Over ten months after COVID-19 hit the Federal Capital Territory (FCT), the responders from the Health and Human Services Secretariat of the FCT are still battling several challenges in their response efforts. The Emergency Operations Centre (EOC) set up on March 20th, 2020 currently operates on nine response pillars with each pillar lead carrying out specific activities as part of the response.
They also have key performance indicators used to monitor and assess their activities. The daily EOC meetings and briefings are coordinated by each of the pillar leads. They present reports and data which are analysed, and feedback is given to all the stakeholders involved in the response at the state and federal levels. The FCT also leverages technology in its response activities, for data collection, analysis, and dissemination.
The nine response pillars include epidemiology, surveillance and point of entry, laboratory, health and safety, Infection Prevention and Control (IPC), case management, logistics, research, and risk communication.
Dr. Iniobong Ekong, the Deputy Director E-health, Department of Health Planning, Research and Statistics in the Health and Human Services Secretariat of the FCT joined the response activities as a digital health specialist to provide support and coordination spoke on some bottlenecks impeding the State’s response and measures implemented to mitigate them.
The availability of dedicated resource persons and response strategies have however not put a stop to several bottlenecks impeding the states response activities. One of such challenges was the long turnaround time for receiving test results.
“To me, this is one of the greatest challenges. The time between sample collection and notifying or getting results. Over 62% of the people that call are asking for their test results.” Dr. Ekong said.
This was because of challenges in the value chain of testing activities, and limited laboratories for sample testing, resulting in backlogs of samples from some of the North Central and North Western states – Kaduna, Kogi, and Nasarawa. To mitigate this, the FCT opened up more sample collection centres, including private laboratories (numbering up to 15 as of September 24 2020), and created a bulk SMS service, where up to one thousand results are sent out once they are ready. To further shorten the process, the Nigeria Centre for Disease Control (NCDC) piloted direct SMS from the laboratory enabling the result to get to the patient before getting to the State. The NCDC is also working towards aligning the data capture to be done directly from the field rather than writing on paper first and going to the office to transcribe. Presently, the turnaround time for results is about 24 to 48 hours.
Another challenge that presented was data integration. To mitigate this, the team coordinated an automated and integrated call centre, where they brought all the different levels together into an integrated FCT COVID-19 call centre with a toll-free number that was given out to the public, so that calls could be recorded, monitored, and the data aggregated into a dashboard.
Finally, individuals calling in to seek information also started reporting having symptoms or have been in contact with either suspected infected persons or a confirmed case. This presented a challenge of linking their request with the actual services that they needed. As a solution, the services of the FCT COVID-19 call centre were expanded to also schedule appointments for testing in a sample collection centre.
Collaborations and Partnerships
Responding to the pandemic so far in the FCT has proven to be a whole health sector response, not just the public health department. The department has worked with the World Health Organization, the Nigeria Centre for Disease Control, Africa Centres for Disease Control and Prevention (Africa CDC), Clinton Health Access Initiative, The African Field Epidemiology Network (AFENET), Nigeria Medical Association, Nursing and Medical Council, and Veterinary Council.
At the Federal level, the Presidential Task Force on COVID-19 (PTF-COVID-19) and NCDC are the major drivers of the response and at the state level, the FCT Task Force pilots the response activities. They issue guidelines for public gathering, case management, laboratory testing, decontamination, safe burials, and diagnosis.
Dr. Ekong said “In terms of funding, the response has been largely driven by the government, but a lot of partners have supported, including the private sector. Most recently, the World Bank has also stepped up to support every state, there is a grant of a hundred million naira for every state, and the FCT are currently in the process of accessing it.”
As schools, event centres, and other public places reopen, the Emergency Operations Centres meet daily to plan for a possible spike in positive cases, as well as devise ways to mitigate the spread of the virus. They are also working to increase testing by increasing access to sample collection centres, debunking misinformation, and working closely with security officials to ensure adherence to all safety guidelines by the public.
This narrative was done in December 2020 as part of the #COVID19NigeriaStories documentation project on state-level responses to COVID-19, implemented by the Nigeria Centre for Disease Control and Nigeria Health Watch with support from the Ford Foundation.