Ethiopian Healthcare Workers' Experiences During the COVID-19 Pandemic (preprint)

Background: The COVID-19 pandemic has caused widespread health and socioeconomic disruptions around the world. Understanding the impact that this crisis has had on health workers and the delivery of routine health care services within countries provides evidence on pandemic preparedness and response. Here, we conduct an investigation into these factors for the Ethiopian context. Methods and findings: We conducted an online cross-sectional survey with Ethiopian health care professionals between August 27 and October 10, 2020 via existing research networks. The variables of interest were confidence in COVID-19 related knowledge, training and experience, the adoption of precautionary health practices, risk perceptions, and respondent concerns. The majority of surveyed health care professionals in Ethiopia reported seeing fewer patients than usual during the COVID-19 crisis, gaps in pandemic training, inadequate access to personal protective equipment (PPE) and barriers to accessing COVID-19 testing. Most health care professionals were also deeply concerned and worried about their own COVID-19 risks and the likelihood that they would transmit the disease to others. Conclusions: Our study findings point to a possible reduction in routine health care services during the COVID-19 pandemic and gaps in pandemic preparedness in Ethiopia. The ministry of health and other stakeholders should work towards improving access to PPE and testing, and identify approaches to ensure that essential healthcare provision (such as immunizations) is not disrupted during crises akin to the COVID-19 outbreak.

Gender and Ebola in Eastern Democratic Republic of the Congo: Pathways to Protective Behavioral Outcomes During the 2018-2020 Ebola Outbreak (preprint)

Background: The Democratic Republic of the Congo (DRC) witnessed the world’s second largest Ebola Virus Disease (EVD) outbreak killing 2290 individuals, with women disportionately infected (57% of all cases) despite no evidence on differential biological risk for EVD. We assessed if men and women differ in personal protective behaviors (vaccine acceptance, health-seeking behaviors, physical distancing) and the mediating role of gender differences in levels of EVD information and knowledge, perceived disease risk, and social relations. Methods: We conducted a multi-stage cluster survey of 1395 individuals in North Kivu between 20 April – 10 May, 2019, a period of high transmission in the sampled region of DRC. We conducted path analyses using a structural equation modeling framework to examine associations among variables as hypothesized. Findings: We found associations between gender and all EVD preventive behavioral outcomes, with evidence for the mediating role of EVD knowledge and belief in rumors. Men reported greater EVD accuracy compared to women. Greater EVD knowledge accuracy was associated with increases in vaccine acceptance, formal care seeking, and self-protection behaviors. Lower belief in rumors led to greater vaccine acceptance, and greater EVD information awareness led to increased adoption of self-protection behaviors. Interpretation: In any response to infectious disease, such as the current COVID-19 pandemic, it is critical to not only design gender-sensitive communication and vaccination strategies, but also to engage women and the community as a whole in the response.Funding: The Enhanced Learning and Research for Humanitarian Assistance (ELRHA) and United Nations Development Programme (UNDP) provided funding for the study.Declaration of Interest: We declare no competing interests.Ethical Approval: The survey was approved by Brigham and Women’s Hospital Human Research Committee and the Research Center on Democracy and Development in Africa, Free university of the Great Lakes Countries in the Democratic Republic of the Congo.

Mobile phone data and COVID-19: Missing an opportunity? (preprint)

This paper describes how mobile phone data can guide government and public health authorities in determining the best course of action to control the COVID-19 pandemic and in assessing the effectiveness of control measures such as physical distancing. It identifies key gaps and reasons why this kind of data is only scarcely used, although their value in similar epidemics has proven in a number of use cases. It presents ways to overcome these gaps and key recommendations for urgent action, most notably the establishment of mixed expert groups on national and regional level, and the inclusion and support of governments and public authorities early on. It is authored by a group of experienced data scientists, epidemiologists, demographers and representatives of mobile network operators who jointly put their work at the service of the global effort to combat the COVID-19 pandemic.