271 0.267 0.267 rg BT 26.250 535.315 Td /F1 9.8 Tf [(. This review establishes the current lack of data to support the implementation of the resolution. These collated results identify )] TJ ET BT 26.250 523.410 Td /F1 9.8 Tf [(the valuable disaster management experience found in the core literature within the context of the health system levers. These )] TJ ET BT 26.250 511.506 Td /F1 9.8 Tf [(findings can be used by researchers and practitioners to develop a holistic health system approach to disaster management, )] TJ ET BT 26.250 499.601 Td /F1 9.8 Tf [(supporting the aims of the adopted World Health Assembly resolution.)] TJ ET q 26.250 462.247 555.000 27.473 re W n 0.271 0.267 0.267 rg BT 26.250 478.731 Td /F1 9.8 Tf [(Panel 2 RESEARCH IN CONTEXT: Previous reviews do not address the need for a holistic health system approach towards )] TJ ET BT 26.250 464.995 Td /F1 9.8 Tf [(disaster management)] TJ ET Q 1.000 1.000 1.000 rg 26.250 247.356 555.000 207.391 re f 0.267 0.267 0.267 rg 26.625 453.622 554.250 0.750 re f 26.625 247.731 554.250 0.750 re f 26.625 247.731 0.750 206.641 re f 580.125 247.731 0.750 206.641 re f 0.271 0.267 0.267 rg BT 31.875 443.767 Td /F1 9.8 Tf [(Further searches for relevant reviews were conducted on MEDLINE, Embase, PubMed, Database of Abstracts of Reviews of )] TJ ET BT 31.875 436.136 Td /F1 9.8 Tf [(Effects \(DARE\) and The Cochrane Library databases. None of the searches identified papers describing the need for a )] TJ ET BT 31.875 428.505 Td /F1 9.8 Tf [(holistic health system approach to developing disaster management practice.)] TJ ET BT 31.875 413.374 Td /F1 9.8 Tf [(Other disaster-related reviews:)] TJ ET BT 31.875 405.742 Td /F1 9.8 Tf [( Savoia et al. reviewed the public health system research for emergency preparedness literature in the USA only. Their )] TJ ET BT 31.875 398.111 Td /F1 9.8 Tf [(findings highlight the lack of any previous reviews in this area and the paucity of rigorous research in spite of the emergency )] TJ ET BT 31.875 388.119 Td /F1 9.8 Tf [(preparedness literature having grown by about 33% per year since 2001 )] TJ ET 0.267 0.267 0.267 rg BT 346.195 388.568 Td /F4 8.7 Tf [(7)] TJ ET 0.271 0.267 0.267 rg BT 351.014 388.119 Td /F1 9.8 Tf [(.)] TJ ET BT 31.875 379.898 Td /F1 9.8 Tf [( Revere et al. reviewed 25 communication systems and tools for health-related emergency preparedness and response in )] TJ ET BT 31.875 372.267 Td /F1 9.8 Tf [(the USA. They found this component of disaster management under-developed in the literature and the appropriate )] TJ ET BT 31.875 362.275 Td /F1 9.8 Tf [(evaluation of the effectiveness of the systems absent )] TJ ET 0.267 0.267 0.267 rg BT 263.291 362.724 Td /F4 8.7 Tf [(8)] TJ ET 0.271 0.267 0.267 rg BT 268.110 362.275 Td /F1 9.8 Tf [(.)] TJ ET BT 31.875 354.053 Td /F1 9.8 Tf [( Potter et al.s review of the literature on emergency preparedness training effectiveness for the CDC was commissioned as )] TJ ET BT 31.875 346.422 Td /F1 9.8 Tf [(a result of the increase in disaster management training opportunities but lack of a mechanism to objectively assess the )] TJ ET BT 31.875 338.791 Td /F1 9.8 Tf [(effectiveness of training. They identify the need for evaluations of training, and that this should be based on performance )] TJ ET BT 31.875 328.799 Td /F1 9.8 Tf [(improvement assessed through field exercises )] TJ ET 0.267 0.267 0.267 rg BT 235.075 329.248 Td /F4 8.7 Tf [(9)] TJ ET 0.271 0.267 0.267 rg BT 239.893 328.799 Td /F1 9.8 Tf [(.)] TJ ET BT 31.875 320.578 Td /F1 9.8 Tf [( Auf der Heide highlights the importance of drawing on actual disaster experiences from the field to develop disaster )] TJ ET BT 31.875 312.946 Td /F1 9.8 Tf [(management practice, identifying a series of disaster myths to demonstrate the impact of failing to incorporate learning from )] TJ ET BT 31.875 302.955 Td /F1 9.8 Tf [(real disaster experiences )] TJ ET 0.267 0.267 0.267 rg BT 142.957 303.404 Td /F4 8.7 Tf [(10)] TJ ET 0.271 0.267 0.267 rg BT 152.594 302.955 Td /F1 9.8 Tf [(.)] TJ ET BT 31.875 287.233 Td /F1 9.8 Tf [(In summary, this review provides an important overview of disaster management from 2000 to 2011, collating evidence from )] TJ ET BT 31.875 279.602 Td /F1 9.8 Tf [(the core literature at a time when this issue is receiving increased international attention. WHO member states and )] TJ ET BT 31.875 271.971 Td /F1 9.8 Tf [(researchers are yet to adequately respond to the World Health Assemblys 2011 resolution to build health system resilience )] TJ ET BT 31.875 261.979 Td /F1 9.8 Tf [(to disasters )] TJ ET 0.267 0.267 0.267 rg BT 84.437 262.428 Td /F4 8.7 Tf [(1)] TJ ET 0.271 0.267 0.267 rg BT 89.256 261.979 Td /F1 9.8 Tf [(. This review progresses that agenda; it identifies the lack of comprehensive disaster management )] TJ ET BT 31.875 253.757 Td /F1 9.8 Tf [(implementation across health systems and the need for objective measures to be developed.)] TJ ET BT 26.250 192.832 Td /F1 9.8 Tf [(As a review of current experience, this work provides a platform for further qualitative analysis to identify the emerging themes )] TJ ET BT 26.250 180.928 Td /F1 9.8 Tf [(and deliver practical, translatable evidence for multi-professional teams to build resilience across the health system in the face )] TJ ET BT 26.250 169.023 Td /F1 9.8 Tf [(of all-hazards. For example, further qualitative analyses of these publications, not reported here, have been used to )] TJ ET BT 26.250 157.118 Td /F1 9.8 Tf [(complement the WHO Toolkit on Evaluating Crisis Management for the WHO Regional Office of Europe )] TJ ET 0.267 0.267 0.267 rg BT 475.998 158.625 Td /F4 8.7 Tf [(11)] TJ ET BT 485.635 158.625 Td /F4 8.7 Tf [(12)] TJ ET 0.271 0.267 0.267 rg BT 495.273 157.118 Td /F1 9.8 Tf [(. This recently )] TJ ET BT 26.250 145.213 Td /F1 9.8 Tf [(developed tool aims to progress a health systems approach to disaster management)] TJ ET 0.267 0.267 0.267 rg BT 390.959 146.721 Td /F4 8.7 Tf [(1)] TJ ET BT 395.777 146.721 Td /F4 8.7 Tf [(12)] TJ ET 0.271 0.267 0.267 rg BT 405.415 145.213 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 125.809 Td /F4 9.8 Tf [(Strengths of this design and method.)] TJ ET BT 198.523 125.809 Td /F1 9.8 Tf [( The reviewed literature embodied a vast amount of information. A separate content )] TJ ET BT 26.250 113.904 Td /F1 9.8 Tf [(matrix was originally completed on every paper reviewed, providing detail that can be used to guide disaster management from )] TJ ET BT 26.250 101.999 Td /F1 9.8 Tf [(planning to acute response, recovery and rebuilding health systems post-disaster. The analysis and collation of this evidence )] TJ ET BT 26.250 90.094 Td /F1 9.8 Tf [(within the context of health system levers would allow a holistic approach to disaster management to be progressed.)] TJ ET BT 26.250 70.690 Td /F4 9.8 Tf [(Limitations.)] TJ ET BT 80.967 70.690 Td /F1 9.8 Tf [( The variety of papers analysed meant that some quality appraisal categories were not applicable for all )] TJ ET BT 26.250 58.785 Td /F1 9.8 Tf [(documents; it was thus not appropriate to assign a numerical value to the quality appraisal. Qualitative comments were )] TJ ET BT 26.250 46.880 Td /F1 9.8 Tf [(recorded for each paper to account for this issue. The Summary Table of Reviewed Papers \(Appendix 2\) presents comments )] TJ ET Q q 15.000 32.594 577.500 744.406 re W n 0.271 0.267 0.267 rg BT 26.250 750.278 Td /F4 12.0 Tf [(Conclusion)] TJ ET BT 26.250 730.324 Td /F1 9.8 Tf [(This review analyses and collates the worldwide experience of disasters found in the core literature within the context of health )] TJ ET BT 26.250 718.419 Td /F1 9.8 Tf [(system levers. The aim and analysis structure of this review are innovative and the outcomes have international topical )] TJ ET BT 26.250 706.515 Td /F1 9.8 Tf [(relevance and applicability, as evidenced by the recent World Health Assemblys adopted resolution on this topic )] TJ ET 0.267 0.267 0.267 rg BT 513.965 708.022 Td /F4 8.7 Tf [(1)] TJ ET 0.271 0.267 0.267 rg BT 518.783 706.515 Td /F1 9.8 Tf [( and WHO )] TJ ET BT 26.250 694.610 Td /F1 9.8 Tf [(Regional Office for Europes recent development of the WHO Toolkit for Evaluating Crisis Management )] TJ ET 0.267 0.267 0.267 rg BT 473.297 696.117 Td /F4 8.7 Tf [(12)] TJ ET 0.271 0.267 0.267 rg BT 482.935 694.610 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 675.205 Td /F1 9.8 Tf [(This work provides an initial exploration of the evidence to support the aim that disaster management may be developed