HP+’s capacity strengthening activities in three regions in Burkina Faso are part of efforts to increase the rate of COVID-19 vaccination. At the grassroots level, HP+ conducted advocacy activities with more than 800 community and religious leaders to facilitate their engagement in the promotion of COVID-19 vaccination. These leaders adapted HP+’s tailored messages to drive behavior change. In the Center, Hauts-Bassins, and Centre-Nord regions, vaccination coverage increased from 1.6, 4.3, and 1.5 percent in December 2021, respectively, to 5.1, 15.5, and 6.2 percent after campaigns in January 2022. At the governmental level, HP+ helped organize workshops in the three regions where more than 50 regional health directorate staff and 86 health district staff were briefed in COVID-19 vaccine logistics and management as well as communication and key messages for the population. HP+ also supported the organization of 19 district-level advocacy meetings in the three regions. The national Ministry of Health is planning to implement HP+’s approach in other regions of the country as part of its vaccination rollout.
The COVID-19 vaccination rollout strategy in Burkina Faso has been challenged by the proliferation of misinformation spread through the community, including through social media and other local media, which can lead to vaccine hesitancy. To address the situation, HP+, in concert with the Communications Unit of the Ministry of Health, first identified rumors and misinformation. The project then identified themes and developed messages with key responses stratified by audience (healthcare workers and the general population). Evidence-based information to address rumors and increase vaccination coverage has been disseminated through training and advocacy briefings with government, healthcare workers, civil society, bloggers, influencers, and local radio.
In Mali, HP+ has been supporting the Sub-Directorate of Immunization (SDI) of the Ministry of Health to prepare the country’s health system to receive the Pfizer vaccine in March of 2022. As part of this effort, the country recently received 10 pieces of ultra-cold chain equipment from UNICEF/Japan, with distribution managed by SDI. HP+ has been strengthening SDI staff capacity on the management of cold chain equipment and vaccines, bolstering SDI’s resilience against COVID-19 and capacity to effectively deliver routine vaccinations throughout Mali. HP+’s secondee to SDI, Dr. Famoussa Konaté, has played a principal role in Mali’s COVID-19 response and the Expanded Vaccination Program. Read more about lessons learned from his technical support to strengthen SDI capacity, improve processes, and bolster the health system.
Leading up to UHC Day, a new piece on “The Elusive Goal of Universal Health Coverage” by HP+’s health financing lead, Eduardo Gonzalez-Pier, was published by New Security Beat on December 10, 2021. In the article, he argues that the COVID-19 “pandemic has been a stark reminder of the human and economic costs of not having made larger and smarter investments in health" and that "we should not let a health crisis of this magnitude go to waste." The article closes with important lessons learned, with a leading takeaway being the need to invest in health system strengthening, which not only saves lives but also delivers high rates of economic returns.
In September 2021, Guatemala’s Ministry of Health (MSPAS) adopted the Home Management of COVID-19 Patients: A Practical Guide for Healthcare Personnel as national guidance. HEP+ is using the guide—which was adapted from HP+’s 2020 COVID-19 Home-Based Quality Care guide—to train MSPAS healthcare workers on how to provide home-based care. Since September 30, 2021, 133 healthcare providers from Alta Verapaz, Quiché, San Marcos, and Metropolitan areas were trained; the next training will be held in Huehuetenango. The guide will be shared with those who have been trained, who will then share the information with health personnel in their health areas who did not receive the HEP+ training. While written for healthcare workers, the guide is equally useful for personal use or when caring for a household member with COVID-19.
In Ouagadougou on September 25, 2021, 956 people received COVID-19 vaccines in one day, representing twice the daily average of people vaccinated in all the 88 vaccination sites in the Central Region since the start of Burkina Faso’s COVID-19 vaccine roll out. The mass vaccination event for adults was hosted by the U.S. Embassy in collaboration with the Ministry of Health and organized by HP+, which also managed transportation logistics for vaccine delivery, promoted participation through traditional and social media, and coordinated and supervised the team administering the vaccines. The vaccines administered were part of a shipment of 302,600 doses of the Johnson & Johnson vaccine provided by the U.S. Government, which supports immunization in Burkina Faso through the COVAX initiative and a bilateral partnership. This one-day event was a major boost to the country’s vaccination effort, which was launched on June 2, 2021. Prior to the event, only 2.4 percent of the country's targeted population was immunized. General Secretary of the Ministry of Health, Dr. Wilfried Ouedraogo, praised the initiative and support of the U.S. Government to mitigating the impact of COVID-19 in Burkina Faso.
