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Containment strategies: lessons from early COVID-19 responses in five African countries
World Health Organization WHO, Regional Office of Africa; AHOP
WHO Regional Office for Africa
(2021)
C_WHO
The number of COVID-19 cases is on the rise again, with South Africa nearing half of all confirmed cases in the WHO African Region. Threats of new variants loom and low vaccination coverage raises questions on the future of the response to COVID-19. Prevention remains the
...
key strategy in most sub-Saharan countries. Five National Centres (NCs) from the African Health Observatory Platform on Health Systems and Policies (AHOP), based in Ethiopia, Kenya, Nigeria, Rwanda and Senegal, reflect on lessons to be learnt from their containment responses in the initial phases. They construct timelines to highlight the policies and challenges associated with introducing a range of public health containment measures and
discuss the extent to which these measures continue to be valuable given the ever-changing nature of the pandemic.
more
Herd immunity by mass vaccination offers the potential to substantially limit the continuing spread of COVID-19, but high levels of vaccine hesitancy threaten this goal. In a cross-country analysis of vaccine hesitant respondents across Latin America in January 2021, we experimentally tested how fiv
...
e features of mass vaccination campaigns—the vaccine’s producer, efficacy, endorser, distributor, and current population uptake rate—shifted willingness to take a COVID-19 vaccine. We find that citizens preferred Western-produced vaccines, but were highly influenced by factual information about vaccine efficacy. Vaccine hesitant individuals were more responsive to vaccine messengers with medical expertise than political, religious, or media elite endorsements. Citizen trust in foreign governments, domestic leaders, and state institutions moderated the effects of the campaign features on vaccine acceptance. These findings can help inform the design of unfolding mass inoculation campaigns.
more
INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimat
...
e the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
more
Anopheles stephensi is an invasive mosquito species which has been found spreading across Africa. While this species presents a new challenge for malaria control on the continent, its surveillance and management have been ongoing in Asia for many years. This document aims to summarize
...
key lessons from 3 countries – India, the Islamic Republic of Iran and Sri Lanka – that have been working to control An. stephensi. It is hoped that their experiences and insights will be valuable for countries encountering An. stephensi for the first time.
more
9 March 2022, Timely and accurate diagnostic testing for SARS-CoV-2 is an essential part of a comprehensive COVID-19 response strategy. Ag-RDTs can be performed by individuals in which they collect their own specimen, perform a simple rapid test and interpret their test result themselves at a time a
...
nd place of their choosing, termed COVID-19 self-testing. This interim guidance provides a new recommendation that COVID-19 self-testing, using SARS-CoV-2 Ag-RDTs, should be offered as part of SARS-CoV-2 testing services. It also includes implementation considerations that can guide decisions on whether, and how, to adopt self-testing in different contexts, including the populations being prioritized; the disease prevalence in that population; and the impact on accessibility of testing, health care services and result reporting.
more
The arrival and rapid spread of the mosquito-borne viral disease Chikungunya across the Americas is one of the most significant public health developments of recent years, preceding and mirroring the subsequent spread of Zika. Globalization in trade and travel can lead to the importation of these vi
...
ruses, but climatic conditions strongly affect the efficiency of transmission in local settings. In order to direct preparedness for future outbreaks, it is necessary to anticipate global regions that could become suitable for Chikungunya transmission. Here, we present global correlative niche models for autochthonous Chikungunya transmission. These models were used as the basis for projections under the representative concentration pathway (RCP) 4.5 and 8.5 climate change scenarios. In a further step, hazard maps, which account for population densities, were produced. The baseline models successfully delineate current areas of active Chikungunya transmission. Projections under the RCP 4.5 and 8.5 scenarios suggest the likelihood of expansion of transmission-suitable areas in many parts of the world, including China, sub-Saharan Africa, South America, the United States and continental Europe. The models presented here can be used to inform public health preparedness planning in a highly interconnected world.
more
The Arid and Semi-Arid lands (ASAL) constitute about 80% (467,200 sq. km) of Kenya’s total land mass and is grouped into geographical zones including the Savannah covering most of the North- eastern and South-eastern parts, the Coastal region, the North Rift Valley, the Highlands and the Lake Vict
...