across )] TJ ET BT 26.250 663.300 Td /F1 9.8 Tf [(countries using a health system approach. This paper calls for further research, or the publication of previously unpublished )] TJ ET BT 26.250 651.396 Td /F1 9.8 Tf [(data, to establish objective measures to support policy and practice in integrating disaster management across the health )] TJ ET BT 26.250 639.491 Td /F1 9.8 Tf [(system. This will contribute to sustainable health system resilience for populations in the face of all-hazards disaster.)] TJ ET BT 26.250 602.888 Td /F4 12.0 Tf [(Discussion)] TJ ET BT 26.250 582.934 Td /F1 9.8 Tf [(The review has demonstrated that a holistic health system approach to disaster management has not been described in the )] TJ ET BT 26.250 571.029 Td /F1 9.8 Tf [(core literature not as primary research, wider articles, or as a topic for review \(Panel 2\). The WHO has placed an emphasis on )] TJ ET BT 26.250 559.125 Td /F1 9.8 Tf [(health systems since the World Health Report in 2000, culminating in the 64th World Health Assembly in May 2011 adopting a )] TJ ET BT 26.250 547.220 Td /F1 9.8 Tf [(resolution on strengthening national health emergency and disaster management capacities and resilience of health systems )] TJ ET 0.267 0.267 0.267 rg BT 570.875 548.727 Td /F4 8.7 Tf [(1)] TJ ET 0.271 0.267 0.267 rg BT 26.250 535.315 Td /F1 9.8 Tf [(. This review establishes the current lack of data to support the implementation of the resolution. These collated results identify )] TJ ET BT 26.250 523.410 Td /F1 9.8 Tf [(the valuable disaster management experience found in the core literature within the context of the health system levers. These )] TJ ET BT 26.250 511.506 Td /F1 9.8 Tf [(findings can be used by researchers and practitioners to develop a holistic health system approach to disaster management, )] TJ ET BT 26.250 499.601 Td /F1 9.8 Tf [(supporting the aims of the adopted World Health Assembly resolution.)] TJ ET q 26.250 462.247 555.000 27.473 re W n 0.271 0.267 0.267 rg BT 26.250 478.731 Td /F1 9.8 Tf [(Panel 2 RESEARCH IN CONTEXT: Previous reviews do not address the need for a holistic health system approach towards )] TJ ET BT 26.250 464.995 Td /F1 9.8 Tf [(disaster management)] TJ ET Q 1.000 1.000 1.000 rg 26.250 247.356 555.000 207.391 re f 0.267 0.267 0.267 rg 26.625 453.622 554.250 0.750 re f 26.625 247.731 554.250 0.750 re f 26.625 247.731 0.750 206.641 re f 580.125 247.731 0.750 206.641 re f 0.271 0.267 0.267 rg BT 31.875 443.767 Td /F1 9.8 Tf [(Further searches for relevant reviews were conducted on MEDLINE, Embase, PubMed, Database of Abstracts of Reviews of )] TJ ET BT 31.875 436.136 Td /F1 9.8 Tf [(Effects \(DARE\) and The Cochrane Library databases. None of the searches identified papers describing the need for a )] TJ ET BT 31.875 428.505 Td /F1 9.8 Tf [(holistic health system approach to developing disaster management practice.)] TJ ET BT 31.875 413.374 Td /F1 9.8 Tf [(Other disaster-related reviews:)] TJ ET BT 31.875 405.742 Td /F1 9.8 Tf [( Savoia et al. reviewed the public health system research for emergency preparedness literature in the USA only. Their )] TJ ET BT 31.875 398.111 Td /F1 9.8 Tf [(findings highlight the lack of any previous reviews in this area and the paucity of rigorous research in spite of the emergency )] TJ ET BT 31.875 388.119 Td /F1 9.8 Tf [(preparedness literature having grown by about 33% per year since 2001 )] TJ ET 0.267 0.267 0.267 rg BT 346.195 388.568 Td /F4 8.7 Tf [(7)] TJ ET 0.271 0.267 0.267 rg BT 351.014 388.119 Td /F1 9.8 Tf [(.)] TJ ET BT 31.875 379.898 Td /F1 9.8 Tf [( Revere et al. reviewed 25 communication systems and tools for health-related emergency preparedness and response in )] TJ ET BT 31.875 372.267 Td /F1 9.8 Tf [(the USA. They found this component of disaster management under-developed in the literature and the appropriate )] TJ ET BT 31.875 362.275 Td /F1 9.8 Tf [(evaluation of the effectiveness of the systems absent )] TJ ET 0.267 0.267 0.267 rg BT 263.291 362.724 Td /F4 8.7 Tf [(8)] TJ ET 0.271 0.267 0.267 rg BT 268.110 362.275 Td /F1 9.8 Tf [(.)] TJ ET BT 31.875 354.053 Td /F1 9.8 Tf [( Potter et al.s review of the literature on emergency preparedness training effectiveness for the CDC was commissioned as )] TJ ET BT 31.875 346.422 Td /F1 9.8 Tf [(a result of the increase in disaster management training opportunities but lack of a mechanism to objectively assess the )] TJ ET BT 31.875 338.791 Td /F1 9.8 Tf [(effectiveness of training. They identify the need for evaluations of training, and that this should be based on performance )] TJ ET BT 31.875 328.799 Td /F1 9.8 Tf [(improvement assessed through field exercises )] TJ ET 0.267 0.267 0.267 rg BT 235.075 329.248 Td /F4 8.7 Tf [(9)] TJ ET 0.271 0.267 0.267 rg BT 239.893 328.799 Td /F1 9.8 Tf [(.)] TJ ET BT 31.875 320.578 Td /F1 9.8 Tf [( Auf der Heide highlights the importance of drawing on actual disaster experiences from the field to develop disaster )] TJ ET BT 31.875 312.946 Td /F1 9.8 Tf [(management practice, identifying a series of disaster myths to demonstrate the impact of failing to incorporate learning from )] TJ ET BT 31.875 302.955 Td /F1 9.8 Tf [(real disaster experiences )] TJ ET 0.267 0.267 0.267 rg BT 142.957 303.404 Td /F4 8.7 Tf [(10)] TJ ET 0.271 0.267 0.267 rg BT 152.594 302.955 Td /F1 9.8 Tf [(.)] TJ ET BT 31.875 287.233 Td /F1 9.8 Tf [(In summary, this review provides an important overview of disaster management from 2000 to 2011, collating evidence from )] TJ ET BT 31.875 279.602 Td /F1 9.8 Tf [(the core literature at a time when this issue is receiving increased international attention. WHO member states and )] TJ ET BT 31.875 271.971 Td /F1 9.8 Tf [(researchers are yet to adequately respond to the World Health Assemblys 2011 resolution to build health system resilience )] TJ ET BT 31.875 261.979 Td /F1 9.8 Tf [(to disasters )] TJ ET 0.267 0.267 0.267 rg BT 84.437 262.428 Td /F4 8.7 Tf [(1)] TJ ET 0.271 0.267 0.267 rg BT 89.256 261.979 Td /F1 9.8 Tf [(. This review progresses that agenda; it identifies the lack of comprehensive disaster management )] TJ ET BT 31.875 253.757 Td /F1 9.8 Tf [(implementation across health systems and the need for objective measures to be developed.)] TJ ET BT 26.250 192.832 Td /F1 9.8 Tf [(As a review of current experience, this work provides a platform for further qualitative analysis to identify the emerging themes )] TJ ET BT 26.250 180.928 Td /F1 9.8 Tf [(and deliver practical, translatable evidence for multi-professional teams to build resilience across the health system in the face )] TJ ET BT 26.250 169.023 Td /F1 9.8 Tf [(of all-hazards. For example, further qualitative analyses of these publications, not reported here, have been used to )] TJ ET BT 26.250 157.118 Td /F1 9.8 Tf [(complement the WHO Toolkit on Evaluating Crisis Management for the WHO Regional Office of Europe )] TJ ET 0.267 0.267 0.267 rg BT 475.998 158.625 Td /F4 8.7 Tf [(11)] TJ ET BT 485.635 158.625 Td /F4 8.7 Tf [(12)] TJ ET 0.271 0.267 0.267 rg BT 495.273 157.118 Td /F1 9.8 Tf [(. This recently )] TJ ET BT 26.250 145.213 Td /F1 9.8 Tf [(developed tool aims to progress a health systems approach to disaster management)] TJ ET 0.267 0.267 0.267 rg BT 390.959 146.721 Td /F4 8.7 Tf [(1)] TJ ET BT 395.777 146.721 Td /F4 8.7 Tf [(12)] TJ ET 0.271 0.267 0.267 rg BT 405.415 145.213 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 125.809 Td /F4 9.8 Tf [(Strengths of this design and method.)] TJ ET BT 198.523 125.809 Td /F1 9.8 Tf [( The reviewed literature embodied a vast amount of information. A separate content )] TJ ET BT 26.250 113.904 Td /F1 9.8 Tf [(matrix was originally completed on every paper reviewed, providing detail that can be used to guide disaster management from )] TJ ET BT 26.250 101.999 Td /F1 9.8 Tf [(planning to acute response, recovery and rebuilding health systems post-disaster. The analysis and collation of this evidence )] TJ ET BT 26.250 90.094 Td /F1 9.8 Tf [(within the context of health system levers would allow a holistic approach to disaster management to be progressed.)] TJ ET BT 26.250 70.690 Td /F4 9.8 Tf [(Limitations.)] TJ ET BT 80.967 70.690 Td /F1 9.8 Tf [( The variety of papers analysed meant that some quality appraisal categories were not applicable for all )] TJ ET BT 26.250 58.785 Td /F1 9.8 Tf [(documents; it was thus not appropriate to assign a numerical value to the quality appraisal. Qualitative comments were )] TJ ET BT 26.250 46.880 Td /F1 9.8 Tf [(recorded for each paper to account for this issue. 