Reactivation of Surgical Campaigns after the Covid Pandemic: Surgeons in Action with Hernia International Foundations in 2022

Aim: The Cirujanos en Accion and Hernia International foundations carried out their own and collaborative surgical campaigns in developing countries. In 2020 and 2021 the programme had to be suspended due to Covid. In 2022 we restarted our actions, analysed the difficulties of reactivation and described the campaigns that had been carried out and those that had to be delayed. Material/ Methods: We describe the 9 campaigns of Surgeons in Action, our own and in collaboration with Hernia International and our own campaign to the region of Naborno Karabakh, planned for September and cancelled 24 hours before departure due to the resurgence of armed conflict. An analysis is made of volunteers, places, type (adults or children or mixed), collaborations with other foundations, patients operated and procedures done according to pathologies, integration with local staff with exchange of knowledge. Result(s): Made in 8 countries (Benin, Camerun, Gambia (2), Kenya, Liberia, Mozambique, Tanzania, Sierra Leone) and postponed in one country, the Naborno Karabakh region of Armenia. 85 volunteers (25 general and 10 paediatric surgeons, 19 anaesthetists, 3 intensivists, 23 nurses, 5 audiovisuals);local staff;1144 patients (473 children, 671 adults), 1325 procedures for various pathologies (hernias, goitres, hydroceles, undescendend testis, soft tissue tumours, etc.) Conclusion(s): 9 campaigns have been carried out successfully and new locations have been opened with a good projection for the coming years, and we have experienced difficulties with the cancellation of a mega-campaign in an area with geopolitical conflicts - to be taken into account in the future.

Impact of health systems reform on COVID-19 control in Sierra Leone: a case study.

BACKGROUND: There are various impacts of COVID-19 on health systems of the world. The health systems of low- and middle-income countries are less developed. Therefore, they have greater tendencies to experience challenges and vulnerabilities in COVID-19 control compared to high-income countries. It is important to contain the spread of the virus, and likewise strengthen the capacity of health systems in order for the response to be effective and swift. The experience from 2014 to 2016 Ebola outbreak in Sierra Leone served as preparation for COVID-19 outbreak. The aim of this study is to determine how control of COVID-19 outbreak in Sierra Leone was enhanced by the lessons learned from 2014 to 2016 Ebola outbreak, and health systems reform. METHODS: We used data from a qualitative case study conducted in four districts in Sierra Leone through key informant interviews, focus group discussions, document, and archive record reviews. A total of 32 key informant interviews and 14 focus group discussions were conducted. A thematic analysis was used to analyze the data, and all transcripts were coded and analyzed with the aid of ATLAS.ti 9 software program. RESULTS: The six themes obtained were composed of categories that connect with each other and with codes to form networks. The analysis of the responses demonstrated that "Multisectoral Leadership and Cooperation", "Government Collaboration among International Partners", and "Awareness in the Community" were among the key interventions used during the control of 2014-2016 Ebola virus disease outbreak, which were applied in the control of COVID-19. An infectious disease outbreak control model was proposed based on the results obtained from the analysis of the lessons learned during the Ebola virus disease outbreak, and health systems reform. CONCLUSIONS: "Multisectoral Leadership and Cooperation", "Government Collaboration among International Partners" and "Awareness in the Community" are key strategies that enhanced the control of the COVID-19 outbreak in Sierra Leone. It is recommended that they are implemented in controlling COVID-19 pandemic or any other infectious disease outbreak. The proposed model can be used in controlling infectious disease outbreaks, especially in low- and middle-income countries. Further research is needed to validate the usefulness of these interventions in overcoming an infectious disease outbreak.