oria Basin. The ASAL host about 35% of Kenyas population (13 million people) and over 60% of its inhabitants live below the poverty line, subsisting on less than one US dollar per day.
more
The goal of the global outbreak response for monkeypox is to stop human-to-human transmission of monkeypox, with a priority focus on communities at high risk of exposure which may differ according to context, and to effectively use strong public health measures to prevent onward spread of the diseas
...
e. Judicious use of vaccines can support this response. This interim guidance, developed with the advice and support of the Strategic Advisory Group of Experts (SAGE) Working Group on smallpox and monkeypox vaccines, provides the first WHO recommendations on vaccines and immunization for monkeypox. Key points follow.
more
During the first year of the Covid-19 pandemic, the world’s economy slowed. Yet, the global annual average particulate pollution (PM2.5) was largely unchanged from 2019 levels. At the same time, growing evidence shows air pollution—even when experienced at very low levels—hurts human health. T
...
his recently led the World Health Organization (WHO) to revise its guideline for what it considers a safe level of exposure of particulate pollution, bringing most of the world—97.3 percent of the global population—into the unsafe zone. The AQLI finds that particulate air pollution takes 2.2 years off global average life expectancy, or a combined 17 billion life-years, relative to a world that met the WHO guideline. This impact on life expectancy is comparable to that of smoking, more than three times that of alcohol use and unsafe water, six times that of HIV/AIDS, and 89 times that of conflict and terrorism.
more
The Interim Guidance for Risk Communication and Community Engagement (RCCE) outlines recommendations, considerations and methods to raise awareness, manage risk perception, maintain trust and proactively support people at risk to make informed decisions to protect themselves and others from monkeypo
...
x. The guidance includes recommendations on identifying and communicating with affected populations and key audiences and avoiding stigma in communications outreach. It also includes key messages about symptoms of monkeypox, transmission, prevention measures, and communicating about uncertainty. This document also provides RCCE guidance for managers and planners of gatherings and events, where close physical contact may create an environment conducive for the transmission of monkeypox. Additionally, this document includes a compendium of recommendations for RCCE methods and resources to support the monkeypox response.
more
After a decade of crisis, Syria remains one of the world’s most complex humanitarian crises. Continued hostilities, new and protracted displacement, increased returns and the sustained destruction of communities have impacted Syrians’ lives and futures in a devastating way. The 2021 Humanitarian
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Needs Overview (HNO) identified that 13.4 million people, more than half of country’s pre-crisis population, need humanitarian support. Of this figure, 12.4 million require health care.
more
Despite the continuing war in Ukraine, the Government is preparing for the country’s recovery and reconstruction. Given the magnitude of the attacks on the health infrastructure and consequent disruption to health system functioning, reconstruction of the health system is integral to the country
...
s recovery. The immediate priorities are to restore essential services, respond to new physical and mental health needs, protect public health, and provide a secure and attractive environment for the return of both health professionals and the general population. This policy note identifies strategic directions for post-war health system recovery in the short and longer terms, while sustaining essential health services during the ongoing invasion
more
The objective of Health in the Americas: Overview of the Region of the Americas in the Context of the COVID-19 Pandemic is to respond to the need to address important public health issues in an increasingly timely manner, while serving as a platform with a close focus on specific issues of regional
...
importance. This 2022 edition is the second in its new format, providing an overview of the analysis, as well as an in-depth description of the key issues related to COVID-19 in the Region of the Americas. This overview is supported by the Health in the Americas+ virtual platform, which offers interactive resources for data analysis and allows for the comparison of information disaggregated by subregions and countries.
more
This report’s central premise is that diagnostics and therapeutics, and associated test to treat strategies, are fundamental components of the pandemic response, both for COVID-19 and for future health threats. Two years into the COVID-19 pandemic, this report reflects on the main challenges and
...
key solutions on the road to equitable access to diagnostics and therapeutics.
This report draws from experience gained through the Access to COVID-19 Tools (ACT) Accelerator Diagnostics and Therapeutics pillars, and includes the perspectives of collaborating stakeholders (countries, civil society representatives and the private sector). Building on these findings, this report proposes sixteen recommended actions to address what have been identified as key structural challenges and specifies a potential owner for each action.
more
As of September 2022, just over one million forced
migrants from Ukraine have entered Germany, making Germany the third largest recipient of migrants
(Ukraine Refugee Situation, 2022).