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up-to-date.)] TJ ET BT 26.250 724.262 Td /F4 9.8 Tf [(Bias.)] TJ ET BT 49.552 724.262 Td /F1 9.8 Tf [( Bias is inherent to some of the individual documents reviewed due to the variety of formats included, such as opinion )] TJ ET BT 26.250 712.357 Td /F1 9.8 Tf [(pieces and letters to journals. The qualitative nature of the documents means that this bias does not reduce the validity of each )] TJ ET BT 26.250 700.452 Td /F1 9.8 Tf [(document for inclusion in the review, as they expose important areas of controversy and present pertinent, all be it often )] TJ ET BT 26.250 688.548 Td /F1 9.8 Tf [(specific, experiences from the field. The nature of disasters means that most will not happen again in precisely the same way, )] TJ ET BT 26.250 676.643 Td /F1 9.8 Tf [(so each experience and related lessons warrant consideration in their contribution to a health system strengthening approach to )] TJ ET BT 26.250 664.738 Td /F1 9.8 Tf [(disaster management.)] TJ ET BT 26.250 645.333 Td /F1 9.8 Tf [(Overall, this review shows that much of disaster management research and commentary is taking place in the United States )] TJ ET BT 26.250 633.429 Td /F1 9.8 Tf [(\(USA\), which is progressive in disaster management funding, theory, and institutions. Thus, a significant portion of the literature )] TJ ET BT 26.250 621.524 Td /F1 9.8 Tf [(reviewed is USA-centric and reflects the availability of resources found only in the developed world. The disconnected nature of )] TJ ET BT 26.250 609.619 Td /F1 9.8 Tf [(health disaster management in the USA means that much of the planning and resources have been implemented within )] TJ ET BT 26.250 597.714 Td /F1 9.8 Tf [(isolation )] TJ ET 0.267 0.267 0.267 rg BT 64.724 599.222 Td /F4 8.7 Tf [(13)] TJ ET 0.271 0.267 0.267 rg BT 74.361 597.714 Td /F1 9.8 Tf [( , thus the literature generated is illuminating for all countries. This highlights the limitations and additional obstacles )] TJ ET BT 26.250 585.810 Td /F1 9.8 Tf [(of not employing a health system wide approach.)] TJ ET BT 26.250 566.405 Td /F1 9.8 Tf [(A bias to the literature selection is that this review did not include documents from the grey literature. Instead, the objective was )] TJ ET BT 26.250 554.500 Td /F1 9.8 Tf [(to establish whether the academic literature supported the objectives of the World Health Assembly resolution. I expect that )] TJ ET BT 26.250 542.595 Td /F1 9.8 Tf [(inclusion of the grey literature would result in a less USA-centric view of disasters and management structures. An analysis of )] TJ ET BT 26.250 530.691 Td /F1 9.8 Tf [(the wider relevant literature would be a worthwhile progression of this work.)] TJ ET BT 26.250 511.286 Td /F4 9.8 Tf [(Implications for Public Health policy and practice.)] TJ ET BT 257.072 511.286 Td /F1 9.8 Tf [( The Summary Table of Reviewed Papers \(Appendix 2\) collates a diverse )] TJ ET BT 26.250 499.381 Td /F1 9.8 Tf [(range of worldwide disaster experiences and identifies the specific literature which can provide valuable lessons. Professionals )] TJ ET BT 26.250 487.476 Td /F1 9.8 Tf [(concerned with disaster management from around the world can use this review to identify developments to be made across all )] TJ ET BT 26.250 475.572 Td /F1 9.8 Tf [(health system levers to enhance their preparedness and resilience to all-hazards disasters. This collation is important as much )] TJ ET BT 26.250 463.667 Td /F1 9.8 Tf [(of the health system literature ignores the need to incorporate disaster planning and management.)] TJ ET BT 26.250 444.262 Td /F1 9.8 Tf [(This initial exploration provides scope for development. A holistic health system approach to all-hazards disaster management )] TJ ET BT 26.250 432.357 Td /F1 9.8 Tf [(should reduce resource duplication at every phase of disaster management, maximise human and capital investment, optimise )] TJ ET BT 26.250 420.453 Td /F1 9.8 Tf [(immediate and long term health outcomes, and prevent set-backs to a health system in the wake of a disaster )] TJ ET 0.267 0.267 0.267 rg BT 501.514 421.960 Td /F4 8.7 Tf [(14)] TJ ET 0.271 0.267 0.267 rg BT 511.151 420.453 Td /F1 9.8 Tf [( . Future health )] TJ ET BT 26.250 408.548 Td /F1 9.8 Tf [(system research must address the issue of disaster management in response to the call made by this World Health Assembly )] TJ ET BT 26.250 396.643 Td /F1 9.8 Tf [(resolution in May 2011. Evaluation methods need to be developed and conducted. Issues of practical implementation must be )] TJ ET BT 26.250 384.738 Td /F1 9.8 Tf [(clarified so that priorities can be established, such as how to incorporate disaster management across local, national and )] TJ ET BT 26.250 372.834 Td /F1 9.8 Tf [(regional levels to produce an integrated health system. Panel 3 provides a summary of how this paper aims to progress policy )] TJ ET BT 26.250 360.929 Td /F1 9.8 Tf [(and practice.)] TJ ET q 26.250 337.312 555.000 13.736 re W n 0.271 0.267 0.267 rg BT 26.250 340.059 Td /F1 9.8 Tf [(Panel 3 Key Messages)] TJ ET Q 1.000 1.000 1.000 rg 26.250 248.692 555.000 81.120 re f 0.267 0.267 0.267 rg 26.625 328.687 554.250 0.750 re f 26.625 249.067 554.250 0.750 re f 26.625 249.067 0.750 80.370 re f 580.125 249.067 0.750 80.370 re f 0.271 0.267 0.267 rg BT 31.875 316.471 Td /F1 9.8 Tf [( The World Health Assembly adopted a resolution on this issue in 2011 )] TJ ET 0.267 0.267 0.267 rg BT 344.177 316.920 Td /F4 8.7 Tf [(1)] TJ ET 0.271 0.267 0.267 rg BT 348.996 316.471 Td /F1 9.8 Tf [( with the aim to promote a health systems approach )] TJ ET BT 31.875 308.250 Td /F1 9.8 Tf [(to disaster management to build resilience in the face of all-hazards disasters.)] TJ ET BT 31.875 293.118 Td /F1 9.8 Tf [( This systematic review of the core literature shows that a holistic health system approach to disaster management has not )] TJ ET BT 31.875 285.487 Td /F1 9.8 Tf [(yet been adopted and there are no evaluations of the approach.)] TJ ET BT 31.875 270.356 Td /F1 9.8 Tf [( It provides a collation of the worldwide experience of disaster management as described in the core literature in the period )] TJ ET BT 31.875 262.725 Td /F1 9.8 Tf [(2000 to 2011. This is an initial step to progress research and practice in this area, describing the importance of a health )] TJ ET BT 31.875 255.093 Td /F1 9.8 Tf [(systems approach to disaster management, and providing evidence to be used in developing policy and practice.)] TJ ET BT 26.250 176.971 Td /F4 12.0 Tf [(Competing interests)] TJ ET BT 26.250 157.016 Td /F1 9.8 Tf [(The author has declared that no competing interests exist.)] TJ ET BT 26.250 120.414 Td /F4 12.0 Tf [(Acknowledgements)] TJ ET BT 26.250 100.460 Td /F1 9.8 Tf [( Dr Claire Bayntun is grateful to be funded by NIHR as an Academic Clinical Fellow in Public Health. The Department of )] TJ ET BT 26.250 88.555 Td /F1 9.8 Tf [(Primary Care & Public Health at Imperial College London is grateful for support from the NIHR Collaboration for Leadership in )] TJ ET BT 26.250 76.650 Td /F1 9.8 Tf [(Applied Health Research & Care \(CLAHRC\) Scheme, the NIHR Biomedical Research Centre scheme, and the Imperial Centre )] TJ ET BT 26.250 64.745 Td /F1 9.8 Tf [(for Patient Safety and Service Quality. Dr Thomas Marrs, Clinical Research Fellow second reviewer. Professor Virginia )] TJ ET BT 26.250 52.841 Td /F1 9.8 Tf [(Murray guidance and editing of draft.)] TJ ET Q q 15.000 13.308 577.500 763.692 re W n 0.271 0.267 0.267 rg BT 26.250 767.476 Td /F1 9.8 Tf [(that are pertinent to the aim of this review, including the type of evidence presented by the publications, such as case report. )] TJ ET BT 26.250 755.571 Td /F1 9.8 Tf [(The use of peer-reviewed core journals from 2000 to 2011 establishes a quality standard on the otherwise diverse formats of )] TJ ET BT 26.250 743.667 Td /F1 9.8 Tf [(the reviewed publications, while allowing the identified disaster management material to be up-to-date.)] TJ ET BT 26.250 724.262 Td /F4 9.8 Tf [(Bias.)] TJ ET BT 49.552 724.262 Td /F1 9.8 Tf [( Bias is inherent to some of the individual documents reviewed due to the variety of formats included, such as opinion )] TJ ET BT 26.250 712.357 Td /F1 9.8 Tf [(pieces and letters to journals. The qualitative nature of the documents means that this bias does not reduce the validity of each )] TJ ET BT 26.250 700.452 Td /F1 9.8 Tf [(document for inclusion in the review, as they expose important areas of controversy and present