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Coordination Mechanism for MNH Service Continuity in the context of COVID-19

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April 2020,Addis Ababa

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Introduction

• On 31 December 2019, new type of corona virus identified in Wuhan, China. Later spread to other countries
• Ethiopia had destinations in many of the affected countries including China and makes hundreds of flights per a week to these countries.
• Total population-110 million

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• EPHI Public Health EOC Activated on 27 January 2020.

-Screening at Bole International Airport and other entry corridors -Key messages developed and made available to the public

-Two isolation facilities established

-Designated facility identified for clinical assessment and treatment

-EPHI laboratory capacitated to do COVID-19 test

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• Ethiopia confirmed the first case of COVID on 13 March 2020-imported case

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Current Status

As of 22 April 2020,

-9771 tested and 116 confirmed cases( mostly imported)

-21 recovered and 3 deaths

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Measures taken

• PHEOC activated at national and regional level
• ECC activated on March 16
• COVID coordinating structure formed at different level
• COVID preparedness and response plan developed with different scenarios
• Banned ET flights to many destinations
• closed all schools including higher institutions
• Mandatory quarantine
• reduced civil servants office engagement work by more than half and allowed work from  home
• declared State of Emergency
• FMOH-Command post established

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COVID preparedness and response plan

• The Public Health Emergency Operations Center is leading and coordinating the operationalization of the plan.

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Planning Scenarios

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Scenario1; Best case scenario

No confirmed COVID-19 case in Ethiopia.

Scenario 2; Medium case scenario

Ethiopia confirms an outbreak of COVID-19, however the index case is identified early, and transmission is limited to not more than two Regions

Scenario 3; Worst case scenario

Ethiopia confirms COVID-19 outbreak and, the outbreak spreads to more than 2 regions with high number of cases and/or death.

Assumptions-all 21%urban and 50 of rural population at risk

-Ro of 2.5,%of estimated to be infected to be 60% of pop’n at risk

-optimal social distancing infection low by 60%

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COVID preparedness and response plan

• Priority activities by seven pillars developed( adopted from WHO)

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• Leadership and coordination Pillar

-Activate and operationalize EOC

-develop COVID preparedness and response plan

-Establish multispectral taskforce

-map partners and resource mobilization

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Other pillars: surveillance, Lab, point of entry, case Mx and IPC, risk communication, logistics/ procurement

COVID Coordination Structure in Ethiopia

MNH Service Continuity

Anticipated challenges

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• Misconceptions about COVID-19 leading to distorted attitudes and limited/no visits to health facilities
• Disruption of critical supply chain
• Overwhelmed medical facilities
• Shortages of personal protective equipment
• Disruption of basic medical services
• Shortage of health care workforce
• increased COVID-19 exposure among patients on chronic care follow-ups

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Governance and coordination Mechanism

What has been done on MNH service Continuity?

Coordination:

-Coordination by the state Minister-weekly meeting

-Regional ,zonal and district deputy bureau heads

-facility head in Hospital and Health center

-regular virtual MNH TWG meetings with partners

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Tools/ guidelines

• Implementation guide dev’t, shred to all regions
• Communication materials
• Algorithms for ANC and laboring mothers
• Comprehensive COVID 19 management handbook developed
• Monitoring-Indicators defined for weekly and monthly monitoring

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Thank you