A radio station based in Kenya’s southeastern coast recently hosted a live family planning discussion between a Muslim leader and a local Kilifi County government official. HP+ helped arrange for the interviews and discussed key talking points with the presenters. The discussion on Lulu FM between Muslim leader Ustadh Rashid and Kilifi County reproductive health coordinator Ken Miriti highlighted collaborative efforts between the county government and religious leaders to promote uniform messaging for family planning among interfaith communities in Kilifi. Kilifi County has among the lowest modern contraceptive uptake rates in Kenya and religion and cultural issues were identified in the county’s costed implementation plan as key contributing factors. Faith leaders in the area use different avenues to address existing myths and misconceptions about family planning through the lens of religious norms and beliefs. HP+ has fostered joint accountability between the county government and faith leaders from Christian and Muslim communities to implement family planning interventions. Throughout the COVID-19 pandemic, HP+ has supported this strong network of interfaith leaders from Christian and Muslim communities in Kilifi County to be more involved with family planning. HP+ will continue to support the Department of Health to engage with more leaders from established faith networks, to sensitize them on family planning, and enlist them as family planning champions in their communities.
As a result of data collected and analyzed by HEP+, the Guatemalan Ministry of Health (MSPAS) authorized the COVID-19 vaccination for everyone 18 years and over in specific rural areas, as opposed to following vaccination administration by age groups. MSPAS also adopted a community engagement plan to better promote vaccination in rural communities. HEP+ conducted evaluations of two rural communities in Quiché and explained to the government the challenges of reaching the most remote communities while following the current national vaccination plan. HEP+ also collaborated with community leaders and municipal authorities to develop a strategy to promote vaccination in the rural community of Ixcán in Quiché. Since this engagement, Ixcán has experienced an increase in the number of people vaccinated and the percentage of the population fully vaccinated exceeds the department average of 10.3%. HEP+ is using the same approach of community evaluation, vaccination plan modification, and community engagement with the local health area directorates in the departments of Ixil, San Marcos, and Alta Verapaz, and aims to continue implementing the strategy at the national level.
Frontline healthcare workers at Guatemala’s Ministry of Public Health and Social Assistance (MSPAS) recently completed an HEP+-created series of training sessions on COVID-19 care. “Improving the Quality and Hospital Care of Patients with COVID-19” covered epidemiology and management of COVID-19, COVID-19 therapy and therapeutic options, intubation, mechanical ventilation, nosocomial infections, anesthesia and management of delirium, ventilator weaning, and other topics. Thirty-nine doctors and 42 respiratory therapists and nursing staff completed the 26 hours of theoretical and practical training in June. A second training series in July and August covered mental health for health workers, the use of antibiotics in the patient with COVID-19, post-COVID-19 syndrome, and fungal infections in a COVID-19 patient. Health workers who have completed the course will train the staff under their charge on the same material. Thus far, a total number of 1,421 attendees have attended these additional sessions in July and August. HEP+ will provide technical assistance to update the infection prevention and control manuals in the coming weeks.
The School of Medicine of the Universidad San Carlos de Guatemala recently established a course titled "Public Health and Demography, Reproductive Health and Nutrition," with Health Policy Plus deputy director and family planning expert Jay Gribble delivering the launch keynote address. At the June 11 event, Gribble stressed the importance of focusing on the need for multisectoral approaches, systems interventions, and integrated methodologies to promote local development. In a blog post building on the speech—The Data Imperative in Guatemala's COVID-19 Recovery—Gribble and Robin Brazier, assistant country activity manager for Health and Education Policy Plus (HEP+) in Guatemala, shared their perspectives on the critical role data can play in improving public health and local development, particularly in the context of a global pandemic. In the post, they discuss how, as the COVID-19 pandemic continues in Guatemala, a focus on improved data collection and systems, data use, and data triangulation across sectors is imperative for decisionmakers to best address the pandemic’s impact across other health areas.