pertinent, all be it often )] TJ ET BT 26.250 688.548 Td /F1 9.8 Tf [(specific, experiences from the field. The nature of disasters means that most will not happen again in precisely the same way, )] TJ ET BT 26.250 676.643 Td /F1 9.8 Tf [(so each experience and related lessons warrant consideration in their contribution to a health system strengthening approach to )] TJ ET BT 26.250 664.738 Td /F1 9.8 Tf [(disaster management.)] TJ ET BT 26.250 645.333 Td /F1 9.8 Tf [(Overall, this review shows that much of disaster management research and commentary is taking place in the United States )] TJ ET BT 26.250 633.429 Td /F1 9.8 Tf [(\(USA\), which is progressive in disaster management funding, theory, and institutions. Thus, a significant portion of the literature )] TJ ET BT 26.250 621.524 Td /F1 9.8 Tf [(reviewed is USA-centric and reflects the availability of resources found only in the developed world. The disconnected nature of )] TJ ET BT 26.250 609.619 Td /F1 9.8 Tf [(health disaster management in the USA means that much of the planning and resources have been implemented within )] TJ ET BT 26.250 597.714 Td /F1 9.8 Tf [(isolation )] TJ ET 0.267 0.267 0.267 rg BT 64.724 599.222 Td /F4 8.7 Tf [(13)] TJ ET 0.271 0.267 0.267 rg BT 74.361 597.714 Td /F1 9.8 Tf [( , thus the literature generated is illuminating for all countries. This highlights the limitations and additional obstacles )] TJ ET BT 26.250 585.810 Td /F1 9.8 Tf [(of not employing a health system wide approach.)] TJ ET BT 26.250 566.405 Td /F1 9.8 Tf [(A bias to the literature selection is that this review did not include documents from the grey literature. Instead, the objective was )] TJ ET BT 26.250 554.500 Td /F1 9.8 Tf [(to establish whether the academic literature supported the objectives of the World Health Assembly resolution. I expect that )] TJ ET BT 26.250 542.595 Td /F1 9.8 Tf [(inclusion of the grey literature would result in a less USA-centric view of disasters and management structures. An analysis of )] TJ ET BT 26.250 530.691 Td /F1 9.8 Tf [(the wider relevant literature would be a worthwhile progression of this work.)] TJ ET BT 26.250 511.286 Td /F4 9.8 Tf [(Implications for Public Health policy and practice.)] TJ ET BT 257.072 511.286 Td /F1 9.8 Tf [( The Summary Table of Reviewed Papers \(Appendix 2\) collates a diverse )] TJ ET BT 26.250 499.381 Td /F1 9.8 Tf [(range of worldwide disaster experiences and identifies the specific literature which can provide valuable lessons. Professionals )] TJ ET BT 26.250 487.476 Td /F1 9.8 Tf [(concerned with disaster management from around the world can use this review to identify developments to be made across all )] TJ ET BT 26.250 475.572 Td /F1 9.8 Tf [(health system levers to enhance their preparedness and resilience to all-hazards disasters. This collation is important as much )] TJ ET BT 26.250 463.667 Td /F1 9.8 Tf [(of the health system literature ignores the need to incorporate disaster planning and management.)] TJ ET BT 26.250 444.262 Td /F1 9.8 Tf [(This initial exploration provides scope for development. A holistic health system approach to all-hazards disaster management )] TJ ET BT 26.250 432.357 Td /F1 9.8 Tf [(should reduce resource duplication at every phase of disaster management, maximise human and capital investment, optimise )] TJ ET BT 26.250 420.453 Td /F1 9.8 Tf [(immediate and long term health outcomes, and prevent set-backs to a health system in the wake of a disaster )] TJ ET 0.267 0.267 0.267 rg BT 501.514 421.960 Td /F4 8.7 Tf [(14)] TJ ET 0.271 0.267 0.267 rg BT 511.151 420.453 Td /F1 9.8 Tf [( . Future health )] TJ ET BT 26.250 408.548 Td /F1 9.8 Tf [(system research must address the issue of disaster management in response to the call made by this World Health Assembly )] TJ ET BT 26.250 396.643 Td /F1 9.8 Tf [(resolution in May 2011. Evaluation methods need to be developed and conducted. Issues of practical implementation must be )] TJ ET BT 26.250 384.738 Td /F1 9.8 Tf [(clarified so that priorities can be established, such as how to incorporate disaster management across local, national and )] TJ ET BT 26.250 372.834 Td /F1 9.8 Tf [(regional levels to produce an integrated health system. Panel 3 provides a summary of how this paper aims to progress policy )] TJ ET BT 26.250 360.929 Td /F1 9.8 Tf [(and practice.)] TJ ET q 26.250 337.312 555.000 13.736 re W n 0.271 0.267 0.267 rg BT 26.250 340.059 Td /F1 9.8 Tf [(Panel 3 Key Messages)] TJ ET Q 1.000 1.000 1.000 rg 26.250 248.692 555.000 81.120 re f 0.267 0.267 0.267 rg 26.625 328.687 554.250 0.750 re f 26.625 249.067 554.250 0.750 re f 26.625 249.067 0.750 80.370 re f 580.125 249.067 0.750 80.370 re f 0.271 0.267 0.267 rg BT 31.875 316.471 Td /F1 9.8 Tf [( The World Health Assembly adopted a resolution on this issue in 2011 )] TJ ET 0.267 0.267 0.267 rg BT 344.177 316.920 Td /F4 8.7 Tf [(1)] TJ ET 0.271 0.267 0.267 rg BT 348.996 316.471 Td /F1 9.8 Tf [( with the aim to promote a health systems approach )] TJ ET BT 31.875 308.250 Td /F1 9.8 Tf [(to disaster management to build resilience in the face of all-hazards disasters.)] TJ ET BT 31.875 293.118 Td /F1 9.8 Tf [( This systematic review of the core literature shows that a holistic health system approach to disaster management has not )] TJ ET BT 31.875 285.487 Td /F1 9.8 Tf [(yet been adopted and there are no evaluations of the approach.)] TJ ET BT 31.875 270.356 Td /F1 9.8 Tf [( It provides a collation of the worldwide experience of disaster management as described in the core literature in the period )] TJ ET BT 31.875 262.725 Td /F1 9.8 Tf [(2000 to 2011. This is an initial step to progress research and practice in this area, describing the importance of a health )] TJ ET BT 31.875 255.093 Td /F1 9.8 Tf [(systems approach to disaster management, and providing evidence to be used in developing policy and practice.)] TJ ET BT 26.250 176.971 Td /F4 12.0 Tf [(Competing interests)] TJ ET BT 26.250 157.016 Td /F1 9.8 Tf [(The author has declared that no competing interests exist.)] TJ ET BT 26.250 120.414 Td /F4 12.0 Tf [(Acknowledgements)] TJ ET BT 26.250 100.460 Td /F1 9.8 Tf [( Dr Claire Bayntun is grateful to be funded by NIHR as an Academic Clinical Fellow in Public Health. The Department of )] TJ ET BT 26.250 88.555 Td /F1 9.8 Tf [(Primary Care & Public Health at Imperial College London is grateful for support from the NIHR Collaboration for Leadership in )] TJ ET BT 26.250 76.650 Td /F1 9.8 Tf [(Applied Health Research & Care \(CLAHRC\) Scheme, the NIHR Biomedical Research Centre scheme, and the Imperial Centre )] TJ ET BT 26.250 64.745 Td /F1 9.8 Tf [(for Patient Safety and Service Quality. Dr Thomas Marrs, Clinical Research Fellow second reviewer. Professor Virginia )] TJ ET BT 26.250 52.841 Td /F1 9.8 Tf [(Murray guidance and editing of draft.)] TJ ET Q q 15.000 13.308 577.500 763.692 re W n 0.271 0.267 0.267 rg BT 26.250 767.476 Td /F1 9.8 Tf [(that are pertinent to the aim of this review, including the type of evidence presented by the publications, such as case report. )] TJ ET BT 26.250 755.571 Td /F1 9.8 Tf [(The use of peer-reviewed core journals from 2000 to 2011 establishes a quality standard on the otherwise diverse formats of )] TJ ET BT 26.250 743.667 Td /F1 9.8 Tf [(the reviewed publications, while allowing the identified disaster management material to be up-to-date.)] TJ ET BT 26.250 724.262 Td /F4 9.8 Tf [(Bias.)] TJ ET BT 49.552 724.262 Td /F1 9.8 Tf [( Bias is inherent to some of the individual documents reviewed due to the variety of formats included, such as opinion )] TJ ET BT 26.250 712.357 Td /F1 9.8 Tf [(pieces and letters to journals. The qualitative nature of the documents means that this bias does not reduce the validity of each )] TJ ET BT 26.250 700.452 Td /F1 9.8 Tf [(document for inclusion in the review, as they expose important areas of controversy and present pertinent, all be it often )] TJ ET BT 26.250 688.548 Td /F1 9.8 Tf [(specific, experiences from the field. The nature of disasters means that most will not happen again in precisely the same way, )] TJ ET BT 26.250 676.643 Td /F1 9.8 Tf [(so each experience and related lessons warrant consideration in their contribution to a health system strengthening approach to )] TJ ET BT 26.250 664.738 Td /F1 9.8 Tf [(disaster management.)] TJ ET BT 26.250 645.333 Td /F1 9.8 Tf [(Overall, this review shows that much of disaster management research and commentary is taking place in the United States )] TJ ET BT 26.250 633.429 