‘Not Enough’- How health workers in Sub Sahara Africa coped with Covid 19.

Covid -19 is a highly infectious respiratory disease caused by SARS-COV-2. It has caused millions of deaths around the world and led to lasting health problems for those who have survived the disease. It’s outbreak and consequent spread, tested global emergency preparedness practices and resources worldwide. Sub Saharan Africa was not spared the effects of the pandemic and in the backdrop of it’s economic & fiscal challenges as well as under resourced health systems, the healthcare institutions had to get creative fast in order to tackle the challenges adequately.

ACQUIRE held a pre-recorded session on the Institute for Healthcare Improvement (IHI) platform sharing reflections from frontline healthcare institutions acoss five Sub Saharan Africa (SSA) countries on how they coped with the unique and challenging needs that emerged as a resut of Covid-19. With the intention of learning from these institutions and further sharing the knowledge, ACQUIRE held conversations with eight teaching hospitals who care for patients in low resource settings.

To examine the practical approaches that helped these hospitals pivot organizationally and meet both government requirements and patient needs, ACQUIRE asked; How did you solve the problem of not enough? The response was varying and a refreshing pointer to how we can all react with diversity and creativity in challenging times. The discussions covered topics ranging from: Institutional preparations for Covid-19 processes, assessment of stakeholder needs, trouble shooting novel ideas and repositioning post Covid-19.

Key Themes:  Lessons Learned
1. Reflection drives learning“Wow, I didn’t realise just how much we’ve done”   Quality Improvemet Practice: Find regular opportunities to reflect, adjust and document learning.
2. Team InnovationEverybody grew muscle in problem solving and adaptation. New pressures provide new opportunities for innovation.   Quality Improvement Practice: Publicly and privately celebrating teams reminds them that they matter and that you couldn’t do it without them.
3. Learning from dataCoordination and feedback loops were essential for “minding the gaps”   Quality Improvement Practice: Share experiences in order to leapfrog our co-production of knowledge and co-learning.
4. Your Networks MatterShared learning involved participating in WHO/MOH webinars and calling up friends to benchmark with other institutions.   Quality Improvement Practice: Leverage institutional networks for south-south cross learning in everyday practice.

Dr Peter Makanza of Arusha Lutheran Medical Centre  in Tanzania explained how a few weeks into the pandemic they were faced with the reality of having used up a lot of resources and unbudgeted funds in an unprecedented period of time. They therefore had to recalibrate. They formed a case management team to spear head the fight against Covid-19. This team conducted training for the staff members and the neighbouring communities; prepared local guidelines for screening and treating patient; protocols for PPE usage; and enhanced communication with government and local ministiries to ensure efficient allocation and use of resources.

In Ethiopia, one of the greatest challenges was the inherent nature of Covid-19 and it’s transmission method against a close knit community who struggled with the social distancing concept. So,the hospitals embarked on an intensive Health Education campaign which involved training the communities on handwashing, use of masks, social distance and raising awareness on the Covid -19 symptoms to mitigate spread.

Cameroon had an almost similar challenge of community and cultural dynamics. According to Dr Dennis Palmer of Mbingo Baptist Hospital, patients are generally cared for by family members while at the hospital and this means that they take turns visiting. The hospitals had to make adjustments by limiting the number of caregivers allowed and ensure that they were properly kitted with masks to reduce rik of infections. They also had to scale up the contact tracing process of both staff members and  patients.

“Covid-19 tested the bureaucracy that often gets in the way of learning and collaboration. The pandemic challenged us to develop mutual relationships beyond the walls of healthcare and to share resources & strengthen partnerships with the communities we serve” Dr Kellen Kimani of Kenya. The Kenyan Health Institutions became more open to collaboration and partnerships beyond the environs of healthcare. They partnered with industries, learning institutions, community organisations as well as the public and private sectors to support the health system. AIC Kijabe Mission Hospital in Kenya made a noteworthy decision to use cloth gowns in place of hazmat suits because it was going to be the most sustainable option for them. In a commendable twist of events, Kijabe Hospital received help from their community who rallied together to make PPEs for the frontline healthworkers. “The most innovative thing did not even come from the hospital but from the community. Our biggest need was PPEs and we saw the community; teachers, homemakers, spouses and children of staff members come together to make for us PPEs” Dr. Faith Lilly Mailu of Kijabe Hospital.

Covid-19 tested the bureaucracy that often gets in the way of learning and collaboration. The pandemic challenged us to develop mutual relationships beyond the walls of healthcare and to share resources & strengthen partnerships with the communities we serve.    

~ Dr Kellen Kimani, Kenya

The ability to reflect on what took place was very critical because everything happened really fast and the process of how to deal with covid was an intense disaster management one. This information is therefo

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