Sessions on presenting evidence and ideas on public financial management, the health impacts of COVID-19, and health insurance financing were among those delivered by HP+ researchers at this year’s International Health Economics Association (iHEA) online congress. Representatives from HP+ Kenya, Malawi, and Nigeria hosted an organized session on the need for a strong public financial management system and the challenges faced by many countries in delivering better spending in their journeys toward universal health coverage. HP+’s Rebecca Ross collaborated with the London School of Hygiene and Tropical Medicine to convene an organized session, presenting results from a mixed method study on the impact of Indonesia’s national health insurance scheme on the competitive landscape of public and private healthcare providers. View HP+’s sessions.
HP+ Kenya is successfully reshaping its approaches to keep project activities running in the face of COVID-19 restrictions and, in the process, strengthening capacity and implementing sustainable processes that appear likely to outlive the current pandemic. HP+ has been adapting to the restrictions on movement imposed by the COVID-19 pandemic by training local county teams in data collection and analysis as well as planning and budgeting using virtual trainings. For example, HP+ trained a Kajiado County government representative on data collection of the geocodes required to map antiretroviral treatment sites and private pharmacies. Instead of recruiting independent research teams and sending them to the field, this alternative minimizes movement of people and strengthens capacity of local county staff.
In June, HEP+ completed a series of training sessions for frontline health care workers at Guatemala’s Ministry of Health (MSPAS). HEP+ designed the content for and delivered the course, “Improving the Quality and Hospital Care of Patients with COVID-19.” The series covered topics such as epidemiology and management of COVID-19, COVID-19 therapy and therapeutic options, intubation, mechanical ventilation, nosocomial infections, anesthesia and management of delirium, and ventilator weaning. Eighty-one healthcare providers (39 doctors and 42 respiratory therapists and nursing staff) completed the 26 hours of theoretical and practical training. To continue the knowledge transfer within hospitals, those health workers who have completed the course will train the staff under their charge on the topics about which they have learned. HEP+ will provide technical assistance to update the infection prevention and control manuals in the coming weeks. A second training series is being conducted in July and August 2021, which will cover mental health for health workers, rational use of antibiotics in the patient with COVID-19, post-COVID-19 syndrome, and fungal infections in a COVID-19 patient.
Uganda has adapted an HP+-produced COVID-19 guide in support of the 75 percent of cases in the country that can benefit from home care. The document can guide health workers, village health teams, caregivers, patients, and family members on how to effectively implement home-based care activities and manage the disease. The adaptation was spearheaded by the USAID Uganda Health Systems Strengthening Activity and the USAID Social and Behavior Change Activity with the Uganda Ministry of Health.
HP+ recently trained Honduran microbiologists on technology that delivers faster and better targeted testing for the COVID-19 virus. The new technology, called TaqPath, incorporates a reagent that cuts the time required for diagnostics from two hours to one, increasing the number of samples that can be processed per lab per day from 500 to 800. In addition, it will allow Honduran scientists to sequence samples that they previously sent to Brazil for further analysis. USAID provided the materials and reagents for the training and processing of 100,000 samples. The May training involved more than 60 microbiologists from four laboratories in Honduras. A training of laboratory supervisors was followed by a seminar series on the use of TaqPath and molecular biology co-delivered by HP+ and manufacturer Thermo Fisher. Learn more about HP+ activities in Honduras.