Td /F1 9.8 Tf [(\(USA\), which is progressive in disaster management funding, theory, and institutions. Thus, a significant portion of the literature )] TJ ET BT 26.250 621.524 Td /F1 9.8 Tf [(reviewed is USA-centric and reflects the availability of resources found only in the developed world. The disconnected nature of )] TJ ET BT 26.250 609.619 Td /F1 9.8 Tf [(health disaster management in the USA means that much of the planning and resources have been implemented within )] TJ ET BT 26.250 597.714 Td /F1 9.8 Tf [(isolation )] TJ ET 0.267 0.267 0.267 rg BT 64.724 599.222 Td /F4 8.7 Tf [(13)] TJ ET 0.271 0.267 0.267 rg BT 74.361 597.714 Td /F1 9.8 Tf [( , thus the literature generated is illuminating for all countries. This highlights the limitations and additional obstacles )] TJ ET BT 26.250 585.810 Td /F1 9.8 Tf [(of not employing a health system wide approach.)] TJ ET BT 26.250 566.405 Td /F1 9.8 Tf [(A bias to the literature selection is that this review did not include documents from the grey literature. Instead, the objective was )] TJ ET BT 26.250 554.500 Td /F1 9.8 Tf [(to establish whether the academic literature supported the objectives of the World Health Assembly resolution. I expect that )] TJ ET BT 26.250 542.595 Td /F1 9.8 Tf [(inclusion of the grey literature would result in a less USA-centric view of disasters and management structures. An analysis of )] TJ ET BT 26.250 530.691 Td /F1 9.8 Tf [(the wider relevant literature would be a worthwhile progression of this work.)] TJ ET BT 26.250 511.286 Td /F4 9.8 Tf [(Implications for Public Health policy and practice.)] TJ ET BT 257.072 511.286 Td /F1 9.8 Tf [( The Summary Table of Reviewed Papers \(Appendix 2\) collates a diverse )] TJ ET BT 26.250 499.381 Td /F1 9.8 Tf [(range of worldwide disaster experiences and identifies the specific literature which can provide valuable lessons. Professionals )] TJ ET BT 26.250 487.476 Td /F1 9.8 Tf [(concerned with disaster management from around the world can use this review to identify developments to be made across all )] TJ ET BT 26.250 475.572 Td /F1 9.8 Tf [(health system levers to enhance their preparedness and resilience to all-hazards disasters. This collation is important as much )] TJ ET BT 26.250 463.667 Td /F1 9.8 Tf [(of the health system literature ignores the need to incorporate disaster planning and management.)] TJ ET BT 26.250 444.262 Td /F1 9.8 Tf [(This initial exploration provides scope for development. A holistic health system approach to all-hazards disaster management )] TJ ET BT 26.250 432.357 Td /F1 9.8 Tf [(should reduce resource duplication at every phase of disaster management, maximise human and capital investment, optimise )] TJ ET BT 26.250 420.453 Td /F1 9.8 Tf [(immediate and long term health outcomes, and prevent set-backs to a health system in the wake of a disaster )] TJ ET 0.267 0.267 0.267 rg BT 501.514 421.960 Td /F4 8.7 Tf [(14)] TJ ET 0.271 0.267 0.267 rg BT 511.151 420.453 Td /F1 9.8 Tf [( . Future health )] TJ ET BT 26.250 408.548 Td /F1 9.8 Tf [(system research must address the issue of disaster management in response to the call made by this World Health Assembly )] TJ ET BT 26.250 396.643 Td /F1 9.8 Tf [(resolution in May 2011. Evaluation methods need to be developed and conducted. Issues of practical implementation must be )] TJ ET BT 26.250 384.738 Td /F1 9.8 Tf [(clarified so that priorities can be established, such as how to incorporate disaster management across local, national and )] TJ ET BT 26.250 372.834 Td /F1 9.8 Tf [(regional levels to produce an integrated health system. Panel 3 provides a summary of how this paper aims to progress policy )] TJ ET BT 26.250 360.929 Td /F1 9.8 Tf [(and practice.)] TJ ET q 26.250 337.312 555.000 13.736 re W n 0.271 0.267 0.267 rg BT 26.250 340.059 Td /F1 9.8 Tf [(Panel 3 Key Messages)] TJ ET Q 1.000 1.000 1.000 rg 26.250 248.692 555.000 81.120 re f 0.267 0.267 0.267 rg 26.625 328.687 554.250 0.750 re f 26.625 249.067 554.250 0.750 re f 26.625 249.067 0.750 80.370 re f 580.125 249.067 0.750 80.370 re f 0.271 0.267 0.267 rg BT 31.875 316.471 Td /F1 9.8 Tf [( The World Health Assembly adopted a resolution on this issue in 2011 )] TJ ET 0.267 0.267 0.267 rg BT 344.177 316.920 Td /F4 8.7 Tf [(1)] TJ ET 0.271 0.267 0.267 rg BT 348.996 316.471 Td /F1 9.8 Tf [( with the aim to promote a health systems approach )] TJ ET BT 31.875 308.250 Td /F1 9.8 Tf [(to disaster management to build resilience in the face of all-hazards disasters.)] TJ ET BT 31.875 293.118 Td /F1 9.8 Tf [( This systematic review of the core literature shows that a holistic health system approach to disaster management has not )] TJ ET BT 31.875 285.487 Td /F1 9.8 Tf [(yet been adopted and there are no evaluations of the approach.)] TJ ET BT 31.875 270.356 Td /F1 9.8 Tf [( It provides a collation of the worldwide experience of disaster management as described in the core literature in the period )] TJ ET BT 31.875 262.725 Td /F1 9.8 Tf [(2000 to 2011. This is an initial step to progress research and practice in this area, describing the importance of a health )] TJ ET BT 31.875 255.093 Td /F1 9.8 Tf [(systems approach to disaster management, and providing evidence to be used in developing policy and practice.)] TJ ET BT 26.250 176.971 Td /F4 12.0 Tf [(Competing interests)] TJ ET BT 26.250 157.016 Td /F1 9.8 Tf [(The author has declared that no competing interests exist.)] TJ ET BT 26.250 120.414 Td /F4 12.0 Tf [(Acknowledgements)] TJ ET BT 26.250 100.460 Td /F1 9.8 Tf [( Dr Claire Bayntun is grateful to be funded by NIHR as an Academic Clinical Fellow in Public Health. The Department of )] TJ ET BT 26.250 88.555 Td /F1 9.8 Tf [(Primary Care & Public Health at Imperial College London is grateful for support from the NIHR Collaboration for Leadership in )] TJ ET BT 26.250 76.650 Td /F1 9.8 Tf [(Applied Health Research & Care \(CLAHRC\) Scheme, the NIHR Biomedical Research Centre scheme, and the Imperial Centre )] TJ ET BT 26.250 64.745 Td /F1 9.8 Tf [(for Patient Safety and Service Quality. Dr Thomas Marrs, Clinical Research Fellow second reviewer. Professor Virginia )] TJ ET BT 26.250 52.841 Td /F1 9.8 Tf [(Murray guidance and editing of draft.)] TJ ET Q q 0.000 0.000 0.000 rg BT 291.710 19.825 Td /F1 11.0 Tf [(5)] TJ ET BT 25.000 19.825 Td /F1 11.0 Tf [(PLOS Currents Disasters)] TJ ET Q endstream endobj 199 0 obj << /Type /Annot /Subtype /Link /A 200 0 R /Border [0 0 0] /H /I /Rect [ 64.7235 598.4199 74.3608 607.2382 ] >> endobj 200 0 obj << /Type /Action >> endobj 201 0 obj << /Type /Annot /Subtype /Link /A 202 0 R /Border [0 0 0] /H /I /Rect [ 501.5138 421.1582 511.1511 429.9765 ] >> endobj 202 0 obj << /Type /Action >> endobj 203 0 obj << /Type /Annot /Subtype /Link /A 204 0 R /Border [0 0 0] /H /I /Rect [ 344.1773 316.1184 348.9959 324.9367 ] >> endobj 204 0 obj << /Type /Action >> endobj 205 0 obj << /Type /Annot /Subtype /Link /A 206 0 R /Border [0 0 0] /H /I /Rect [ 64.7235 598.4199 74.3608 607.2382 ] >> endobj 206 0 obj << /Type /Action >> endobj 207 0 obj << /Type /Annot /Subtype /Link /A 208 0 R /Border [0 0 0] /H /I 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26.250 713.126 Td /F4 12.0 Tf [(Quality appraisal criteria \(Harden et al., 2004\))] TJ ET 0.271 0.267 0.267 RG 40.337 696.140 m 40.337 696.586 40.154 697.030 39.838 697.346 c 39.522 697.662 39.078 697.846 38.631 697.846 c 38.185 697.846 37.741 697.662 37.425 697.346 c 37.109 697.030 36.925 696.586 36.925 696.140 c 36.925 695.693 37.109 695.249 37.425 694.933 c 37.741 694.617 38.185 694.434 38.631 694.434 c 39.078 694.434 39.522 694.617 39.838 694.933 c 40.154 695.249 40.337 695.693 40.337 696.140 c f BT 45.750 693.172 Td /F1 9.8 Tf [(An explicit theoretical framework and/or literature review)] TJ ET 40.337 680.485 m 40.337 680.932 40.154 681.376 39.838 681.692 c 39.522 682.007 39.078 682.191 38.631 682.191 c 38.185 682.191 37.741 682.007 37.425 681.692 c 37.109 681.376 36.925 680.932 36.925 680.485 c 36.925 680.038 37.109 679.594 37.425 679.278 c 37.741 678.963 38.185 678.779 38.631 678.779 c 39.078 678.779 39.522 678.963 39.838 679.278 c 40.154 679.594 40.337 680.038 40.337 680.485 c f BT 45.750 677.517 Td /F1 9.8 Tf [(Aims and objectives clearly stated)] TJ ET 40.337 664.830 m 40.337 665.277 40.154 665.721 39.838 666.037 c 39.522 666.353 39.078 666.536 38.631 666.536 c 38.185 666.536 37.741 666.353 37.425 666.037 c 37.109 665.721 36.925 665.277 36.925 664.830 c 36.925 664.384 37.109 663.940 37.425 663.624 c 37.741 663.308 38.185 