"This Is Where We Have Scored”: Exploring the Interface between Project and Institutional Sustainability Facilitated by a Faith-Based Development Organisation in Sierra Leone

This paper explores the issue of project sustainability through an analysis of the experiences of a Faith-Based Development Organisation (FBDO) in Bo, Sierra Leone. The FBDO in question was approached by members of their local Catholic Women Association (CWA) to help them with the planning and management of a farm that had been donated to them by a chief. They agreed to this, and a series of workshops were held in June 2014, along with follow-up discussions with local experts and businesses as to what could be done to help support the women in their endeavour. Amongst other priorities, the women identified the need for the farm to produce food, income and help with their development. However, an outbreak of the Ebola virus that occurred between 2014 and 2016, following as it did on the back of an 11-year (1991–2002) civil war in Sierra Leone, led to a re-evaluation of the farm project in the eyes of the FBDO as they decided to shift to earlier priorities in education and health care. Given the constraints regarding resources and personnel, community projects, such as the CWA farm project, became of much lesser importance even though it resonated strongly with the goals of the FBDO and government, and had garnered much support amongst international donors. The paper sets out that story, beginning with the workshops and discussions held in 2014, and the ramifications of these responses to various ‘shocks', such as those presented by the civil war and disease outbreaks (Ebola and COVID-19);it also provides recommendations that might be of use regarding the interface between project and institutional sustainability within FBDOs and, indeed, the wider community of development organisations.

Wild meat consumption in urban Sierra Leone during the Covid-19 pandemic

Wild meat is associated with an increased risk of zoonotic diseases. In some West African countries wild meat consumption declined as the result of official restrictions following Ebola outbreaks during 2013-2016, and was also affected by the current Covid-19 pandemic. In Sierra Leone, a country affected by these diseases, we documented wild meat use in four markets in the capital, Freetown. From a total of 197 interviews, we analysed the influence of age and gender on the types of wild meat eaten and the reasons for their consumption. We found that more men than women consumed wild meat, and for both genders taste was the main reason for eating wild meat. Age did not affect wild meat consumption amongst women. Evidence for changes in consumer behaviour in response to zoonotic disease risk was mixed. Although some consumers avoided wild meat because of disease risk, none stated this was the primary reason for not eating wild meat, and monkeys (presumed to carry a high zoonotic disease risk) were amongst the species cited as being consumed often. More work is needed to identify the best pathway towards safe and sustainable consumption of wild meat in urban Sierra Leone.

Contesting the crisis narrative: epidemic accounts in Sierra Leone, Tanzania, and Democratic Republic of the Congo.

Scientists and global commentators watched African countries closely in the early months of the COVID-19 pandemic, predicting an impending disaster: the virus was projected to overwhelm already weak health systems. These expectations were informed by imaginaries of Africa as an inevitable site of epidemic disaster. This paper draws on accounts from Sierra Leone, Tanzania, and Democratic Republic of the Congo to contrast global catastrophe framings with everyday imaginations and experiences of crisis and crisis management. Utilising ethnographic research, the paper initially explores how COVID-19 was understood in relation to previous epidemics, from HIV (human immunodeficiency virus) to Ebola, as well as political conflict. It then considers how global crisis narratives both inform and are in tension with everyday collective and personal experiences. The paper brings these empirical reflections into a conversation with theoretical debates on the discursive construction of crisis and its effects, and argues that these tensions matter because crisis framings have consequences.

Clinical presentations and management of COVID-19 infected children seen in a district health facility in Kambia, northern Sierra Leone

Studies reporting the clinical presentations of COVID-19 in children in sub-Saharan Africa are few, especially from resource-constrained countries. This case series reports the demographic and clinical characteristics and laboratory findings of confirmed cases of COVID-19 in children seen at a district hospital in Sierra Leone. This is a report of nine COVID-19 paediatric cases managed at a secondary level hospital in Kambia District, Northern Sierra Leone. Each child was detected by contact tracing after an infected adult was identified by the COVID-19 response team. The clinical symptoms at presentation, clinical courses, and treatments instituted and patient outcomes are discussed in the context of the facilities available at a typical West African district hospital. Nine out of 30 individuals with confirmed COVID-19 infection who presented to the hospital from 24 April to 20 September 2020 and who were admitted to the isolation center of the hospital were in the paediatric age group. The mean age (SD) and median (IQR) of the children were 69.0 +/- 51.7months and 84.0 (10.5, 108.0) months, respectively;five (55.6%) were males. The children were asymptomatic or only had mild illnesses and none required intranasal oxygen or ventilatory support. In the five symptomatic children, the most common symptoms were fever (40%) and cough (40%). All children had normal haemoglobin, platelet and white blood cell (WBC) count. Four children had a positive malaria test and were treated with a complete course of anti-malaria medications. No child received steroid or had specific anti-COVID-19 treatment. All children stayed in the isolation center for 14 days and were re-tested for COVID-19 two weeks after initial diagnosis. No complications have been reported in any of them since discharge. The proportion of children among COVID-19 infected cases seen in a rural community in Sierra Leone was 30%. Fever was the most common symptom and malaria was confirmed in 40% of the infected children. This has significant implication on the diagnosis of COVID-19 in malaria-endemic settings and on how best to manage children who present with fever during the COVID-19 pandemic. Copyright © Hammed Hassan Adetola et al.