Malawi is developing guidelines on how to sustain youth-friendly health services (YFHS) as evidence shows that the COVID-19 pandemic has drastically decreased the use of such care. The use of YFHS declined by approximately one-third in April/May of 2020 compared to the same period in 2019, according to two 2020 assessments on COVID-19 and YFHS. In response, HP+ Malawi is working with government and other stakeholders to develop National Guidelines for Sustaining Provision of Youth-Friendly Health Services amidst the COVID-19 Pandemic. The guidelines, which are being developed by a multisectoral group of stakeholders, are intended for both governmental and nongovernmental entities that offer health information and services to young people. They are a framework to hold implementers accountable for offering services during the pandemic as well as a way to empower communities and youth themselves to better understand their right to access health services despite COVID-19-related restrictions or access barriers. The government of Malawi is further discussing how to expand the scope of the guidelines to address public health emergencies beyond COVID-19.
HEP+ Guatemala held a virtual conference on May 6 for more than 480 healthcare and hospital workers about therapeutic options to treat COVID-19. It was the first in a series of 27 training sessions to develop capacities among frontline healthcare workers to improve quality of care for COVID-19 patients in Guatemala. Conference keynote speaker Dr. William Checkley, associate professor of medicine at Johns Hopkins University, shared resources to improve clinical practice in the care of COVID-19 patients. The session also featured remarks from Dr. Francisco Coma, vice-minister of hospitals for Guatemala’s Ministry of Public Health and Social Assistance; Dr. Yma Alfaro of USAID/Guatemala; and Herminia Reyes, country director for HEP+ Guatemala. The session improved understanding of current, evidence-based options available to treat patients diagnosed with COVID-19 and promoted the exchange of experiences, challenges, and improvements in patient care.
HEP+ is actively supporting the Guatemalan Ministry of Health and Social Assistance in rolling out the country’s second phase of its vaccination plan. HEP+ is coordinating efforts among government agencies, private sector representatives, and other implementing partners to set up in-person registration stands at accessible points and help deploy vaccination posts based on population density. HEP+’s activities have resulted in the installation of 547 vaccination centers and 49 registration stations for people without an internet connection. HEP+ also supported the ministry with the IT support necessary to launch its COVID-19 Vaccine Website, where Guatemalans can register online for COVID-19 vaccinations. With these activities, Guatemala expects to speed up the second vaccination phase, forestall crowds at vaccination sites, and increase the number of vaccinated people in the country. As of May 10, more than 131,000 people 70 years of age and older had registered on the website. Guatemala hopes to vaccinate 620,000 people over the age of 70 as part of phase two of its vaccination plan.
With financial and technical support from USAID, the Pan American Health Organization, and HP+, 3 new molecular laboratories were constructed in Cortes, Copan, and Atlantida. With these additional laboratories, the turnaround time for COVID-19 test results has been reduced from almost one month to 48 hours (previously, COVID-19 diagnostics were available only at the national laboratory in Tegucigalpa). By increasing the geographic distribution of laboratory capability, the Ministry of Health is now able increase the availability of testing and sample processing for communities across the country, improving COVID-19 response efforts at the local level. To support the opening of the laboratories, HP+ created standard operating procedures and strengthened the capacity of lab staff, including microbiologists and lab technicians, through technical training and certification in microbiology and sample processing.
As part of the global effort to equitably supply vaccines to countries in need, HP+ convened academic and program implementation experts to share best practices, lessons learned, and tools to support rollout in low-resource countries. Under an accelerated effort, developing countries will be supported by the COVAX mechanism to immunize 20 percent of the population in 2021. The target group, scale, and intensity of this immunization campaign is significantly different than those handled by health ministries and immunization programs in the past. Joining the discussion to explore this were Ramon Soto of HP+’s COVID-19 response team in Honduras, Dr. Laila Woc-Colburn from Emory University’s School of Medicine, Dr. Edwin Asturias from the University of Colorado Denver, and Danielle Darrow de Mora of FHI 360. Key issues emerging from the discussion include strategies to deliver vaccines to hard-to-reach populations including migrants and indigenous populations and the need to include communities in rollout planning (microplanning). Panelists proposed effective strategies on the prevention, identification, and management of rare adverse events.