663.124 38.631 663.124 c 39.078 663.124 39.522 663.308 39.838 663.624 c 40.154 663.940 40.337 664.384 40.337 664.830 c f BT 45.750 661.863 Td /F1 9.8 Tf [(A clear description of context)] TJ ET 40.337 649.175 m 40.337 649.622 40.154 650.066 39.838 650.382 c 39.522 650.698 39.078 650.882 38.631 650.882 c 38.185 650.882 37.741 650.698 37.425 650.382 c 37.109 650.066 36.925 649.622 36.925 649.175 c 36.925 648.729 37.109 648.285 37.425 647.969 c 37.741 647.653 38.185 647.469 38.631 647.469 c 39.078 647.469 39.522 647.653 39.838 647.969 c 40.154 648.285 40.337 648.729 40.337 649.175 c f BT 45.750 646.208 Td /F1 9.8 Tf [(A clear description of 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Td /F1 9.8 Tf [(Attempts made to establish the reliability or validity of data/\(information\) analysis)] TJ ET 40.337 602.211 m 40.337 602.658 40.154 603.102 39.838 603.418 c 39.522 603.734 39.078 603.917 38.631 603.917 c 38.185 603.917 37.741 603.734 37.425 603.418 c 37.109 603.102 36.925 602.658 36.925 602.211 c 36.925 601.765 37.109 601.321 37.425 601.005 c 37.741 600.689 38.185 600.505 38.631 600.505 c 39.078 600.505 39.522 600.689 39.838 601.005 c 40.154 601.321 40.337 601.765 40.337 602.211 c f BT 45.750 599.244 Td /F1 9.8 Tf [(Inclusion of sufficient original data/\(primary source information\) to mediate between evidence and interpretation)] TJ ET 40.337 586.556 m 40.337 587.003 40.154 587.447 39.838 587.763 c 39.522 588.079 39.078 588.263 38.631 588.263 c 38.185 588.263 37.741 588.079 37.425 587.763 c 37.109 587.447 36.925 587.003 36.925 586.556 c 36.925 586.110 37.109 585.666 37.425 585.350 c 37.741 585.034 38.185 584.850 38.631 584.850 c 39.078 584.850 39.522 585.034 39.838 585.350 c 40.154 585.666 40.337 586.110 40.337 586.556 c f BT 45.750 583.589 Td /F1 9.8 Tf [(Other comments)] TJ ET BT 26.250 543.236 Td /F4 12.0 Tf [(APPENDIX 2)] TJ ET BT 26.250 506.084 Td /F4 12.0 Tf [(PRISMA checklist, Matrix template and Summary table of reviewed articles)] TJ ET BT 26.250 486.130 Td /F1 9.8 Tf [(Appendices including the PRISMA checklist, the Matrix template and the Summary table of the reviewed articles are available )] TJ ET BT 26.250 474.225 Td /F1 9.8 Tf [(here:)] TJ ET BT 26.250 454.821 Td /F1 9.8 Tf [(https://figshare.com/articles/Appendices_-_A_health_system_approach_to_all-)] TJ ET BT 26.250 442.916 Td /F1 9.8 Tf [(hazards_disaster_management:_A_systematic_review/93444)] TJ ET BT 26.250 406.313 Td /F4 12.0 Tf [(References)] TJ ET BT 26.250 378.859 Td /F1 9.8 Tf [(1.)] TJ ET BT 38.132 378.859 Td /F1 9.8 Tf [(World Health Assembly. \(2011\) 64th World Health Assembly Agenda item 13.4 - Strengthening national health emergency )] TJ ET BT 26.250 366.954 Td /F1 9.8 Tf [(and disaster management capacities and resilience of health systems. [Online] Available from: )] TJ ET BT 26.250 355.050 Td /F1 9.8 Tf [(https://apps.who.int/gb/ebwha/pdf_files/WHA64/A64_R10-en.pdf [Accessed 22 Dec 2011].)] TJ ET BT 26.250 335.645 Td /F1 9.8 Tf [(2.)] TJ ET BT 38.132 335.645 Td /F1 9.8 Tf [(WHO. \(2007\) Everybody's business. Strengthening health systems to improve health outcomes : WHOs framework for )] TJ ET BT 26.250 323.740 Td /F1 9.8 Tf [(action. . [Online] Available from: https://www.who.int/healthsystems/strategy/everybodys_business.pdf [Accessed July 2011].)] TJ ET BT 26.250 304.335 Td /F1 9.8 Tf [(3.)] TJ ET BT 38.132 304.335 Td /F1 9.8 Tf [(WHO. World Health Report 2000. 2000.)] TJ ET BT 26.250 284.931 Td /F1 9.8 Tf [(4.)] TJ ET BT 38.132 284.931 Td /F1 9.8 Tf [(Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting )] TJ ET BT 26.250 273.026 Td /F1 9.8 Tf [(systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. )] TJ ET BT 26.250 261.121 Td /F1 9.8 Tf [(PLoS.Med. 2009;6\(7\):e1000100.)] TJ ET BT 26.250 241.716 Td /F1 9.8 Tf [(5.)] TJ ET BT 38.132 241.716 Td /F1 9.8 Tf [(Global Assessment of National Health Sector Emergency Preparedness and Response. ; 2008.)] TJ ET BT 26.250 222.312 Td /F1 9.8 Tf [(6.)] TJ ET BT 38.132 222.312 Td /F1 9.8 Tf [(Harden A, Garcia J, Oliver S, Rees R, Shepherd J, Brunton G, et al. Applying systematic review methods to studies of )] TJ ET BT 26.250 210.407 Td /F1 9.8 Tf [(peoples views: an example from public health research. Epidemiology & Community Health 2004;58:794-800.)] TJ ET BT 26.250 191.002 Td /F1 9.8 Tf [(7.)] TJ ET BT 38.132 191.002 Td /F1 9.8 Tf [(Savoia E, Massin-Short SB, Rodday AM, Aaron LA, Higdon MA, Stoto MA. Public health systems research in emergency )] TJ ET BT 26.250 179.097 Td /F1 9.8 Tf [(preparedness: a review of the literature. Am J Prev Med. 2009;Aug;37\(2\):150-6.)] TJ ET BT 26.250 159.693 Td /F1 9.8 Tf [(8.)] TJ ET BT 38.132 159.693 Td /F1 9.8 Tf [(Revere D, Nelson K, Thiede H, Duchin J, Stergachis A, Baseman J. Public health emergency preparedness and response )] TJ ET BT 26.250 147.788 Td /F1 9.8 Tf [(communications with health care providers: a literature review. BMC Public Health. 2011;11:337)] TJ ET BT 26.250 128.383 Td /F1 9.8 Tf [(9.)] TJ ET BT 38.132 128.383 Td /F1 9.8 Tf [(Potter MA, Miner KR, Barnett DJ, Cadigan R, Lloyd L, Olson DK, et al. The evidence base for effectiveness of preparedness )] TJ ET BT 26.250 116.478 Td /F1 9.8 Tf [(training: a retrospective analysis. Public Health Rep 2010 Nov-Dec;125\(Suppl 5\):15-23.)] TJ ET BT 26.250 97.074 Td /F1 9.8 Tf [(10.)] TJ ET BT 43.553 97.074 Td /F1 9.8 Tf [(Auf der Heide E. The importance of evidence-based disaster planning. Ann Emerg Med. 2006;Jan;47\(1\):34-49.)] TJ ET BT 26.250 77.669 Td /F1 9.8 Tf [(11.)] TJ ET BT 43.553 77.669 Td /F1 9.8 Tf [(Bayntun C, Rockenschaub G, Murray V. Developing a health system approach to disaster management: A qualitative )] TJ ET BT 26.250 65.764 Td /F1 9.8 Tf [(analysis of the core literature to complement the WHO Toolkit for assessing health-system capacity for crisis management. )] TJ ET BT 26.250 53.859 Td /F1 9.8 Tf [(PLOS Currents Disasters. 2012 Aug 22. doi: 10.1371/5028b6037259a.)] TJ ET Q q 15.000 43.979 577.500 733.021 re W n 0.271 0.267 0.267 rg BT 26.250 750.278 Td /F4 12.0 Tf [(APPENDIX 1)] TJ ET BT 26.250 713.126 Td /F4 12.0 Tf [(Quality appraisal criteria \(Harden et al., 2004\))] TJ ET 0.271 0.267 0.267 RG 40.337 696.140 m 40.337 696.586 40.154 697.030 39.838 697.346 c 39.522 697.662 39.078 697.846 38.631 697.846 c 38.185 697.846 37.741 697.662 37.425 697.346 c 37.109 697.030 36.925 696.586 36.925 696.140 c 36.925 695.693 37.109 695.249 37.425 694.933 c 37.741 694.617 38.185 694.434 38.631 694.434 c 39.078 694.434 39.522 694.617 39.838 694.933 c 40.154 695.249 40.337 695.693 40.337 696.140 c f BT 45.750 693.172 Td /F1 9.8 Tf [(An explicit theoretical framework and/or literature review)] TJ ET 40.337 680.485 m 40.337 680.932 40.154 681.376 39.838 681.692 c 39.522 682.007 39.078 682.191 38.631 682.191 c 38.185 682.191 37.741 682.007 37.425 681.692 c 37.109 681.376 36.925 680.932 36.925 680.485 c 36.925 680.038 37.109 679.594 37.425 679.278 c 37.741 678.963 38.185 678.779 38.631 678.779 c 39.078 678.779 39.522 678.963 39.838 679.278 c 40.154 679.594 40.337 680.038 40.337 680.485 c f BT 45.750 677.517 Td /F1 9.8 Tf [(Aims and objectives clearly stated)] TJ ET 40.337 664.830 m 40.337 665.277 40.154 665.721 39.838 666.037 c 39.522 666.353 39.078 666.536 38.631 666.536 c 38.185 666.536 37.741 666.353 37.425 666.037 c 37.109 665.721 36.925 665.277 36.925 664.830 c 36.925 664.384 37.109 663.940 37.425 663.624 c 37.741 663.308 38.185 663.124 38.631 663.124 c 39.078 663.124 39.522 663.308 39.838 663.624 c 40.154 663.940 40.337 664.384 40.337 664.830 c f BT 45.750 661.863 Td /F1 9.8 Tf [(A clear description of context)] TJ ET 40.337 649.175 m 40.337 649.622 40.154 650.066 39.838 650.382 c 39.522 650.698 39.078 650.882 38.631 650.882 c 38.185 650.882 37.741 650.698 37.425 650.382 c 37.109 650.066 36.925 649.622 36.925 649.175 c 36.925 648.729 37.109 648.285 37.425 647.969 c 37.741 647.653 38.185 647.469 38.631 647.469 c 39.078 647.469 39.522 647.653 39.838 647.969 c 40.154 648.285 40.337 648.729 40.337 649.175 c f BT 45.750 646.208 Td /F1 9.8 Tf [(A clear description of the sample and how it was recruited \(may not be relevant\))] TJ ET 40.337 633.521 m 40.337 633.967 40.154 634.411 39.838 634.727 c 39.522 635.043 39.078 635.227 38.631 635.227 c 38.185 635.227 37.741 635.043 37.425 634.727 c 37.109 634.411 36.925 633.967 36.925 633.521 c 36.925 633.074 37.109 632.630 37.425 632.314 c 37.741 631.998 38.185 631.814 38.631 631.814 c 39.078 631.814 39.522 631.998 39.838 632.314 c 40.154 632.630 40.337 633.074 40.337 633.521 