How Ethiopia is maintaining health services during a pandemic?

Nearly a month after the World Health Organization (WHO) declared novel coronavirus a global pandemic, Ethiopia declared a state of emergency, when the country recorded 55 confirmed COVID-19 cases and 2 deaths. The government refrained from sending the country into lockdown in an effort to preserve the country’s economy. Since August, the government has been debating lifting the state of emergency or temporarily extending it for a further three months. Recently, an 80% spike in COVID-19 cases over a span of 12 hours was recorded, which was attributed to the testing campaign launched in early August, which aims to conduct 200,000 tests. In the first week of September, the number of confirmed cases in Ethiopia grew by 15.7% compared to 2.2% in Nigeria, 16.1% in India and 5% in the United States of America.

In addition to the COVID-19 pandemic, Ethiopia is also grappling with cholera and yellow fever outbreaks. According to a Ministry of Health (MoH) update, there was a 14% decline in pentavalent and measles-containing-vaccine first-dose (MCV1) coverage from January 2020 to April 2020. The decline in coverage in the first quarter of 2020 could be attributed to the reduced number of outreach sessions and demand for immunisation – primarily driven by restriction of movement; fear of contracting the virus; and shortage of personal protective equipment (PPE) for health workers. Following intense sensitisation efforts by the MoH, service uptake resumed in the second quarter. However, human papillomavirus (HPV) vaccine second-dose vaccination was postponed to October 2020 due to school closures.

Each vaccination team had six members, including a health worker assigned to carry out COVID-19 screening and education.

A measles follow-up campaign, targeting 14.9 million children aged 9 months – 5 years, was initially planned for April but was postponed in light of the pandemic. However, following a National Immunization Technical Advisory Group (NITAG) recommendation that the measles follow-up campaign should be conducted, the MoH launched the campaign on 30 June under WHO’s pandemic guidance, and it has now been completed. The supplementary immunisation activities were done over 10 days to limit crowds and comply with COVID-19 protection measures. Each vaccination team had six members, including a health worker assigned to carry out COVID-19 screening and education. Reports indicate that, overall, the campaign was successful, with provisional results showing more than 90% coverage. The success was attributed to some key interventions, including, the availability of PPE and infection prevention and control (IPC), school closures and other COVID-19 precautions, strong social mobilisation activities, the proximity of vaccination sites to the communities and, in some places, the use of mobile teams and extended campaign implementation days. Though overall the campaign was successful, it was not without challenges. Mass political protests erupted the week the measles follow-up campaign was launched, following the murder of a popular singer. This affected four regions: Addis Ababa, Oromia, Dire Dawa and Harari; where the campaign resumed only once the security situation had stabilised.

In addition to ensuring minimal disruption to health services such as immunisation services, the government has been focused on the broader COVID-19 response. The response focusses on strengthening community surveillance to improve case-finding, expanding laboratory capacity for testing samples, improving the quality of care at quarantine centres, following a reduction in the quarantine period from 14 to 7 days and incentivising local production of items such as PPE to prevent supply shortages.

Read the full 8 September situation report here.