In a recent blog post, HP+ deputy director Sara Bowsky argues that community healthcare workers and advocates for the marginalized need a seat at the table where governance decisions are being made. The call comes as the COVID-19 vaccination rollout has exposed inequities in access in both the United States and developing countries. She weighs the advantages and disadvantages of local and national responses to the pandemic. “But what’s needed is a balanced, adaptable approach—one that draws on the power and actions of communities in conjunction with federal and state agencies, and the collaboration needed to reinforce such a response,” she writes.
With the help of HEP+, the Guatemalan government is on track for a successful distribution of 400,000 doses of the COVID-19 vaccine from Astra Zeneca. After four months of HEP+ support, the Guatemalan government unveiled the National Vaccination Plan Against COVID-19 on February 9, will receive the vaccine in late February, and plans to begin distribution in the beginning of March. The vaccination process will cover several months and reach, in order, 1) health care workers, 2) those 70 and older, 3) people with pre-existing medical conditions, 4) other. HEP+ will continue to support the Ministry of Health for the full rollout.
While some patients with SARS-CoV-2 infection require hospitalization, most can be cared for at home. HP+ developed a new visual guide, COVID-19 Home-Based Quality Care: A Practical Guide for Healthcare Workers, to help healthcare workers educate patients, their families, and other household members on how to care for patients at home and prevent transmission of the virus. The guide also provides healthcare workers with information on caring for special conditions and identifying the need for timely referral to a hospital. The guide is equally useful for personal use or when caring for a household member with COVID-19. The guide is available for download in Spanish and English from the HP+ website and via the UCSF Open Critical Care Portal.
HEP+ is training local leaders and experts in Guatemala on how to plan for and deliver services related to COVID-19. The training is designed to help participants work with local authorities in planning for both COVD-19 care and prevention services. So far, 130 area chiefs, epidemiologists, statisticians, and heads of service provision from five health areas have taken the course. In addition to these three trainings, reaching leaders from Escuintla, Santa Rosa, Retalhuleu, Suchitepéquez and Sacatepéquez health areas, HP+ is planning an additional three sessions. At the conclusion of the in-person training, HP+ will index the material and make it available throughout the country, giving health experts quicker access to this information to better respond to the ongoing pandemic.
HP+ has helped coordinate the donation of 50 ventilators, facilitated by USAID, to the Guatemalan Ministry of Health. In early December, HP+ provided more than 100 medical and paramedical personnel from five Guatemalan hospitals in-person training in the use of ventilators. Equipped with improved treatment protocols and patient care options, healthcare workers will be able to immediately use the ventilators to treat COVID-19 patients. They will also be able to provide other necessary therapies for adults and children in need of ventilator support. In upcoming weeks, HP+ will provide training for two additional hospitals and will continue to provide technical assistance to ensure adequate use and handling of the equipment.
HP+ has helped the government of Honduras develop and publish an extensive epidemiological report of the COVID-19 pandemic in the country. This report has provided useful information to not only government agencies but also outside parties such as journalists and clinicians. With the publication of this report, the Health Surveillance Unit in the Secretariat of Health is positioned to produce monthly epidemiological reports that capture new and emerging data, such as that from rapid diagnostic tests, while also continuing to improve the quality of reported epidemiological indicators in the country. The report provides key epidemiological data from March 10, 2020, when the first COVID-19 case was identified in Honduras, through November 14, 2020 (epidemiological weeks 11-46).
In a new HP+ blog entry published December 16, Steven Forsythe and Suneeta Sharma discuss the direct and indirect economic impacts of COVID-19 on African economies, including food insecurity, poverty, education, and health. The co-authors provide recommendations to prepare multisectoral responses for a future pandemic. “Health programs cannot focus solely on COVID-19 and must instead also focus on other health concerns that have been affected by COVID-19, including access to family planning and reproductive health services; maternal and child health services; and malaria, tuberculosis and HIV prevention and treatment,” they state. “Thus, health systems strengthening must be a priority not only as a health measure, but also to reduce the economic implications of COVID-19.”