c f BT 45.750 630.553 Td /F1 9.8 Tf [(A clear description of methods used to collect and analyse data/\(information\).)] TJ ET 40.337 617.866 m 40.337 618.313 40.154 618.757 39.838 619.073 c 39.522 619.388 39.078 619.572 38.631 619.572 c 38.185 619.572 37.741 619.388 37.425 619.073 c 37.109 618.757 36.925 618.313 36.925 617.866 c 36.925 617.419 37.109 616.975 37.425 616.659 c 37.741 616.344 38.185 616.160 38.631 616.160 c 39.078 616.160 39.522 616.344 39.838 616.659 c 40.154 616.975 40.337 617.419 40.337 617.866 c f BT 45.750 614.898 Td /F1 9.8 Tf [(Attempts made to establish the reliability or validity of data/\(information\) analysis)] TJ ET 40.337 602.211 m 40.337 602.658 40.154 603.102 39.838 603.418 c 39.522 603.734 39.078 603.917 38.631 603.917 c 38.185 603.917 37.741 603.734 37.425 603.418 c 37.109 603.102 36.925 602.658 36.925 602.211 c 36.925 601.765 37.109 601.321 37.425 601.005 c 37.741 600.689 38.185 600.505 38.631 600.505 c 39.078 600.505 39.522 600.689 39.838 601.005 c 40.154 601.321 40.337 601.765 40.337 602.211 c f BT 45.750 599.244 Td /F1 9.8 Tf [(Inclusion of sufficient original data/\(primary source information\) to mediate between evidence and interpretation)] TJ ET 40.337 586.556 m 40.337 587.003 40.154 587.447 39.838 587.763 c 39.522 588.079 39.078 588.263 38.631 588.263 c 38.185 588.263 37.741 588.079 37.425 587.763 c 37.109 587.447 36.925 587.003 36.925 586.556 c 36.925 586.110 37.109 585.666 37.425 585.350 c 37.741 585.034 38.185 584.850 38.631 584.850 c 39.078 584.850 39.522 585.034 39.838 585.350 c 40.154 585.666 40.337 586.110 40.337 586.556 c f BT 45.750 583.589 Td /F1 9.8 Tf [(Other comments)] TJ ET BT 26.250 543.236 Td /F4 12.0 Tf [(APPENDIX 2)] TJ ET BT 26.250 506.084 Td /F4 12.0 Tf [(PRISMA checklist, Matrix template and Summary table of reviewed articles)] TJ ET BT 26.250 486.130 Td /F1 9.8 Tf [(Appendices including the PRISMA checklist, the Matrix template and the Summary table of the reviewed articles are available )] TJ ET BT 26.250 474.225 Td /F1 9.8 Tf [(here:)] TJ ET BT 26.250 454.821 Td /F1 9.8 Tf [(https://figshare.com/articles/Appendices_-_A_health_system_approach_to_all-)] TJ ET BT 26.250 442.916 Td /F1 9.8 Tf [(hazards_disaster_management:_A_systematic_review/93444)] TJ ET BT 26.250 406.313 Td /F4 12.0 Tf [(References)] TJ ET BT 26.250 378.859 Td /F1 9.8 Tf [(1.)] TJ ET BT 38.132 378.859 Td /F1 9.8 Tf [(World Health Assembly. \(2011\) 64th World Health Assembly Agenda item 13.4 - Strengthening national health emergency )] TJ ET BT 26.250 366.954 Td /F1 9.8 Tf [(and disaster management capacities and resilience of health systems. [Online] Available from: )] TJ ET BT 26.250 355.050 Td /F1 9.8 Tf [(https://apps.who.int/gb/ebwha/pdf_files/WHA64/A64_R10-en.pdf [Accessed 22 Dec 2011].)] TJ ET BT 26.250 335.645 Td /F1 9.8 Tf [(2.)] TJ ET BT 38.132 335.645 Td /F1 9.8 Tf [(WHO. \(2007\) Everybody's business. Strengthening health systems to improve health outcomes : WHOs framework for )] TJ ET BT 26.250 323.740 Td /F1 9.8 Tf [(action. . [Online] Available from: https://www.who.int/healthsystems/strategy/everybodys_business.pdf [Accessed July 2011].)] TJ ET BT 26.250 304.335 Td /F1 9.8 Tf [(3.)] TJ ET BT 38.132 304.335 Td /F1 9.8 Tf [(WHO. World Health Report 2000. 2000.)] TJ ET BT 26.250 284.931 Td /F1 9.8 Tf [(4.)] TJ ET BT 38.132 284.931 Td /F1 9.8 Tf [(Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting )] TJ ET BT 26.250 273.026 Td /F1 9.8 Tf [(systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. )] TJ ET BT 26.250 261.121 Td /F1 9.8 Tf [(PLoS.Med. 2009;6\(7\):e1000100.)] TJ ET BT 26.250 241.716 Td /F1 9.8 Tf [(5.)] TJ ET BT 38.132 241.716 Td /F1 9.8 Tf [(Global Assessment of National Health Sector Emergency Preparedness and Response. ; 2008.)] TJ ET BT 26.250 222.312 Td /F1 9.8 Tf [(6.)] TJ ET BT 38.132 222.312 Td /F1 9.8 Tf [(Harden A, Garcia J, Oliver S, Rees R, Shepherd J, Brunton G, et al. Applying systematic review methods to studies of )] TJ ET BT 26.250 210.407 Td /F1 9.8 Tf [(peoples views: an example from public health research. Epidemiology & Community Health 2004;58:794-800.)] TJ ET BT 26.250 191.002 Td /F1 9.8 Tf [(7.)] TJ ET BT 38.132 191.002 Td /F1 9.8 Tf [(Savoia E, Massin-Short SB, Rodday AM, Aaron LA, Higdon MA, Stoto MA. Public health systems research in emergency )] TJ ET BT 26.250 179.097 Td /F1 9.8 Tf [(preparedness: a review of the literature. Am J Prev Med. 2009;Aug;37\(2\):150-6.)] TJ ET BT 26.250 159.693 Td /F1 9.8 Tf [(8.)] TJ ET BT 38.132 159.693 Td /F1 9.8 Tf [(Revere D, Nelson K, Thiede H, Duchin J, Stergachis A, Baseman J. Public health emergency preparedness and response )] TJ ET BT 26.250 147.788 Td /F1 9.8 Tf [(communications with health care providers: a literature review. BMC Public Health. 2011;11:337)] TJ ET BT 26.250 128.383 Td /F1 9.8 Tf [(9.)] TJ ET BT 38.132 128.383 Td /F1 9.8 Tf [(Potter MA, Miner KR, Barnett DJ, Cadigan R, Lloyd L, Olson DK, et al. The evidence base for effectiveness of preparedness )] TJ ET BT 26.250 116.478 Td /F1 9.8 Tf [(training: a retrospective analysis. Public Health Rep 2010 Nov-Dec;125\(Suppl 5\):15-23.)] TJ ET BT 26.250 97.074 Td /F1 9.8 Tf [(10.)] TJ ET BT 43.553 97.074 Td /F1 9.8 Tf [(Auf der Heide E. The importance of evidence-based disaster planning. Ann Emerg Med. 2006;Jan;47\(1\):34-49.)] TJ ET BT 26.250 77.669 Td /F1 9.8 Tf [(11.)] TJ ET BT 43.553 77.669 Td /F1 9.8 Tf [(Bayntun C, Rockenschaub G, Murray V. Developing a health system approach to disaster management: A qualitative )] TJ ET BT 26.250 65.764 Td /F1 9.8 Tf [(analysis of the core literature to complement the WHO Toolkit for assessing health-system capacity for crisis management. )] TJ ET BT 26.250 53.859 Td /F1 9.8 Tf [(PLOS Currents Disasters. 2012 Aug 22. doi: 10.1371/5028b6037259a.)] TJ ET Q q 15.000 43.979 577.500 733.021 re W n 0.271 0.267 0.267 rg BT 26.250 750.278 Td /F4 12.0 Tf [(APPENDIX 1)] TJ ET BT 26.250 713.126 Td /F4 12.0 Tf [(Quality appraisal criteria \(Harden et al., 2004\))] TJ ET 0.271 0.267 0.267 RG 40.337 696.140 m 40.337 696.586 40.154 697.030 39.838 697.346 c 39.522 697.662 39.078 697.846 38.631 697.846 c 38.185 697.846 37.741 697.662 37.425 697.346 c 37.109 697.030 36.925 696.586 36.925 696.140 c 36.925 695.693 37.109 695.249 37.425 694.933 c 37.741 694.617 38.185 694.434 38.631 694.434 c 39.078 694.434 39.522 694.617 39.838 694.933 c 40.154 695.249 40.337 695.693 40.337 696.140 c f BT 45.750 693.172 Td /F1 9.8 Tf [(An explicit theoretical framework and/or literature review)] TJ ET 40.337 680.485 m 40.337 680.932 40.154 681.376 39.838 681.692 c 39.522 682.007 39.078 682.191 38.631 682.191 c 38.185 682.191 37.741 682.007 37.425 681.692 c 37.109 681.376 36.925 680.932 36.925 680.485 c 36.925 680.038 37.109 679.594 37.425 679.278 c 37.741 678.963 38.185 678.779 38.631 678.779 c 39.078 678.779 39.522 678.963 39.838 679.278 c 40.154 679.594 40.337 680.038 40.337 680.485 c f BT 45.750 677.517 Td /F1 9.8 Tf [(Aims and objectives clearly stated)] TJ ET 40.337 664.830 m 40.337 665.277 40.154 665.721 39.838 666.037 c 39.522 666.353 39.078 666.536 38.631 666.536 c 38.185 666.536 37.741 666.353 37.425 666.037 c 37.109 665.721 36.925 665.277 36.925 664.830 c 36.925 664.384 37.109 663.940 37.425 663.624 c 37.741 663.308 38.185 663.124 38.631 663.124 c 39.078 663.124 39.522 663.308 39.838 663.624 c 40.154 663.940 40.337 664.384 40.337 664.830 c f BT 45.750 661.863 Td /F1 9.8 Tf [(A clear description of context)] TJ ET 40.337 649.175 m 40.337 649.622 40.154 650.066 39.838 650.382 c 39.522 650.698 39.078 650.882 38.631 650.882 c 38.185 650.882 37.741 650.698 37.425 650.382 c 37.109 650.066 36.925 649.622 36.925 649.175 c 36.925 648.729 37.109 648.285 37.425 647.969 c 37.741 647.653 38.185 647.469 38.631 647.469 c 39.078 647.469 39.522 647.653 39.838 647.969 c 40.154 648.285 40.337 648.729 40.337 649.175 c f BT 45.750 646.208 Td /F1 9.8 Tf [(A clear description of the sample and how it was recruited \(may not be relevant\))] TJ ET 40.337 633.521 m 40.337 633.967 40.154 634.411 39.838 634.727 c 39.522 635.043 39.078 635.227 38.631 635.227 c 38.185 635.227 37.741 635.043 37.425 634.727 c 37.109 634.411 36.925 633.967 36.925 633.521 c 36.925 633.074 37.109 632.630 37.425 632.314 c 37.741 631.998 38.185 631.814 38.631 631.814 c 39.078 631.814 39.522 631.998 39.838 632.314 c 40.154 632.630 40.337 633.074 40.337 633.521 c f BT 45.750 630.553 Td /F1 9.8 Tf [(A clear description of methods used to collect and analyse data/\(information\).)] TJ ET 40.337 617.866 m 40.337 618.313 