Achieving SDGs and addressing health emergencies in Africa: strengthening health promotion.

In 1986, the World Health Organization (WHO) convened the first Global Conference on Health Promotion held in Ottawa, Canada. This conference yielded the Ottawa Charter which defined health promotion as the process of enabling people to increase control over, and to improve, their health. A series of conferences followed and in 2005, WHO convened the Sixth Global Conference in Bangkok, Thailand, which yielded the Bangkok Charter for Health Promotion. This Charter for the first time expanded the role of health promotion to include addressing social determinants of health. Ministers of Health from 47 countries of the WHO Regional Office for Africa in 2012 endorsed the Health Promotion: Strategy for the African Region. This Strategy highlighted eight priority interventions required to address health risk factors and their determinants. In 2011, the Rio Political Declaration on Addressing Social Determinants of Health was adopted by Health Ministers and civil society groups to address inequalities and inequities within and between populations. The main action areas were good governance to tackle the root causes of health inequities; promoting participation and ownership; community leadership for action on social determinants; global action on social determinants to align priorities and stakeholders; and monitoring progress on implementation of policies and strategies. Health promotion has been prominent as part of disease outbreak response, including for Ebola and COVID-19. It has been an integral part of improving maternal and child health mortality and morbidity as well as TB, HIV/AIDS and malaria; and lately reducing the impact of noncommunicable diseases, namely diabetes, high blood pressure and cancer. While challenges continue in strengthening health promotion, there have been concerted efforts to place health promotion on the development agenda in countries through Health in All Policies (HiAP), capacity strengthening, monitoring and evaluation, and innovative financing policy options using dedicated tax from tobacco and alcohol, and road use.

A health promotion approach to emergency management: effective community engagement strategies from five cases.

Community engagement is crucial for controlling disease outbreak and mitigating natural and industrial disasters. The COVID-19 pandemic has reconfirmed the need to elevate community engagement to build equity, trust and sustained action in future health promotion preparedness strategies. Using the health promotion strategy of strengthening community action enhances the opportunity for better outcomes. There is, therefore, a need to improve our understanding of community engagement practices during crises, scale-up good community engagement initiatives, and improve and sustain people-centered approaches to emergency responses. This paper presents five case studies from the United States, Singapore, Sierra Leone, Kenya and South Africa that demonstrate the potential strengths that can be nurtured to build resilience in local communities to help mitigate the impact of disasters and emergencies. The case studies highlight the importance of co-developing relevant education and communication strategies, amplifying the role of community leaders, empowering community members to achieve shared goals, assessing and adapting to changing contexts, pre-planning and readiness for future emergencies and acknowledgement of historic context.

The effect of increased mobility on SARS-CoV-2 transmission: a descriptive study of the trends of COVID-19 in Zimbabwe between December 2020 and January 2021.

INTRODUCTION: when the first cases of COVID-19 were reported in Zimbabwe in March 2020, the local outbreak was characterised by an insidious increase in national caseload. This first wave was mainly attributable to imported cases, peaking around July 2020. By October 2020, the number of cases reported daily had declined to less than 100 cases per day signalling the end of the first wave. This pattern mirrored the global trends. In December 2020, reports of new COVID-19 variants emerged and coincided with the beginning of the second wave within the ongoing pandemic. This paper reports on the analysis conducted on the new wave of COVID-19 beginning December 2020 to January 2021. The objective of this study was to document the evolving presumptive second wave of the COVID-19 pandemic in Zimbabwe from December 2020 to January 2021. METHODS: this is a retrospective analysis of secondary data extracted from the daily situation reports published by the Ministry of Health and Child Welfare, Zimbabwe and World Health Organization Country Office, Zimbabwe. The period under consideration started from 1st December 2020 to 31st January 2021. RESULTS: there was a 333% increase in the number of confirmed COVID-19 cases starting 1st December 2020, to 31st January 2021. These new cases were mainly attributed to community transmission though there were a few imported cases. There was a 439% increase in the absolute number of deaths; however, the case fatality rate remained low at 3.6%, and comparable to that from other countries. Harare, Bulawayo and Manical and provinces accounted for 60% of the case burden, with the other seven provinces only accounting for 40%. By mid-January, the number of incident COVID-19 cases started to decline significantly, to levels similar to the residual levels seen during the first wave. CONCLUSION: the second wave, which lasted a period of less than 2 months, had a steep rise and sharp decline in the incident cases and fatalities. The steep rise was attributable to increased mobility, with a consequent increase in the chains of community transmission. The declines, noted from mid-January 2021, may be partly attributable to a strict national lockdown, though more in-depth exploration of the drivers of transmission is needed to tailor effective interventions for future control. Differentiated strategies maybe needed according to the case burdens in the different provinces. In anticipation of further waves, the introduction of safe and effective vaccines might be the game changer if the vaccines are widely availed to the population to levels adequate to achieve herd immunity. Meanwhile, infection prevention and control guidelines must continue to be observed.

A descriptive study of the trends of COVID-19 in Zimbabwe from March-June 2020: policy and strategy implications.

INTRODUCTION: the first cases of COVID-19 were reported in China in December 2019. Since then, the disease has evolved to become a global pandemic. Zimbabwe reported its first case on 20th March 2020, and the number has been increasing steadily. However, Zimbabwe has not witnessed the exponential growth witnessed in other countries so far, and the trajectory seems different. We set out to describe the epidemiological trends of COVID-19 in Zimbabwe from when the first case was confirmed to June 2020. METHODS: data were collected from daily situation reports that were published by the Zimbabwean Ministry of Health and Child Care from 20th March to 27th June 2020. Missing data on the daily situation reports was not imputed. RESULTS: as of 27th June 2020, Zimbabwe had 567 confirmed COVID-19 cases. Eighty-two percent of these were returning residents and 18% were local transmission. The testing was heavily skewed towards returnees despite a comprehensive testing strategy. Of the confirmed cases, 142 were reported as recovered. However, demographic data for the cases were missing from the reports. It was not possible to estimate the probable period of infection of an active case, and case fatality in Zimbabwe was about 1% for the first 4 months of the pandemic. CONCLUSION: the epidemiological trends of COVID-19 experienced in Zimbabwe between March and June 2020 are somewhat different from what has been observed elsewhere. Further research to determine the reasons for the differences is warranted, to inform public health practice and tailor make suitable interventions.