A new blog published on the Wilson Center’s New Security Beat by HP+’s Dara Carr -- Reducing the Risk of Pandemic Disease Threats Through Multisectoral Action -- looks past our current “war time” footing on COVID-19 to the importance of sustaining and strengthening multisectoral collaboration to address future shocks. She discusses barriers to multisectoral collaboration and makes the case that existing policy assessment and advocacy approaches, including evidence-generating policy models, can be readily adapted to help address these barriers. The blog is part of a series edited by HP+’s deputy director for family planning, Jay Gribble, titled A Multisectoral Endeavor Called Health. The series examines the benefits of multisectoral actions in responding to the complex environment in which we live and explores the interrelationships between health and other sectors. Other topics in the series discuss the need for multisectoral collaboration to achieve health outcomes; the link between the health and nutrition sectors; the need for a creative and flexible policy and financing environment for effective planning across sectors.
In El Salvador, HP+ engaged 83 healthcare professionals in 20 facilities across six municipalities to adapt and disseminate evidence-based guidelines and pilot a training for clinical management of COVID-19. The guidelines and training, which cover diagnosis and treatment, as well as triage, hospital referral, home care management, and infection prevention and control, have strengthened COVID-19 response efforts within primary healthcare and household settings and improved patient perceptions of safety. Moving forward, the training will be expanded to include additional content for nurses and cascaded to enhance the capacity of healthcare professionals to engage effectively in the COVID-19 response in El Salvador.
In Malawi, youth clubs are thriving, enabling young people to continue to access youth-friendly health services (YFHS) during the COVID-19 pandemic. The 45 youth clubs in Mangochi, trained by HP+ and the USAID AgDiv Project in June 2019 on enterprise and entrepreneurship, have been mentored by an HP+-trained multisectoral ministry team and youth champion during the pandemic. They have invested approximately MWK 459,000 (US$611) in their respective centers, supporting the provision of YFHS and information on COVID-19 to youth throughout the region.
To take a closer look into women’s and girls’ self-articulated demands for their own healthcare, HP+ partner White Ribbon Alliance launched the Brave Voices, Bold Actions: Women’s Health, Rights & You podcast. Season one takes a deep dive into respectful maternity care through the lens of the Respectful Maternity Care Charter. Throughout 10 episodes, the podcast features the voices of brave women, girls, health professionals, and global leaders who discuss changes that should be made to improve sexual, reproductive, and maternal health outcomes, including during the COVID-19 pandemic.
Last month, more than 2,300 public and private sector health professionals in Guatemala participated in five hours of live training on COVID-19. The two sessions—broadcast on YouTube—featured presentations from top local experts and interactive questions from viewers. Since airing, more than 18,000 additional views have been recorded. In coordination with key health sector stakeholders, HEP+ facilitated and moderated the sessions and solicited participant input for future trainings. With a solid foundation of knowledge on the basics of COVID-19, health professionals nationwide will be able to improve practices in service delivery to support Guatemala’s pandemic response.
In collaboration with USAID, Project EpiC, and the Honduran Ministry of Health, HP+ has trained nearly 400 frontline healthcare workers providing critical care to COVID-19 patients across Tegucigalpa and San Pedro Sula, home to approximately 70 percent of COVID-19 patients in Honduras. Healthcare workers used a training curriculum, developed with HP+ support, on use of U.S. Government-donated ventilators and infection prevention and control protocols to enable them to provide mechanical ventilation to patients and protect themselves from COVID-19 in their workplaces. At an August 28 virtual celebration with the Honduran Minister of Health Alba Flores, EpiC Project Director Hally Mahler, and USAID Honduras Director of Education Meredith Fox, Flores thanked the U.S. Government and HP+ for their support. She remarked, “The capacity development processes and the ventilation equipment have strengthened care provision” in Honduras, and that “the pandemic has challenged our medical and nursing professionals to improve their knowledge and practices.”
HP+ supported the Honduran Ministry of Health to revise COVID-19 isolation criteria using a symptoms-based strategy in place of laboratory results-based processes. The new criteria, which align with international guidance, shorten required isolation time for improving non-severe and non-immunocompromised cases and asymptomatic cases and no longer require a negative real-time PCR test. HP+ supported local professional medical networks and the Pan American Health Organization to facilitate clinical discussions, update the guidance, and implement the guidelines. The revised criteria will allow facility staff who meet the revised criteria to safely leave isolation earlier and return home to their families.
