Tunisian first COVID-19 Intra-Action Review, March-July 2021

ABSTRACT

Introduction/ Background: The objective of the Intra-Action Review (IAR) was to review the Tunisian COVID-19 national preparedness and response best practices and challenges to adjust the response to the crisis and impact of COVID-19 pandemic on health systems. Methods: RIA is an interactive and structured methodology, developed by WHO to identify best practices and challenges in a response to an ongoing crisis. The first RIA on COVID-19 response in Tunisia was carried out, under the Tunisian Ministry of Health in cooperation with the German Biological Safety Program and the Biosecurity Cooperation Project in Tunisia, from March 30 to July 1, 2021. Four pillars of the Covid-19 response were selected for review coordination, laboratory, points of entry, and logistic support. Results: The RIA identified 24 best practices, 23 challenges and 23 recommendations to improve the current response by adopting appropriate actions for immediate, mid and long-term implementation. The best practices include availability of a prevention, preparedness, response and resilience plan (2P2R), an Early Warning, Alert and Response System (EWARS);regular weekly teleconference “EPICOV”;trained Rapid Response Teams (RRTs), Field epidemiologist and laboratory staff, decentralization of SARS-CoV-2 testing;and an efficient stock management system. The most important challenges were leadership and coordination mechanism, legal framework, human resources, and genomic-sequencing surveillance capacity. Impact The RIA was an opportunity to analyze the operational capacity of the Tunisian health system to respond to the pandemic in collaboration with other relevant sectors. The results of the RIA will serve to adjust the national response to Covid-19. Conclusion: The recommendations target a legal framework, a quality assurance management system and an Integrated Disease Surveillance and Response (IDRS) system. The RIA recommended also to enhance coordination within and between pillars;and mobilize funds to support 2P2R, EWARS, IDRS and human resources and provide a basis for future joint activities.