Keyword: health systems

ABSTRACT: One of the major public health emergencies that has affected lives globally is infectious disease outbreaks. These issues are of great concern due to their potential to transcend borders. The control and management of such outbreaks even with the attention channelled towards it globally has been a difficult task in many developing and underdeveloped countries of the world of which the majority of sub-saharan african countries fall under. However, with this review, we aim to contribute to the body of knowledge dedicated towards control of infectious diseases by analyzing the preparedness of Sub-Saharan African (SSA) countries in managing infectious disease outbreaks based on lessons from recent outbreaks (with focus on COVID-19, Lassa fever and Ebola outbreaks). In carrying out this narrative review, we make use of PubMed and African Journals Online (AJOL) as the primary literature sources. To ensure we capture publications from reputable organizations that are solely involved in control of infectious diseases in the region, we carried out a grey literature search.
However in this review, we synthesized challenges such as weak healthcare systems, inadequate healthcare infrastructure, inefficient surveillance systems, poor data management and reporting practices, limited laboratory capacity and reliance on external donors for supplies during emergencies.
The review proposes potential interventional measures aimed at addressing these challenges aimed at enhancing the preparedness
The findings from this review provide critical insights into the preparedness gaps and potential interventions, informing policy and practice to enhance the region's resilience future outbreaks.

ABSTRACT: Background: Vaccination is one of the most effective public health interventions yet increasing numbers of unjustified medical exemptions in Kazakhstan threaten both herd immunity and public trust. In 2020 alone, over 208,000 temporary and 2,600 permanent exemptions were issued—often based on questionable clinical criteria. This study aims to explore the drivers behind the rising number of medical exemptions in Kazakhstan, with a particular focus on the perspectives and attitudes of healthcare professionals.
Methods: A qualitative approach was employed, combining a desk review of national immunization policies and statistical reports with 27 in-depth interviews conducted in 2021–2022. Participants included healthcare providers and public health experts across urban and rural regions of Kazakhstan. Thematic analysis was used to identify key patterns in the data. Relevant national regulations were also reviewed and compared with international standards.
Results: Thematic analysis revealed four major areas of concern: (1) inconsistencies in pre-vaccination monitoring practices, (2) variability in post-vaccination follow-up procedures, (3) divergent roles and responsibilities among stakeholders in granting medical exemptions, and (4) limitations in surveillance and data systems for tracking and verifying exemptions. Findings suggest that physician over-cautiousness, legal insecurity, parental pressure, and inconsistent training are key drivers of unnecessary exemptions. The overdiagnosis of precautionary conditions—particularly by specialists such as neurologists—further contributes to false contraindications. These practices erode vaccine confidence and create barriers to timely immunization.
Conclusion: Addressing the growing problem of unwarranted medical exemptions requires policy reform, clearer clinical guidelines, enhanced physician training, and improved digital monitoring systems. Strengthening these areas is essential for restoring public trust, reducing unjustified exemptions, and ensuring high vaccination coverage in Kazakhstan.