Changes in Childhood Immunizations and Intermittent Preventive Malaria Treatment in a Peripheral, Referral Immunization Center During the First 12 Months of COVID-19 Pandemic in Sierra Leone, Western Africa.

Background: There is increasing evidence that the COVID-19 pandemic disrupted childhood immunization services. However, detailed reports on immunizations and preventive antimalarial prophylactic treatments delivered and how the trends changed in referral centers in low-income countries are still missing. Methods: We performed a retrospective cross-sectional study. Data for vaccinations administered to children <5 years of age, according to the local vaccination schedule, were extracted from the official records of the Kent Community Health Post, Sierra Leone, in the period between April 2019 and March 2021. We compared the vaccinations performed in the first year, considered as a pre-Covid period, with the second year, post-Covid period. Both the period was then divided in four trimester each and the same analysis was operated for each trimester. A Chi-square goodness of fit test was performed to compare the number of vaccinations performed both in the 2 years and in the 8 trimesters. Findings: Seven thousand two hundred and eighty-three vaccinations were administered: 4,641 in the period between April 2019 and March 2020 and 2,642 between April 2020 and March 2021. The drop in immunizations performed began as soon as the first cases were described in China. The drops were statistically significant when the first three trimesters of the two study periods were compared, while no statistically significant differences were observed for all the vaccines performed in the 4th trimesters. Vaccines administered at birth (BCG) were less affected compared to booster vaccinations. Conclusions: Immunizations administered in a referral health center in Sierra Leone significantly declined during the pandemic. Although the decline was less pronounced in the last months of the pandemic, we don't think that the small increase would indicate the recovery of previously missed vaccinations. These findings open new public health challenges for the coming years.

Local production of alcohol-based hand rub to optimize hand hygiene facility in healthcare settings during COVID-19

Background: Hand hygiene (HH) remains arguably the most effective way to prevent healthcare-associated infections (HAIs) and ultimately improve the prospect of patient safety. Studies have shown that as many as 50%–70% of infections are transmitted through hands due to poor HH practices. HH with use of alcohol-based hand rub (ABHR) is preferred over handwashing with soap and water because of its wide microbial efficacy, time efficiency, and improved skin tolerance. It is also well known that ABHR can be used as an effective prevention measure during disease outbreaks. Before and during the COVID-19 pandemic, health facilities in Sierra Leone have been challenged with HH infrastructural problems such as lack of sinks with constant running water. Before Sierra Leone recorded its first case of COVID-19 in March 2020, the consumption of ABHR in the health facilities was estimated to be 24,000 L per year, which doubled during the COVID-19 pandemic. The demand for commercially available ABHR increased, leading to acute shortages. The estimated cost of the locally produced ABHR ~$2–3 per 500 mL, although it may cost up to $10 for 500 mL when buying imported ABHR products from the local market. Methods: All ingredients were procured locally, and ABHR production was based on WHO formula 1. The production was set for 12 months to cover the estimated annual consumption of ABHR, with periodic monitoring to ensure effective distribution and availability at the point of care. Analysis of assessment results in 12 hospitals from the pre-COVID-19 era (2019) to the COVID-19 era (2021) was performed based on the WHO IPC Assessment Framework (IPCAF) indicator. Results: With an average monthly production of 3,482 L, a total of 41,780 L ABHR was produced and packaged in branded 500-mL containers for distribution to healthcare facilities. This quantity exceeded the estimated demand for ABHR during the COVID-19 pandemic. The data show a considerable increase (from 25% to 44%) in the number of available and functioning HH stations with mainly locally produced ABHR. Results from the monitoring of 575 peripheral health units (PHUs) in 2021 also showed that >67% of PHUs had HH facilities in all clinical areas and that the locally produced ABHR was used in 79% of these HH stations. Conclusions: Locally produced ABHR has shown to be a cost-effective and evidence-based intervention to optimize HH at the point of care. Therefore, localities are encouraged to undertake this realistic and sustainable approach to address issues of acute shortage of ABHR, especially during a global pandemic.Funding: NoneDisclosures: None

