Coordination Effectiveness During Public Health Emergencies: An Institutional Collective Action Framework

• Published date: 01 August 2021
• DOI: 10.1177/0095399720985440
• Date: 01 August 2021
• Author: Julius A. Nukpezah,Ismail Soujaa,Abraham David Benavides
• Subject Matter: Articles

https://doi.org/10.1177/0095399720985440

Administration & Society

2021, Vol. 53(7) 1014 –1045

© The Author(s) 2021

Article reuse guidelines:

sagepub.com/journals-permissions

DOI: 10.1177/0095399720985440

journals.sagepub.com/home/aas

Article

Coordination

Effectiveness During

Public Health

Emergencies: An

Institutional Collective

Action Framework

Ismail Soujaa1, Julius A. Nukpezah2,

and Abraham David Benavides1

Abstract

This article draws on the institutional collective action (ICA) framework

and data from a survey of senior public health and emergency management

professionals in the Dallas–Fort Worth metroplex following the Ebola

outbreak to investigate coordination effectiveness during public health

emergencies. Based on the study findings, the article recommends that

having an identifiable lead agency, official statements from local authorities,

a conducive environment for informal conversations, and communication

activities that inform, connect, and involve professionals is essential for an

effective coordination. Practical implications of the study extend to how to

mitigate collective action dilemmas with regard to coordinating COVID-19

pandemic responses.

1University of North Texas, Denton, USA

2Mississippi State University, MS, USA

Corresponding Author:

Julius A. Nukpezah, Department of Political Science and Public Administration,

Mississippi State University, 104 Bowen Hall, 456 Hardy Rd., Mississippi State,

MS 39762, USA.

Email: jan214@msstate.edu

985440AAS0010.1177/0095399720985440Administration & SocietySoujaa et al.

research-article2021

Soujaa et al. 1015

Keywords

public health emergencies, coordination, Ebola, coronavirus disease,

COVID-19, institutional collective action framework

Introduction

Responding to global challenges that are characterized by wicked problems

require coordination (Head & Alford, 2015; Termeer et al., 2015; Weber &

Khademian, 2008). One such global challenge is public health emergen-

cies—the occurrence of sudden events that affect the public’s health, safety,

and quality of life (Haffajee et al., 2014). The most recent global public

health emergencies since 2000 include the 2002–2004 severe acute respira-

tory syndrome (SARS), the 2009 (H1N1) flu pandemic, the 2014–2016

Ebola virus epidemic, and the more recent and ongoing coronavirus

(COVID-19) pandemic. Since the outbreak of COVID-19 in December

2019, it has infected more than 80 million people worldwide and claimed

more than 1.7 million lives, with more than 336 thousand of the deaths being

reported in the United States as of December 2020. Contagions are no

respecter of borders and treat society as common property resource without

regard to regions or the political fragmentation of metropolitan statistical

areas (MSAs) while at the same time posing challenges to government

responses during public health emergencies.

The political autonomy of governments often leads to confusion about

who owns a public health emergency and who should oversee the response

effort (Andrew et al., 2018; K. Kim et al., 2017). In addition, politically dis-

integrated organizations and agencies operate under different organizational

cultures, institutions, and norms with divergent approaches in how to respond

to emergencies that present challenges to working in concert. For instance,

public health professionals and emergency management professionals

respond to health crises differently. While health professionals are concerned

with contact tracing to track where the contagion started, where it is headed,

and who might have been infected (Rose et al., 2017), emergency manage-

ment professionals usually focus on mass care and provide emergency assis-

tance that can return society to normalcy (Kapucu, 2012). Given the complex

nature of responding to public health emergencies, organizations need to

coordinate their activities if they would be successful in combating

contagions.

Current studies have used the institutional collective action (ICA) frame-

work to examine solutions to collective action problems and identify formal

and informal activities in a multijurisdictional setting to improve the response

1016 Administration & Society 53(7)

to a shared concern (Terman et al., 2020). While formal mechanisms are for-

mally enacted agreements, informal mechanisms are not legally binding

(Terman et al., 2020). However, more recent studies emphasize information

and communication networks that are formal or informal as necessary to inte-

grate independent governments (Kapucu, 2006; K. Kim et al., 2017; Song &

Jung, 2015). The ICA framework has been applied in the areas of environ-

mental policy, emergency management, and climate change policy, among

others (Andrew & Kendra, 2012; Feiock, 2013; Rydin & Pennington, 2000).

However, scant literature exist that extends the theory to public health emer-

gencies, although response to health crises is beset with several collective

action challenges that require coordinated effort from regional allies and thus

merits more scholarly attention.

The present study draws on the ICA framework for theoretical context to

identify those mechanisms—formal, informal, and communication net-

works—that address barriers to coordination and test the determinants of

coordination effectiveness between emergency management and public

health professionals and their respective organizations (Benavides et al.,

2017; K. Kim et al., 2017). More specifically, this study examines the

following:

1. The effects of formal mechanisms on coordination effectiveness

between health professionals and emergency managers during public

health emergencies;

2. The effects of informal mechanisms on coordination effectiveness

between health professionals and emergency management during

public health emergencies; and

3. The effects of information and communication networks on coordina-

tion effectiveness between health professionals and emergency man-

agers dealing with public health emergencies.

Before the COVID-19 pandemic, the Ebola virus disease of 2014–2016

was perhaps the most traumatic public health emergency of international con-

cern. Although the 28,616 confirmed cases and more than 11,000 deaths

(Elston et al., 2017; Emrick et al., 2016) fall far short of what has been

reported for COVID-19 thus far, postinfection mortality rate is extremely

high for the Ebola virus disease (Sullivan et al., 2003). Like COVID-19, the

number, severity, and rapidity of the Ebola disease required coordination

among organizations seeking ways to stop the disease from evolving and

spreading across boundaries. The United States was unprepared during the

Ebola outbreak of 2014, which first reached the Dallas–Fort Worth metro-

politan area, threatening multiple local governments and exposed their vul-

nerability to the contagion (Andrew et al., 2018; Benavides et al., 2017).