In the six months since the World Health Organization (WHO) declared the COVID-19 outbreak a global pandemic, Amref Health Africa has been responding to the virus in eight countries across East, West and Southern Africa.
As a partner to the WHO African Region, Amref was enlisted in the emergency-response taskforces of the Ministries of Health in Ethiopia, Kenya, Malawi, Senegal, South Sudan, Tanzania, Uganda, and Zambia.
By sharing its technical expertise and leveraging its strong relationships with communities, Amref has contributed to shaping the national strategy on COVID-19 and facilitating resource mobilisation to respond to the pandemic in these countries.
The Amref approach
Amref’s approach is multilateral, taking on the crisis at all levels. While its long-established, robust relationships at global, regional and national level make it well-placed to advise on country policy, it remains acutely aware that without community buy-in, actions taken to stop the pandemic will fail. That is why Amref’s response is grounded in community engagement and awareness-raising, delivered through a network of Community Health Workers (CHWs).
Guided by three principal objectives, Amref’s response has focused on preventing transmission, preventing deaths, and preventing social harm. For Amref, it was important to address both the immediate and the secondary impact of COVID-19, taking into account the potential long-term effects on other structural health system concerns, as well as the wider social and psychological impacts, stifled youth opportunities, and increasing rates of gender-based violence (GBV).
The response so far
Harnessing the power of technology to train health workers
Amref’s objective is to train an additional 600,000 health workers – including 270,000 CHWs – across the eight priority countries to strengthen their ability to test, track and treat. Training additional health workers is essential in minimising the impact of COVID-19 on already-fragile health systems, where diverting resources away from other non-COVID health concerns could put the whole system at risk of collapse. Training is delivered through Amref’s mobile-learning platform Leap, which functions on a basic mobile phone without the need for internet connectivity.
So far, through Leap, Amref has trained more than 70,000 volunteer CHWs in all of Kenya’s 47 counties. In Ethiopia, the Ministry of Health commissioned Leap as its go-to mobile learning platform. In the space of one month, all 40,000 of Ethiopia’s Health Extension Workers (HEWs: the equivalent of CHWs) and their supervisors were trained through the platform.
Leap has also been rolled out to train health workers in Malawi and Uganda.
Ensuring life-saving information is accessible to all
As well as delivering health worker training, Amref’s mission is to ensure that vital information around COVID-19, detailing the way individuals and communities can mitigate the risk of transmission, reaches as many people as possible – especially those most vulnerable, including marginalised groups and people living with disabilities.
In Zambia, it partnered with the Ministry of Health to translate existing information packs, which cover how to spot symptoms and the necessary transmission prevention measures, into braille to help those with visual impairments. The packs have been distributed nationwide by the Ministry of Health.
In Simiyu Region, Tanzania, Amref has long-used radio technology to disseminate important information about family planning and sexual and reproductive health and rights within the community. Now, the Government of Tanzania has joined forces with Amref to use its radio platform to share essential information around COVID-19, ensuring it reaches as many people as possible.
Maintaining continuity of care in non-COVID-related health settings
Alongside targeted resource mobilisation to respond to the pandemic itself, an essential aspect of Amref’s overall response has involved maintaining continuity of care for other, non-COVID-related medical concerns. It has continued to invest in and adapt its existing programmes to make them as resilient as possible, taking care to ensure that investment in COVID-19 care has not come at the cost of servicing other illnesses, conditions or injuries.
The Amref Kibera Health Clinic in Nairobi offers a full range of medical services for areas such as maternal and new-born health; family planning; sexual and reproductive health; mental health; support for survivors of GBV; and treatment for other non-communicable diseases such as TB, malaria, and HIV/AIDS. In order to maintain these services, the clinic immediately implemented COVID-19 safety measures, including social distancing where possible, handwashing facilities, sanitisation stations, and routine temperature checks.
Empowering young people in the fight
A deeply concerning secondary impact of COVID-19 is the long-term effect on young people. With rapidly rising cases of unemployment, inadequate access to routine health services, school closures, and increasing cases of sexual and gender-based violence among vulnerable adolescents and youths, the pandemic is likely to significantly shape the future for many young people across Africa.
Amref’s Y-ACT (Youth in Action) initiative was established by the youth, for the youth, in Kenya more than three years ago and is now one of the fastest-growing youth advocacy movements in the region. In the face of COVID-19, Y-ACT is committed to ensuring young people are meaningfully engaged in the fight, giving them the opportunity to contribute to policy decisions that will ultimately affect them. Youth-led teams have been established to work alongside policymakers to co-create long-term solutions.
Raising awareness about gender-based violence
In what has been described by the United Nations as ‘the shadow pandemic,’ gender-based violence – which can include physical, sexual, emotional and psychological abuse – has risen sharply worldwide since the emergence of COVID-19, in part because movement restrictions have left many women isolated and unable to distance themselves from their abusers. For some parts of Africa, this includes a marked increase in rates of female genital mutilation or cutting (FGM/C), rape, domestic violence, forced marriage and teenage pregnancy.
Our pan-African champions are finding new ways to reach FGM/C practising communities, using digital platforms, radio broadcasts, and house-to-house outreach to raise awareness of the heightened risk. In Ethiopia, members of Amref’s Youth Advisory Parliament have been taking to the streets of Addis Ababa, speaking to community members about the heightened risk of GBV and ways to access help.
As Africa’s leading health NGO, Amref Health Africa will be dealing with the ripple effects of COVID-19 for years to come: whether that’s stigma surrounding survivors, the consequences of limited access to family planning services, a spike in vaccine-preventable diseases, an increase in teenage pregnancies, or more women and girls subjected to gender-based violence. In the coming months, it will adopt an agile approach, responding to needs as they arise and are identified by the communities we serve. As the pandemic evolves, Amref will continue providing technical and mental health support to frontline health workers as they cope with the secondary impacts of the crisis.