Extending and Strengthening Routine DHIS2 Surveillance Systems for COVID-19 Responses in Sierra Leone, Sri Lanka, and Uganda.

The COVID-19 pandemic challenged countries to protect their populations from this emerging disease. One aspect of that challenge was to rapidly modify national surveillance systems or create new systems that would effectively detect new cases of COVID-19. Fifty-five countries leveraged past investments in District Health Information Software version 2 (DHIS2) to quickly adapt their national public health surveillance systems for COVID-19 case reporting and response activities. We provide background on DHIS2 and describe case studies from Sierra Leone, Sri Lanka, and Uganda to illustrate how the DHIS2 platform, its community of practice, long-term capacity building, and local autonomy enabled countries to establish an effective COVID-19 response. With these case studies, we provide valuable insights and recommendations for strategies that can be used for national electronic disease surveillance platforms to detect new and emerging pathogens and respond to public health emergencies.

Exploring the effects of new viral illnesses on pregnancy outcomes in sub- Saharan Africa

In sum, the totality of the available evidence suggests that there is currently limited research data relating to the pathogenesis, consequences, and outcomes of pregnancy in African women infected with new viral illnesses such as COVID-19, Lassa fever, and Ebola virus disease. World Health Organization (2020) Ebola virus disease. https://www.who.int/news-room/fact-sheets/detail/ebolavirus-disease 7. In Guidelines for screening and caring for pregnant women with Ebola virus disease for health care providers in US hospitals. Jamieson DJ, Uyeki TM, Callaghan WM, Meaney-Delman D, Rasmussen SA. What obstetrician-gynecologist should know about Ebola: a perspective from the Centers for Disease Control and Prevention.

Human preparedness: Relational infrastructures and medical countermeasures in Sierra Leone.

This paper examines health worker experiences in two areas of post-epidemic preparedness in Sierra Leone - vaccine trials and laboratory strengthening - to reflect on the place of people in current models of epidemic response. Drawing on ethnographic research and interviews with health workers in the aftermath of Ebola, it explores the hopes and expectations that interventions foster for frontline workers in under-resourced health systems, and describes the unseen work involved in sustaining robust response infrastructures. Our analysis focuses on what it means for the people who sustain health systems in an emergency to be 'prepared' for an epidemic. Human preparedness entails more than the presence of a labour force; it involves building and maintaining 'relational infrastructures', often fragile social and moral relationships between health workers, publics, governments, and international organisations. The COVID-19 pandemic has underscored the value of rethinking human resources from an anthropological perspective, and investing in the safety and support of people at the forefront of response. In describing the labour, personal losses, and social risks undertaken by frontline workers for protocols and practicality to meet in an emergency context, we describe the social process of preparedness; that is, the contextual engineering and investment that make response systems work.

Response to Mass-Casualty Incidents and Outbreaks: A Prehospital Disaster Training Package Developed for the National Emergency Medical Service in Sierra Leone.

Sierra Leone is a country highly prone to disasters, still recovering from the catastrophic 2014 Ebola epidemic. In 2018, the country launched its first National Emergency Medical Service (NEMS) aiming to strengthen the provision of essential health services to the population with the long-term goal of creating a resilient health system able to effectively respond to and recover from emergencies. The Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health (CRIMEDIM), together with the Italian NGO Doctors with Africa (CUAMM), under the direct supervision of the Ministry of Health and Sanitation (MoHS), developed a prehospital Disaster Training Package (DTP) to be delivered to all NEMS personnel to boost the prehospital management of mass-casualty incidents (MCIs) and outbreaks. The DTP included a first phase in which NEMS local trainers underwent a training-of-trainers (ToT) course, enabling them to deliver cascade trainings to 16 district ambulance supervisors, 441 paramedics, 441 ambulance drivers, and 36 operators working in the NEMS operation center. This on-going training package represents the first Disaster Medicine training course for prehospital health professionals in Sierra Leone.