As early as March 2022, several news outlets reported that accommodation centers were at or near
capacity in ma
...
ny German states and lacked the resources to quickly register new arrivals (Süddeutsche
Zeitung, 2022; Herz, 2022). Consequently, some states asked for the use of the Königstein Key —
an algorithm used to redistribute forced migrants to different states based on each state’s capacity.5
Depending on which state forced migrants arrive in or where they relocate to, their first stop is typically
a reception facility where they are able to register, begin the asylum application procedure, and access
support services
more
Briefing Note 8.
Ecosystem-based adaptation (EbA) is a strategy for adapting to the adverse impacts of climate change by harnessing nature and the services it can provide. This strategy is crucial for cities and peri-urban areas, threatened by a multitude of climate hazards and home to more than ha
...
lf the human population as of 2018. Despite some outmigration from the largest cities during the COVID-19 pandemic, urbanization will continue, and by 2035, 62.5 percent of the world’s population is expected to reside in urban areas. However, given the need to retrofit, replace and upgrade deteriorating urban infrastructure, and to meet the challenges of climate change, including the urban heat island effect, droughts and more intense flooding, many experts and policymakers see in these demands an opportunity to reinvent cities as greener, less prone to pandemics, and more liveable.
more
Patient safety standards are critical for the establishment and assessment of patient safety programmes within hospitals. This third edition of the Patient safety assessment manual provides an updated set of standards and assessment criteria that reflect current best practice and WHO guidance. The m
...
anual will support the implementation of patient safety assessments and improvement programmes within hospitals as part of the Patient Safety Friendly Hospital Framework to ensure that patient safety is prioritized and facilities and staff implement best practices. The manual is a key tool for use by professional associations regulatory accrediting or oversight bodies and ministries of health to improve patient safety.
more
Uganda hosts approximately 1.1 million refugees making it Africa’s largest refugee hosting country and one of the five largest refugee hosting countries in the world. Most recently, throughout 2016- 2018, Uganda was impacted by three parallel emergencies from South Sudan, the Democratic Republic o
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f the Congo (DRC), and Burundi. In view of the on-going conflicts and famine
vulnerabilities in the Great Lakes Region, more refugee influxes and protracted refugee situations are anticipated in the foreseeable future. The unprecedented mass influx of refugees into Uganda in 2016-2018 has put enormous pressure on
the country’s basic service provision, in particular health and education services. Refugees share all social services with the local host communities. The refugee hosting districts are among the least developed districts in the country, and thus the additional refugee population is putting a high strain on already limited resources.
more
This document, Programme and curriculum development guide, presents a systematic approach to developing programmes and curricula for implementation of the family planning (FP) and comprehensive abortion care (CAC) competencies,and the theory behind the approach. Specifically, the aim is for effectiv
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e implementation of these competencies in the context of pre-service education and training, post-graduate studies and continuing professional development (CPD). This guide is designed for programme and curriculum developers who are preparing or revising formal education and training programmes and curricula for the FP and CAC workforce.
This guide proposes a new FP and CAC Educational Design Model for programme and curriculum development. This model can support competency-based education (CBE) for current and future FP and CAC services, with a pre-service training pathway of at least 12 months, and can also support in-service training. CBE provides the most effective means to orient educational programmes and curricula towards effective health services that meet population health needs, and this Educational Design Model provides a guide for linking the competencies required to provide a range of health services
more
The executive summary of the WHO Global oral health status report presents a snapshot of the most recent data on major oral diseases, risk factors, health system challenges and opportunities for reform. The report’s clear conclusion is that the status of global oral health is alarming and requires
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urgent action. The report will serve as a reference for policy-makers and an orientation for a wide range of stakeholders across different sectors to guide advocacy towards better prioritization of oral health in global, regional and national contexts. In addition, the report provides, as a separate online resource, the first-ever country oral health profiles for all 194 WHO Member States, giving unique insights into key areas and markers of oral health that are relevant for decision-makers.
more