In Malawi’s Chikwawa district, faith healers have been discouraging community members living with HIV from taking antiretroviral therapy (ART). Concerned that this may lead to ART defaults and increased death, religious mother body PECHANOMA facilitated a dialogue with other leaders in July, with HP+ support, to reinforce their role in emphasizing accurate messaging around HIV and COVID-19 and the importance of continuity in ART for people living with HIV. The leaders committed to continue disseminating accurate HIV messaging in their communities by holding meetings with religious and local leaders, disseminating radio and TV messages, and using mobile vans with loudspeaker systems.
Following an HP+ analysis that showed the potential impacts on maternal and neonatal deaths and stillbirths that could occur as a result of declining maternal health services due to diverted services and reduced coverage indirectly caused by the COVID-19 pandemic, HP+ partner the White Ribbon Alliance (WRA) developed and launched the “Safer Together” Respectful Maternity Care advocacy and communications campaign. The campaign is being used by WRA National Alliances and other stakeholders in USAID priority countries—including Pakistan, India, Malawi, and Indonesia—to convene stakeholders, advocate for joint action, and disseminate joint messages to women, communities, and providers.
Since the emergence of COVID-19, the debate on whether health should be re-prioritized in government budgets with explicit allocations and earmarks has re-emerged. On July 27, an HP+ webinar featured recent analyses of fiscal space for health conducted by USAID’s ProtectHealth project in the Philippines and HP+ in Indonesia. In “Fiscal Space for Health in the Era of COVID-19: Constraints and Choices in Preserving Gains for Indonesia and the Philippines,” speakers—including high-level finance ministry officials from both countries—highlighted current fiscal constraints, government budgetary responses to the COVID-19 crunch on revenues, and possible avenues through which additional financing could be raised.
On July 30, an HP+ webinar, “Pivoting During COVID-19: How Health Policy Enables Service Provision in a Pandemic,” showcased the COVID-19 public health response underway in several countries, featuring ongoing service delivery activities in Brazil, El Salvador, and Honduras. Among the speakers were Mariella Ruiz-Rodriguez, an education development officer from USAID/Honduras. Evidence-based health policies allow countries to quickly and effectively pivot from business as usual to full-scale pandemic response. Longer-term strategies that ensure a continuum of care are likewise essential to support. The webinar considered what a holistic COVID-19 response looks like: focused on service delivery and informed by local realities.
HP+ provided technical assistance to the Honduran Ministry of Health to conduct a rapid assessment of 22 critical care facilities across the country. This rapid evaluation assessed the readiness of hospitals to receive and use U.S. Government-donated ventilation equipment; an in-depth assessment is scheduled to be completed by August 15 in collaboration with Project EpiC. Correspondingly, HP+ launched a training series on the use of the ventilators and infection prevention and control. More than 120 (out of 460) healthcare workers have participated to date.
HP+ analyzed how COVID-19 may disrupt health services in Burkina Faso, based on the level of face-to-face interaction with healthcare workers required to deliver interventions and the degree to which the interventions are time-sensitive or can be delayed without significant health impacts. Across the five health areas analyzed—family planning, maternal and child health, tuberculosis, HIV, and malaria—authors estimate that between 4,800 and 19,700 additional deaths could occur in 2020 alone as a result of disruptions from the pandemic. Burkina Faso is taking steps to maintain essential services and find ways to adjust service delivery models to mitigate these potential impacts.
An HP+ webinar on July 8 featured a discussion on Liberia's private sector response to COVID-19 and the Healthcare Federation of Liberia’s efforts to stimulate coordinated private sector engagement in health following a private sector assessment undertaken by HP+ in 2019. Dr. Cuallau Jabbeh-Howe of Liberia’s Ministry of Health, Dr. Nicole Cooper of the Healthcare Federation of Liberia, and Dr. Amit Thakker of Africa Health Business shared reflections on opportunities and challenges of private sector engagement in health and discussed possibilities for collaboration between the public and private health sectors in Liberia. Listen to the webinar here.