For the sake of our children – The WASUP project (World Against Single Use Plastic)

262 Figure 1WASUP Ambassador in Sierra Leone talking about the story of three Plastic bottles written by Professor Gatrad[Figure omitted. See PDF] 262 Figure 2Winner of the plastics artwork exhibition[Figure omitted. See PDF]ResultsFrom a handful of litter picking volunteers, there are hundreds now, including accompanied children. The council has employed staff to oversee litter picking activities and ‘anyone’ can now pick litter and leave it in a transparent bag next to a council bin. Over 50 canal clean events have taken place - secondary school children ‘fishing plastic from the CRT boats.Thirty-three schools took part and learnt about plastic over 3 days in the plastic exhibition. Birmingham Education Partnership, Lendlease and four other construction companies arrange school presentations for WASUP.Working with the Commonwealth Games 2022, many schools have joined the 2022 challenge whereby a WASUP trophy will be presented to any school collecting 2022 bags. Commonwealth Games are involved in the distribution of books locally and eBooks to Commonwealth countries.The gardens are planned and built by pupils and help children connect with nature. The litter picking and gardens, are no doubt helping everyone’s mental and physical wellbeing, particularly during Covid.Over 6000 spectacles were sent out to various countries just in 2021.ConclusionWithin 4 years there are WASUP ambassadors in many parts of the UK and over 30 countries enthusing children in their respective schools (figure 2). WASUP has been presented with the Green Award and the David Middleton Sustainability Award.

SARS-CoV-2 antibody prevalence in Sierra Leone, March 2021: a cross-sectional, nationally representative, age-stratified serosurvey

Introduction/ Background: As of March 2021, the Africa CDC had reported 4,159,055 cases of COVID-19 and 111,357 deaths among the 55 African Union Member States;however, no country has published a nationally representative serosurvey. Such data are vital for understanding the pandemic's progression on the continent, evaluating containment measures, and policy planning. Methods: We conducted a cross-sectional, nationally representative, age-stratified serosurvey in Sierra Leone in March 2021 by randomly selecting 120 Enumeration Areas throughout the country and 10 randomly selected households in each of these. One to two persons per selected household were interviewed to collect information on sociodemographics, symptoms suggestive of COVID-19, exposure history to laboratory-confirmed COVID-19 cases, and history of COVID-19 illness. Capillary blood was collected by fingerstick, and blood samples were tested using the Hangzhou Biotest Biotech RightSign COVID-19 IgG/IgM Rapid Test Cassette. Total seroprevalence was estimated after applying sampling weights. Results: The overall weighted seroprevalence was 2.6% (95% CI 1.9-3.4). This was 43 times higher than the reported number of cases. Rural seropositivity was 1.8% (95% CI 1.0-2.5), and urban seropositivity was 4.2% (95% CI 2.6-5.7). Stratifying by age group and weighting, 1.7% (95% CI 0.2-3.2) of participants age 5-9 tested positive for anti-SARS-CoV-2 antibodies, as did 2.6% (95% CI 0.8- 4.2) of those 10-19, 1.2% (95% 0.2-2.3) of those 20-39, 4.4% (95% CI 2.4-6.4) of those 40-59, and 3.6% (95% CI 1.6-5.6) of those 60 and above. There was a significant difference in seropositivity between rural/urban populations (Rao-Scott Chi-square p=0.002). Impact: This has ramifications for the country's third wave, where the average number of daily reported cases was 87 by the end of the Jone 2021-this could potentially be on the order of 3,700 actual infections, calling for stronger containment measures in a country with only 0.2% of people fully vaccinated. Conclusion: Overall seroprevalence was low compared to countries in Europe and the Americas (suggesting relatively successful containment in Sierra Leone). The results may reflect significant underreporting of incidence and mortality across the continent.

