Evaluating the level of disaster preparedness of Tunisian University Hospitals using the Hospital Safety Index: a nationwide cross-sectional study

Background: Mid-way through the 'Sendai Framework for Disaster Risk Reduction 2015-2030', many nations are spending time, money and effort to enhance their level of preparedness facing disasters, on the other hand communities, countries and even continents are being left behind. Objectives: This study was conducted aiming at evaluating the level of disaster preparedness and response of Tunisian University Hospitals. Methods: This is a cross-sectional nationwide study conducted in Tunisia, from November 2020 to April 2021. Including 9 Tunisian University Hospitals and using the Hospital Safety Index. The data were analysed using the 'Module and safety index calculator'. Results: This study showed that 7 out of the 9 University Hospitals were assigned the 'B' category of safety with overall safety indexes that ranges between 0.37 and 0.62. Also, 4 out of 9 University Hospitals had safety scores less than 0.20 regarding their emergency and disaster management. Conclusions: This is the first study to evaluate disaster preparedness and response of university hospitals in Tunisia and in north Africa. It showed that the lack of knowledge, resources and willingness, are the most important issues that needs to be addressed in order to enhance the preparedness of Tunisian hospitals

A rapid assessment of health system preparedness and response to the COVID-19 pandemic in Guinea

Epidemic-prone diseases have high adverse impacts and pose important threats to global health security. This study aimed to assess levels of health facility preparedness and response to the COVID-19 pandemic in Guinea. This was a cross-sectional study in public and private health facilities/services across 13 Guinean health districts. Managers and healthcare workers (HCWs) from departments in each facility/service were interviewed. Descriptive statistics and comparisons were presented using Pearson's Chi-Squared Test or Fischer exact test. Totally, 197 managers and 1020 HCWs participated in the study. Guidance documents and dedicated spaces for management/isolation of suspected COVID-19 cases were available only in 29% and 26% of facilities, respectively. Capacities to collect (9%) and safely transport (14%) samples were low. Intensive care units (5%), dedicated patient beds (3%), oxygenators (2%), and respirators (0.6%) were almost lacking. While 36% of facilities/services had received infection prevention and control supplies, only 20% had supplies sufficient for 30 days. Moreover, only 9% of HCWs had received formal training on COVID-19. The main sources of information for HCWs were the media (90%) and the internet (58%). Only 30% of HCWs had received personal protective equipment, more in the public sector (p<0.001) and in Conakry (p=0.022). This study showed low levels of preparedness of health facilities/services in Guinea and highlighted a lack of confidence among HCWs who felt unsafe at their workplace. Better governance to improve and maintain the capacity of the Guinean health system to respond to current and future epidemics is needed.

Overview of preparedness and response to COVID-19 in Ghana

The Coronavirus disease 2019 (COVID-19) outbreak in Ghana is part of an ongoing pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). The first two cases of COVID-19 were confirmed in Ghana on 12th March 2020. COVID-19 was consequently declared a Public Health Emergency of National Concern, triggering several response actions, including enhanced surveillance, case detection, case management and contact tracing, closure of borders, suspension of international flights, ban on social gatherings and closure of schools. Preparedness and response plans were activated for implementation at the national, regional, district and community levels. Ghana's Strategic approaches were to limit and stop the importation of cases; detect and contain cases early; expand infrastructure, logistics and capacity to provide quality healthcare for the sick; minimise disruption to social and economic life and increase the domestic capacity of all sectors to deal with existing and future shocks. The health sector strategic frame focused on testing, treatment, and tracking. As of 31st December 2020, a total of 535,168 cases, including 335 deaths (CFR: 0.61%), have been confirmed with 53,928 recoveries and 905 active cases. All the regions have reported cases, with Greater Accra reporting the highest number. The response actions in Ghana have seen highlevel political commitment, appropriate and timely decisions, and a careful balance of public health interventions with economic and socio-cultural dynamics. Efforts are ongoing to intensify non-pharmaceutical interventions, sustain the gains made so far and introduce COVID-19 vaccines to reduce the public health burden of the disease in Ghana

COVID radiology preparedness in Nigeria: How ready are we?

The novel human coronavirus (COVID-19) began in Wuhan China as an interstitial pneumonia of unidentifiable origin in December 2019 and thereafter spread its tentacles all over the world.There is a need for radiology departments in both government and private facilities to be prepared to meet this crisis. Their efforts should be geared not only toward diagnosis, but also to preventing patient-to-patient, staff-to-patient, and staff-to-staff transmission of infection by utilizing social distancing measures and personal protective equipment (PPE).Aim: To evaluate the preparedness of radiologic departments of government hospitals and private centers, by assessing the outlay of the facility and likelihood to attend to COVID patients, type of equipment in the centers, and plans in place for protection of staff and the public.Materials and Methods: The radiology departments of government and private facilities in each geopolitical zone of the country were randomly selected to discuss radiology preparedness in Nigeria using preset guidelines which were sent to radiologists at the facilities. Written informed consent was obtained from the radiologists at the participating centers. Ethical approval was also obtained from the Lagos University Teaching Hospital Health Research Ethics Committee.Results: A total of twelve centers were included in the study, comprising eight government and four private centers. All had plans in place to attend to COVID patients; majority were in the process of developing standard operating procedures (SOPs). Majority of the government facilities lacked mobile equipment and adequate PPEs, with only one computed tomography machine and no holding area in some of the facilities for symptomatic patients unlike the private facilities. They, however, had infection control teams in place.Conclusion: Private radiological centers appear better prepared and more equipped to cope with the crisis than government hospitals. Adequate PPEs, mobile equipment, and isolation rooms need to be provided for the government facilities. Radiology information systems should be installed for remote viewing. Training and retraining on COVID management and decontamination should be conducted periodically. SOPs should be drafted universally and modified for each facility