On June 24, the Prime Minister of Cambodia officially launched a new cash transfer program to offset the impacts of COVID-19 on the country’s poor and vulnerable that will begin with the transfer of about US$50 million to 560,000 poor households. HP+ had supported Cambodia’s General Secretariat for the National Social Protection Council (GS-NSPC) to develop a monitoring and evaluation (M&E) concept note for the program and provided technical assistance to the GS-NSPC team and GIZ contractor implementing COVID-19 M&E activities, improving accountability among local authorities. In Cambodia, health service disruptions related to COVID-19 could potentially result in 559,900 individuals being unable to access contraceptives.
HP+ recently conducted an analysis of available equipment and supplies required to fight COVID-19 in Niger’s capital, Niamey. The analysis pointed to the need for an increase in hygiene supplies to effectively combat the pandemic. As a result, the Bank of Africa Foundation provided handwashing kits to 20 health facilities in the city. The handwashing kits, which are valued at more than one million CFA (approximately US$1,700), are in addition to the 373 million CFA (approximately US$640,000) already granted by the Association of Banks and other financial establishments to the Nigerien government to aid in its pandemic response.
As cases of COVID-19 continue to rise dramatically in Central America, HP+ is supporting the Honduran government to create a Ventilator Task Force to optimize distribution and use of donated ventilators for the most severe cases. Working with the USAID-funded EpiC project and other key stakeholders, the task force is launching a rapid assessment of ventilator readiness across the country’s major health facilities. The donated ventilators—anticipated to be as many as 300 from the U.S. Government alone—could almost double the current number of ventilators present in public sector facilities, saving countless lives in the midst of an unprecedented pandemic. Get more details in our news article.
The New Security Beat, a Wilson Center blog, published a piece by Sara Stratton, HP+ technical director for family planning and maternal and child health. Pandemic Preparedness: Strengthening Family Planning Policies Today to Secure Essential Services for Tomorrow discusses the COVID-19 response and threats to contraceptive access for women in low- and middle-income countries. It sets out policy recommendations to ensure essential services for women and girls are maintained during this and future pandemic responses, including policies on task sharing with private sector suppliers such as pharmacies; policies on self-injection of contraceptives; and gender-informed policies for a female-dominated healthcare workforce.
In May, HP+ supported Madagascar’s Ministry of Public Health’s Family Health Directorate to convene two virtual meetings with the multisectoral family planning committee to address decreases in family planning and maternal and child health service use nationwide. The meetings resulted in development and finalization of a budgeted action plan to ensure continuity of family planning service availability for the 27 districts under stay-at-home orders imposed as a result of COVID-19. Plan activities include ensuring continued availability of family planning products, extending the DMPA subcutaneous auto-injection approach in three regions to prolong the amount of time between visits to health facilities, and emphasizing community health service provision.
In May, with HP+ support, Madagascar validated its new Water, Sanitation, and Hygiene (WASH) sector policy through a virtual workshop led by the WASH minister and attended online by nearly 80 key stakeholders. Adoption of the new policy is a significant achievement within the context of the COVID-19 pandemic, as it enables health facilities to install running water to support handwashing guidelines. Policy implementation, which will be facilitated through the forthcoming national WASH Strategy, aims to enable public access to potable water for the entire population by 2030—a significant increase from the current level of less than half of the population with access.
Two civil society networks supported by HEP+ in Guatemala—Young Artists for Social Justice (JAxJS) and the Sexual and Reproductive Health Watchdog’s Youth Branch (OSAR Youth)—are disseminating key messages to contain the spread of COVID-19 through social media and radio. Local members of JAxJS have produced songs and poetry on preventing contagion, which target young Guatemalans, that receive an average of 7,000 daily views. OSAR Youth has disseminated key messages on the importance of continuing to provide reproductive health services and prevent teenage pregnancies. These civil society partners continue their advocacy efforts amidst the pandemic to maintain FP/RH, human rights, and policy development for disenfranchised populations on the government's policy agenda.