Implementation Support Guide: Development of a National Georeferenced Community Health Worker Master List Hosted in a Registry

Introduction/ Background: Community Health Workers (CHWs) have been a cornerstone of health delivery across the globe for over a century. Unfortunately, this vital cadre is often not counted: information on numbers and location of active CHWs is frequently unavailable and/or inaccurate. This undermines health system planning and impedes CHWs' provision of care. Methods: A functional and institutionalized national georeferenced CHW master list (CHWML) closes these gaps. This document was drafted in response to the urgent need to count and identify CHWs as part of the COVID-19 response. It was a collaborative effort by the Clinton Health Access Initiative (CHAI), Community Health Impact Coalition (CHIC), Global Fund, Living Goods, Health GeoLab Collaborative (HGLC), and UNICEF. More than 50 organizations provided technical review, including Africa CDC, USAID and WHO. Representatives from the ministries of health of Ethiopia, Kenya, Mali, Rwanda, Uganda, Sierra Leone, Togo and Zambia inputted their technical expertise and ongoing needs. Results: A CHWML is a single source of truth containing the data elements required to uniquely identify, effectively describe, enumerate, locate, and contact all CHWs in a country. This guidance was developed to support national governments and their technical/financial partners to develop functional, continuously maintained, shared, and institutionalized CHWML hosted in a national registry. It describes a 7-step process for generating, sharing, and maintaining the CHWML in a registry. Each step includes a decision checklist and key considerations for implementation. The guidance also includes a 3-stage maturity continuum, five candid national-level experiences implementing CHWMLs, and practical resources to aid in operationalization. Impact: Accurate, up-to-date, reliable data on CHWs, which captures their location, qualifications and activities, is critical for strategic decision-making. Hosted and kept up to date in a CHWML, these data are vital not only to support existing CHWs, but to identify and close coverage gaps in pursuit of universal health coverage. Conclusion: While one-off georeferenced censuses of CHWs may be effective for establishing a baseline, it is only a first step toward establishing a functional and institutionalized CHWML. Investing in the development and use of a CHWMLs is a fundamental step in maximizing the impact, efficiency, and equity of health service delivery.

1st International Conference on Public Health in Africa

The proceedings contain 98 papers. The topics discussed include: COVID-19 clinical presentation and SARS-CoV-2 viral kinetics in people living with HIV;estimation of shedding time in laboratory-confirmed COVID-19 cases in South Africa, 2020;temporal dynamics of SARS-COV-2 viral load and related antibodies in West African patients: the COVADIS cohort;establishing a national SARS-CoV-2 surveillance network across South Africa to support wastewater-based genomic and epidemiological monitoring of the COVID pandemic, 2020-2021;prevalence of anti-SARS-CoV-2 IgG antibodies among Kenyan blood donors between June and August 2021;SARS-CoV-2 antibody prevalence in Sierra Leone, March 2021: a cross-sectional, nationally representative, age-stratified serosurvey;first national household seroprevalence survey of SARS-CoV 2 antibodies in Tunisia, April 2021;and SARS-CoV-2 seroprevalence across six states of Nigeria, October 2020 and June 2021.

Improving Care for Children Through Continuous Professional Development for Nurses at Ola During Children's Hospital, Freetown, Sierra Leone

