Willingness of WHO staff to work in health emergencies in the African Region: opportunity for phased deployment of staff and ensure continuity of health services

A human resource base that ensures appropriate deployment of staff to emergencies, addressing different shock events in emergencies, without disrupting continuity of service is germane to a successful response. Consequently, the WHO Health Emergencies programme in the African Region, in collaboration with Africa Centre for Disease Control (ACDC) launched the African Volunteer Health Corps (AVoHC) and Strengthening and Utilization of Response Group for Emergencies (SURGE), an initiative aimed at ensuring a pool of timely responders. We explored the willingness of WHO staff to work in emergencies. A call for expression of interest to be part of the Elite Emergency Experts (Triple E) was published on 5th July 2022 via email and was open for 5 weeks. The responses were analyzed using simple descriptive statistics and presented with graphic illustrations. A total of 1253 WHO staff, from all the six WHO regions, cutting across all cadre, applied to the call. The applicants had various trainings and experiences in emergency and have responded to mostly disease outbreaks. Two-third of the applicants were males. This paper did not explore reasons for the willingness to work in emergencies. However, contrary to fears expressed in literature that health workers would not want to work in emergencies with potential for infections, the applicants have worked mostly in infectious emergencies. Literature identified some themes on factors that could impact on willingness of health workers to work in emergencies. These include concerns for the safety of the responders and impact of partners, child and elderly care, as well as other family obligations, which emergency planners must consider in planning emergency response.

Availability of AFP Specimen Collection Kits and Data Tools in Health Facilities in Selected States in Nigeria

Background: Acute flaccid paralysis (AFP) surveillance was adopted globally as a key strategy for monitoring the progress of the polio eradication initiative. The main objective of AFP surveillance is to detect the presence of circulating wild-type poliovirus and other subtypes of polioviruses. Stool specimen collection kits for AFP surveillance and data tools, regrettably are not always available in health facilities, and thus cause gaps in specimen collection and proper documentation which could ultimately lead to under-reporting of cases. Methods: This survey was undertaken to determine the availability of stool collection kits and data capturing tools in health facilities in some randomly selected states in Nigeria. The main aim was to relate the findings with the quality of the surveillance system in the areas visited and an overall indication of the functionality of the process in the country. Results: The outcome of the study found only 32,598 (74.7%) health facilities out of the 43,644 health facilities who visited and had stool specimen collection kits, while of the 43,582 health facilities visited, only 38,029 (87.3%) health facilities had data tools. Conclusions: Gaps were noticed in the supply of key AFP surveillance components to the health facilities visited, which by extension could apply to those not visited. Countries that are still polio-endemic will have to regularly survey their facilities for the availability of these very important materials. The methodology can be adapted to other diseases to evaluate the strength of the surveillance system.

Using the polio programme to deliver primary health care in Nigeria: implementation research

Objective To evaluate a project that integrated essential primary health-care services into the oral polio vaccine programme in hard-toreach, underserved communities in northern Nigeria.Methods In 2013, Nigeria's polio emergency operation centre adopted a new approach to rapidly raise polio immunity and reduce newborn, child and maternal morbidity and mortality. We identified, trained and equipped eighty-four mobile health teams to provide free vaccination and primary-care services in 3176 hard-to-reach settlements. We conducted cross-sectional surveys of women of childbearing age in households with children younger than 5 years, in 317 randomly selected settlements, pre- and post-intervention (March 2014 and November 2015, respectively). Findings From June 2014 to September 2015 mobile health teams delivered 2 979 408 doses of oral polio vaccine and dewormed 1 562 640 children younger than 5 years old; performed 676 678 antenatal consultations and treated 1 682 671 illnesses in women and children, including pneumonia, diarrhoea and malaria. The baseline survey found that 758 (19.6%) of 3872 children younger than5 years had routine immunization cards and 690/3872 (17.8%) were fully immunized for their age. The endline survey found 1757/3575 children (49.1%) with routine immunization cards and 1750 (49.0%) fully immunized. Children vaccinated with 3 or more doses of oral polio vaccine increased from 2133 (55.1%) to 2666 (74.6%). Households' use of mobile health services in the previous 6 months increased from 509/1472 (34.6%) to 2060/2426(84.9%). Conclusion Integrating routine primary-care services into polio eradication activities in Nigeria resulted in increased coverage for supplemental oral polio vaccine doses and essential maternal, newborn and child health intervention

Hepatitis B infection is highly endemic in Uganda: findings from a national serosurvey

Background: Infant immunization against hepatitis B began in Uganda in 2002. Objective: To determine the baseline prevalence of hepatitis B virus (HBV) infection and explore risk factors. Methods: A hepatitis B prevalence study was nested in the 2005 national HIV/AIDS serobehavioural survey. Demographic characteristics and risk factors were explored by questionnaire. One third of blood specimens (n=5875) from adults aged 15 to 59 years were tested for hepatitis B core antibodies (HBcAb); positive specimens were tested for hepatitis B surface antigen (HBsAg). Results: HBcAb was present in 52.3(95CI: 51.0-53.6) of adults; and HBsAg in 10.3(9.5-11.1). By 15-19 years of age; 40.0had been infected with HBV. Prevalence of both markers was significantly higher across northern Uganda; in rural areas; among the poor and least educated; and in uncircumcised men. Other independent predictors of infection were age; ethnic group; occupation; number of sex partners; and HIV and HSV-2 status. Conclusion: Hepatitis B virus infection is highly endemic in Uganda; with transmission occurring in childhood and adulthood. More than 1.4 million adults are chronically infected and some communities disproportionately affected. The hepatitis B infant immunization programme should be sustained and catch-up vaccination considered for older children