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From response to resilience: Shifting paradigms of COVID-19 reflections from the 75th UN General Assembly

COVID-19 awareness raising training in refugee camp in Sudan. Photo credit: Plan International

“It has been a rollercoaster since the first case was confirmed in March,” reflected Mr. Samson Udho, Midwife and Lecturer of Midwifery & Health at Lira University in Uganda, at a virtual side event presented by Takeda, Devex, and Global CSR Program partners Seed Global Health, JOICFP, Plan International, and World Vision at the virtual 75th United Nations (UN) General Assembly on September 23.

Seed Global Health Physician Educator Dr. Hadelman (center) discusses COVID protocols with WHO representatives in Lusak

Seed Global Health Physician Educator Dr. Hadelman (center) discusses COVID protocols with WHO representatives in Lusaka, Zambia. Photo credit: Seed Global Health

“We are now seeing cases flare up…. At the same time, we’ve seen a reduction in the number of mothers coming to hospitals or clinics for maternity services. COVID-19 is having a devastating effect on essential care.”

As speakers underscored during “From the Frontlines: How to move from COVID-19 to health for all,” health workers around the globe are responding to the COVID-19 pandemic work in already strained health care systems and face numerous challenges. The current crisis has highlighted the need for an empowered health workforce, as well as the urgency to ensure frontline personnel have the necessary resources to work safely and effectively.

Building on discussions hosted by Takeda, Devex, and Seed Global Health at the 2019 UN General Assembly, the 2020 event highlighted COVID-19 response stories of frontline health workers in Kenya, Malawi, Uganda, and India, as well as lessons learned in maintaining essential health services and the comprehensive steps needed to strengthen the health workforce in order to achieve Universal Health Coverage (UHC).

“COVID-19 has shown us that we are all united in risk, while also illustrating how some are far more frequently and profoundly impacted than others,” said Dr. Vanessa Kerry, CEO of Seed Global Health.

Fear and hope: what frontline workers have seen

“COVID-19 has caused a slowdown of essential services in our area,” reported Ms. Alice Atai, Nursing Officer in Uganda. “Children have been pulled from feeding programs. Teenage girls pulled from school. Many are getting pregnant. How can we help them have a safe delivery? We are also seeing a major drop in immunization. There is fear, but we don’t want people to lose hope.”

World Vision Food Basket Program, India.
World Vision Food Basket Program, India.
Photo credit: World Vision

In India, Mr. Awungshi Mayonmi Zimik, Community Health Coordinator for World Vision India, added the challenge of the rural population with limited access to information to grasp the severity of this pandemic and adapt to the new normal. The insufficient support and personal protective equipment (PPE) means that the community health workers and volunteers who take on the crucial task of educating communities and combating misinformation do so at increasing risk.

Mr. Udho elaborated on the importance of PPE: “When patients come to a facility, they immediately assess how safe they will be and whether or not they will come back. Healthcare workers need to be able to present themselves in a way that restores patients’ confidence. For me that means wearing the necessary PPE. When clients see that I am protected, they see that I can also protect them.”

Ms. Jill Adhiambo Mattakwa, Kenya Country Manager for JOICFP, shared that despite coordinated national responses in numerous countries, including Kenya, many midwives and other frontline workers still do not have PPE. “More than 50 healthcare workers that I've worked with contracted COVID-19 disease because they lacked proper PPE.”

Community health volunteer taking temperatures at health facility in Nairobi.

Community health volunteer taking temperatures at health facility in Nairobi. Photo credit: JOICFP

She also shared a story of hope and optimism: when JOICFP supported community health workers in Kenya for disseminating messages to pregnant women about the importance of delivering in hospitals even during the pandemic, women began returning to facilities.

Community health workers serve as liaisons between the community and the health system. On the front lines, they provide advocacy, education, and support to individuals and families – often in remote areas where access to care and trust in facilities and systems can be challenging – to support preventive care, improve quality of life, and connect them with appropriate health options. 

 

Bridging COVID-19 response and investment in health systems

Dr. Mohamed Juldeh Jalloh, Vice-President of the Republic of Sierra Leone, lamented the tragic consequences of diverting resources from essential services. He also shared lessons of urgency learned from the Ebola crisis, which took the lives of nearly 9% of his country’s health workforce. Sierra Leone’s priority today: “to shift from response to resilience.”

Dr. Jalloh called on leaders from developing countries specifically to define and set a new agenda for health for all. “We need dialogue with development partners on the nature of their support to building resilient health systems. We need a flexible, dynamic approach that makes room for investment in COVID-19 response in a way that also helps build robust, well-staffed health systems strong enough to respond to the pandemic and the day to day needs of our people.”

Building on this call to action, Ms. Mattakwa asked leaders to maintain momentum: “Let us continue investing in our health workers so as to promote quality services, both at the facility and community levels. Not doing this puts our ability to achieve UHC at risk because without motivated, trained, protected health workers, then the quality of services in our facilities will be compromised.”

“When systems are fragile and underfunded, we can't win trust from the community,” Mr. Luis Gadama, OB/GYN Department Chief at the Malawi College of Medicine, said.

“Ebola and Zika exposed the fragility of our systems and inequities in access. In Malawi, the government has acknowledged the importance of the health workforce in addition to the need for better overall infrastructure and political commitment.”

Takako Ohyabu, Chief Global Corporate Affairs Officer at Takeda, concluded the event with a call to global leaders to support health systems by strengthening and empowering the health workforce with long-term investments and partnership.

“While training health workers, strengthening health systems, and improving access to care do not always deliver the fanfare of immediate headlines,” she said, “we know they are transforming communities and saving lives. And that’s what matters.”

Walking the talk

In May 2020, Takeda announced a major donation across three UN-led organizations to support essential efforts at the front lines of the coronavirus and the work that prepares health systems to respond effectively to this pandemic now and other emergencies in the future. The announcement builds on the Takeda’s ongoing long-term commitments to empowering health workers through its Global CSR Program and Partnerships.