Background: One in ten children in Sierra Leone dies before their fifth birthday, often as a result of treatable conditions such as malnutrition, malaria and respiratory infections. Ola During Children's Hospital (ODCH), Freetown, is the only tertiary paediatric referral unit in the country, and nursing staff are the major workforce in the hospital. However, there are no postgraduate paediatric nursing qualifications in-country, leaving gaps in staff's paediatric specific knowledge and skills. ODCH management and Welbodi Partnership developed a programme of Continuous Professional Development (CPD) for nurses at the hospital, aiming to improve their knowledge, skills and the quality of nursing care. Part-funded through an ICATCH grant, a group of nursing staff were trained as independent Trainers, Mentors and Managers, to design and deliver CPD modules independently. Together they co-developed and delivered a series of paediatric training modules. Methods: A mixed methods process evaluation was undertaken, guided by the REAIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) Framework. Descriptive statistics were drawn from training and mentorship registers and semi-structured qualitative interviews undertaken with Key Informants (clinical staff, n = 16) at project end. Results: Reach - 81 nurses were trained as trainers and/or mentors and/or managers. Due to high rates of staff turnover it was not feasible to track the proportion of nursing staff reached, however, the vast majority of nursing staff at the hospital are expected to have received training or mentorship training through the programme (approximately 230 staff). Effectiveness - All Key Informants described positive changes to nurses' performance and improvements to multi-disciplinary working. Nurses reported increased confidence in performing their duties efficiently and effectively, and in working across cadres and with doctors. Adoption - 21 (95%) of the staff trained as Trainers and 46 (82%) of the staff trained as Mentors, subsequently delivered training/mentorship. The primary barrier to adoption was the expectation of financial renumeration, however this was addressed through transparent communication and ongoing encouragement. Implementation - Adaptive programming was required throughout, particularly in response to the COVID-19 pandemic;training was redirected towards new COVID-19 Standard Operating Procedures and training methods altered (e.g. smaller groups and information sharing via WhatsApp) Maintenance - As of June 2021, 7 Trainers (32%) and 17 Mentors (14%) were 'active' (had delivered training or mentorship in the previous month). The primary barrier to maintenance was staff being transferred to other hospitals or being on study leave. Welbodi Partnership will continue to work with the Hospital Management on further embedding these CPD practices and addressing the barriers identified. Conclusion: CPD delivered via training-of-trainers was well adopted at ODCH and perceived to improve nurse's performance and multidisciplinary working. However, staff turnover may pose a significant barrier to maintenance. Further attention is needed to develop a robust strategy to mitigate against this.

Planning for the next pandemic: facts and figures

The world is not prepared,” said the report by the Global Preparedness Monitoring Board (GPMB), a body co-convened by the World Bank and World Health Organization (WHO). According to the World Wide Fund For Nature, three or four new zoonotic diseases are emerging each year, and the problem is likely to worsen because of the need to feed a growing population and demand for wild meat as both a necessity and delicacy. According to the GPMB, the 20 per cent fall in Sierra Leone was enough to wipe out five years of development. [...]pressure looks set to grow to contain crop diseases, amid the world’s growing population and a rise in the number of people facing food insecurity from 23 per cent in 2014 to 26 per cent in 2018, according to the UN’s Food and Agriculture Organization.

Summit spurs pledges on malaria, neglected diseases

See PDF] According to the World Health Organization (WHO), Africa was home to 95 per cent of global malaria cases and 96 per cent of malaria deaths in 2020 , with children under five accounting for about 80 per cent of all malaria deaths in the region. Harper urged countries where NTDs are endemic to commit to bring treatment into their health systems and train their health workers to support this, especially in remote communities that also need access to clean water and sanitation. Melanie Renshaw, a senior technical advisor of the African Leaders Malaria Alliance, describes malaria and NTDs as pathfinders for sustainable pandemic preparedness and response and the long-term strengthening of health systems.

COVID-19 vaccine acceptance higher ‘in poor countries’

Speed read People in low- and middle-income countries ‘more willing to take COVID-19 jab’ - study Researchers say findings support prioritisation of vaccines in poorer countries Data points to huge economic toll of slow vaccine rates in developing countries [NEW DELHI] People in low- and middle-income countries (LMICs) appear more willing to take a COVID-19 vaccine than those living in richer countries such as Russia and the US, according to a study published in Nature Medicine. See PDF] Lawrence Gostin, professor of global health law at Georgetown University in the US and director of the World Health Organization (WHO) Collaborating Center on National and Global Health Law, believes high-income countries should immediately donate large quantities of COVID-19 vaccines — not just excess vaccines — and pledge vaccines for the future. A “Global Dashboard” on COVID-19 vaccine equity, developed jointly by the WHO, the United Nations Development Program and the University of Oxford, estimates that if low-income countries could keep up the same COVID-19 vaccination rate as high-income countries, they could add $38 billion to their GDP forecast for 2021.