After the outbreak of Covid 19, organizations in all sectors are still trying to better understand the impact on their work and how they can help. WHO continues to update its guidance on requirements for immunization for emergent needs. 

UNICEF is working with governments and other stakeholders to take stock of the situation and respond where needed, including delivering supplies of oral polio vaccine (OPV) from Ghana that will be used in Sierra Leone.

As a result of these coordinated efforts, all areas affected by this crisis have been able to meet their national immunization coverage rates for most vaccines within a couple weeks by making use of country-owned stocks, funded from existing commitments or emergency funding from donors such as Gavi/GSK.Fabulous Story

Public Health and Intersectoral Capacity after Covid 19 :

1. What additional challenges have been faced by public health organizations, health facilities and their staff during the crisis?

The response to the ongoing Ebola outbreak in West Africa has affected numerous sectors in different ways. While some sectors were less affected by the Ebola outbreak than others, all sectors (health, education, water and sanitation) have been facing difficulties due to shortages of staff and supplies as a result of absences caused by fear for one’s own life and attempts at self-isolation. 

Often water supply systems are under pressure from increasing numbers of people flocking to health facilities, who both require immediate attention and compete for limited resources.

For more information about the scope and scale of this outbreak, please refer to WHO’s Ebola Response Roadmap Situation Reports.

2. How are healthcare facilities coping with the enormous strain placed on them due to this crisis?

Many healthcare staff have been diagnosed with, or have died from the Ebola virus disease (EVD). A major problem is that health facilities continue to experience shortages in health care workers and without them they are difficult to operate normally. Many of those staff members still working in facilities are themselves gravely ill and require treatment.

A report by the IHR Emergency Preparedness Unit estimates that, in response to the Ebola outbreak, over 26 000 healthcare staff have lost their lives and another 40 000 have been infected. According to WHO, of the 145 suspected EVD cases reported outside of Liberia there have been 124 deaths, 51 out of which occurred in 8 provinces of Liberia.

3. What other issues are changing public health funding patterns and how are they being addressed?

Due to the conflict between government departments over resources and a perceived lack of coordination between donors and partners on funding requirements, it has been very difficult for all sectors to raise funds for emergency measures as opposed to ongoing services.

4. What are the challenges for UNICEF and partners to provide needed services during this crisis?

UNICEF has stepped up its response to the Ebola outbreak by providing assistance in response to urgent needs, utilizing remaining available stocks and working with partners on contingency arrangements for implementation. 

UNICEF’s interventions focus on providing children and families with water, hygiene and sanitation supplies, as well as psychological support through education and recreation activities.

5. How can organizations best work together to ensure a coordinated response at all levels?

The international community has always responded when its assistance was requested by Governments in need. This crisis has shown that it is crucial to work together at all levels in order to ensure increased coordination and avoid duplication of efforts.

 WHO has always been a strong partner with UNICEF in the provision of supplies and immunization delivery, most notably after the Ebola outbreak in Angola in 1995.

6. What can organizations do to ensure that their response is coordinated across all stakeholders?

Coordination among intersectoral organizations involves understanding the different sectors affected (health, education, water supply and sanitation) and ensuring that these activities are consistent with national health policy and priorities. 

For example: a systematic approach should be taken to assessing needs. The process needs to be participatory, and in line with national health policy, and should include key actors, such as country governments and civil society.

7. In what ways do organizations share information with other organizations in the field?

There are ongoing efforts to share information through established mechanisms, such as the Interagency Coordination Group (ICG). Through this mechanism all partners can identify gaps along the distribution chain and make use of the different sectors’ capacities. 

As an example, UNICEF had previously distributed a large supply of oral polio vaccine in response to an outbreak of polio in West Africa. This supply is now being used to cover the gaps created by EVD-related incidents.

8. Are organizations working with local partners to develop the capacity of those communities?

UNICEF and partners are supporting health, education and water supply and sanitation institutions through training, community mobilisation and psychosocial support in an effort to strengthen the public health system. 

For example, UNICEF has partnered with the government of Liberia on a social mobilization campaign for affected communities by educating them about Ebola virus disease. 

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