40.154 618.757 39.838 619.073 c 39.522 619.388 39.078 619.572 38.631 619.572 c 38.185 619.572 37.741 619.388 37.425 619.073 c 37.109 618.757 36.925 618.313 36.925 617.866 c 36.925 617.419 37.109 616.975 37.425 616.659 c 37.741 616.344 38.185 616.160 38.631 616.160 c 39.078 616.160 39.522 616.344 39.838 616.659 c 40.154 616.975 40.337 617.419 40.337 617.866 c f BT 45.750 614.898 Td /F1 9.8 Tf [(Attempts made to establish the reliability or validity of data/\(information\) analysis)] TJ ET 40.337 602.211 m 40.337 602.658 40.154 603.102 39.838 603.418 c 39.522 603.734 39.078 603.917 38.631 603.917 c 38.185 603.917 37.741 603.734 37.425 603.418 c 37.109 603.102 36.925 602.658 36.925 602.211 c 36.925 601.765 37.109 601.321 37.425 601.005 c 37.741 600.689 38.185 600.505 38.631 600.505 c 39.078 600.505 39.522 600.689 39.838 601.005 c 40.154 601.321 40.337 601.765 40.337 602.211 c f BT 45.750 599.244 Td /F1 9.8 Tf [(Inclusion of sufficient original data/\(primary source information\) to mediate between evidence and interpretation)] TJ ET 40.337 586.556 m 40.337 587.003 40.154 587.447 39.838 587.763 c 39.522 588.079 39.078 588.263 38.631 588.263 c 38.185 588.263 37.741 588.079 37.425 587.763 c 37.109 587.447 36.925 587.003 36.925 586.556 c 36.925 586.110 37.109 585.666 37.425 585.350 c 37.741 585.034 38.185 584.850 38.631 584.850 c 39.078 584.850 39.522 585.034 39.838 585.350 c 40.154 585.666 40.337 586.110 40.337 586.556 c f BT 45.750 583.589 Td /F1 9.8 Tf [(Other comments)] TJ ET BT 26.250 543.236 Td /F4 12.0 Tf [(APPENDIX 2)] TJ ET BT 26.250 506.084 Td /F4 12.0 Tf [(PRISMA checklist, Matrix template and Summary table of reviewed articles)] TJ ET BT 26.250 486.130 Td /F1 9.8 Tf [(Appendices including the PRISMA checklist, the Matrix template and the Summary table of the reviewed articles are available )] TJ ET BT 26.250 474.225 Td /F1 9.8 Tf [(here:)] TJ ET BT 26.250 454.821 Td /F1 9.8 Tf [(https://figshare.com/articles/Appendices_-_A_health_system_approach_to_all-)] TJ ET BT 26.250 442.916 Td /F1 9.8 Tf [(hazards_disaster_management:_A_systematic_review/93444)] TJ ET BT 26.250 406.313 Td /F4 12.0 Tf [(References)] TJ ET BT 26.250 378.859 Td /F1 9.8 Tf [(1.)] TJ ET BT 38.132 378.859 Td /F1 9.8 Tf [(World Health Assembly. \(2011\) 64th World Health Assembly Agenda item 13.4 - Strengthening national health emergency )] TJ ET BT 26.250 366.954 Td /F1 9.8 Tf [(and disaster management capacities and resilience of health systems. [Online] Available from: )] TJ ET BT 26.250 355.050 Td /F1 9.8 Tf [(https://apps.who.int/gb/ebwha/pdf_files/WHA64/A64_R10-en.pdf [Accessed 22 Dec 2011].)] TJ ET BT 26.250 335.645 Td /F1 9.8 Tf [(2.)] TJ ET BT 38.132 335.645 Td /F1 9.8 Tf [(WHO. \(2007\) Everybody's business. Strengthening health systems to improve health outcomes : WHOs framework for )] TJ ET BT 26.250 323.740 Td /F1 9.8 Tf [(action. . [Online] Available from: https://www.who.int/healthsystems/strategy/everybodys_business.pdf [Accessed July 2011].)] TJ ET BT 26.250 304.335 Td /F1 9.8 Tf [(3.)] TJ ET BT 38.132 304.335 Td /F1 9.8 Tf [(WHO. World Health Report 2000. 2000.)] TJ ET BT 26.250 284.931 Td /F1 9.8 Tf [(4.)] TJ ET BT 38.132 284.931 Td /F1 9.8 Tf [(Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting )] TJ ET BT 26.250 273.026 Td /F1 9.8 Tf [(systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. )] TJ ET BT 26.250 261.121 Td /F1 9.8 Tf [(PLoS.Med. 2009;6\(7\):e1000100.)] TJ ET BT 26.250 241.716 Td /F1 9.8 Tf [(5.)] TJ ET BT 38.132 241.716 Td /F1 9.8 Tf [(Global Assessment of National Health Sector Emergency Preparedness and Response. ; 2008.)] TJ ET BT 26.250 222.312 Td /F1 9.8 Tf [(6.)] TJ ET BT 38.132 222.312 Td /F1 9.8 Tf [(Harden A, Garcia J, Oliver S, Rees R, Shepherd J, Brunton G, et al. Applying systematic review methods to studies of )] TJ ET BT 26.250 210.407 Td /F1 9.8 Tf [(peoples views: an example from public health research. Epidemiology & Community Health 2004;58:794-800.)] TJ ET BT 26.250 191.002 Td /F1 9.8 Tf [(7.)] TJ ET BT 38.132 191.002 Td /F1 9.8 Tf [(Savoia E, Massin-Short SB, Rodday AM, Aaron LA, Higdon MA, Stoto MA. Public health systems research in emergency )] TJ ET BT 26.250 179.097 Td /F1 9.8 Tf [(preparedness: a review of the literature. Am J Prev Med. 2009;Aug;37\(2\):150-6.)] TJ ET BT 26.250 159.693 Td /F1 9.8 Tf [(8.)] TJ ET BT 38.132 159.693 Td /F1 9.8 Tf [(Revere D, Nelson K, Thiede H, Duchin J, Stergachis A, Baseman J. Public health emergency preparedness and response )] TJ ET BT 26.250 147.788 Td /F1 9.8 Tf [(communications with health care providers: a literature review. BMC Public Health. 2011;11:337)] TJ ET BT 26.250 128.383 Td /F1 9.8 Tf [(9.)] TJ ET BT 38.132 128.383 Td /F1 9.8 Tf [(Potter MA, Miner KR, Barnett DJ, Cadigan R, Lloyd L, Olson DK, et al. The evidence base for effectiveness of preparedness )] TJ ET BT 26.250 116.478 Td /F1 9.8 Tf [(training: a retrospective analysis. Public Health Rep 2010 Nov-Dec;125\(Suppl 5\):15-23.)] TJ ET BT 26.250 97.074 Td /F1 9.8 Tf [(10.)] TJ ET BT 43.553 97.074 Td /F1 9.8 Tf [(Auf der Heide E. The importance of evidence-based disaster planning. Ann Emerg Med. 2006;Jan;47\(1\):34-49.)] TJ ET BT 26.250 77.669 Td /F1 9.8 Tf [(11.)] TJ ET BT 43.553 77.669 Td /F1 9.8 Tf [(Bayntun C, Rockenschaub G, Murray V. Developing a health system approach to disaster management: A qualitative )] TJ ET BT 26.250 65.764 Td /F1 9.8 Tf [(analysis of the core literature to complement the WHO Toolkit for assessing health-system capacity for crisis management. )] TJ ET BT 26.250 53.859 Td /F1 9.8 Tf [(PLOS Currents Disasters. 2012 Aug 22. doi: 10.1371/5028b6037259a.)] TJ ET Q q 0.000 0.000 0.000 rg BT 291.710 19.825 Td /F1 11.0 Tf [(6)] TJ ET BT 25.000 19.825 Td /F1 11.0 Tf [(PLOS Currents Disasters)] TJ ET Q endstream endobj 219 0 obj << /Type /Page /Parent 3 0 R /Contents 220 0 R >> endobj 220 0 obj << /Length 3067 >> stream 0.271 0.267 0.267 rg 0.271 0.267 0.267 RG q 15.000 668.072 577.500 108.929 re W n 0.271 0.267 0.267 rg BT 26.250 759.976 Td /F1 9.8 Tf [(12.)] TJ ET BT 43.553 759.976 Td /F1 9.8 Tf [(WHO Regional Office for Europe. Strengthening health-system emergency preparedness: Toolkit for Assessing Health )] TJ ET BT 26.250 748.071 Td /F1 9.8 Tf [(System Capacity for Crisis Management . 2012; Available at: )] TJ ET BT 26.250 736.167 Td /F1 9.8 Tf [(www.euro.who.int/__data/assets/pdf_file/0008/157886/e96187.pdf.)] TJ ET BT 26.250 716.762 Td /F1 9.8 Tf [(13.)] TJ ET BT 43.553 716.762 Td /F1 9.8 Tf [(Kahn LH, Barondess JA. Preparing for disaster: Response matrices in the USA and UK. Journal of Urban Health 2008 )] TJ ET BT 26.250 704.857 Td /F1 9.8 Tf [(November 2008;85\(6\):910-922.)] TJ ET BT 26.250 685.452 Td /F1 9.8 Tf [(14.)] TJ ET BT 43.553 685.452 Td /F1 9.8 Tf [(Responding in a Crisis: The Role of National and International Health Workers Lessons from Haiti. : Merlin; 2010.)] TJ ET Q q 15.000 668.072 577.500 108.929 re W n 0.271 0.267 0.267 rg BT 26.250 759.976 Td /F1 9.8 Tf [(12.)] TJ ET BT 43.553 759.976 Td /F1 9.8 Tf [(WHO Regional Office for Europe. Strengthening health-system emergency preparedness: Toolkit for Assessing Health )] TJ ET BT 26.250 748.071 Td /F1 9.8 Tf [(System Capacity for Crisis Management . 2012; Available at: )] TJ ET BT 26.250 736.167 Td /F1 9.8 Tf [(www.euro.who.int/__data/assets/pdf_file/0008/157886/e96187.pdf.)] TJ ET BT 26.250 716.762 Td /F1 9.8 Tf [(13.)] TJ ET BT 43.553 716.762 Td /F1 9.8 Tf [(Kahn LH, Barondess JA. Preparing for disaster: Response matrices in the USA and UK. Journal of Urban Health 2008 )] TJ ET BT 26.250 704.857 Td /F1 9.8 Tf [(November 2008;85\(6\):910-922.)] TJ ET BT 26.250 685.452 Td /F1 9.8 Tf [(14.)] TJ ET BT 43.553 685.452 Td /F1 9.8 Tf [(Responding in a Crisis: The Role of National and International Health Workers Lessons from Haiti. : Merlin; 2010.)] TJ ET Q q 15.000 668.072 577.500 108.929 re W n 0.271 0.267 0.267 rg BT 26.250 759.976 Td /F1 9.8 Tf [(12.)] TJ ET BT 43.553 759.976 Td /F1 9.8 Tf [(WHO Regional Office for Europe. Strengthening health-system emergency preparedness: Toolkit for Assessing Health )] TJ ET BT 26.250 748.071 Td /F1 9.8 Tf [(System Capacity for Crisis Management . 2012; Available at: )] TJ ET BT 26.250 736.167 Td /F1 9.8 Tf [(www.euro.who.int/__data/assets/pdf_file/0008/157886/e96187.pdf.)] TJ ET BT 26.250 716.762 Td /F1 9.8 Tf [(13.)] TJ ET BT 43.553 716.762 Td /F1 9.8 Tf [(Kahn LH, Barondess JA. Preparing for disaster: Response matrices in the USA and UK. 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