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Government conducts after action review for Crimean-Congo Hemorrhagic Fever

Government conducts after action review for Crimean-Congo Hemorrhagic Fever

Stakeholders held an After-Action Review (AAR) meeting recently in Windhoek to document activities carried out during the Crimean-Congo Hemorrhagic Fever (CCHF) outbreak.

The three-day assessment led by the Ministry of Health and Social Services in partnership with the World Health Organization (WHO), provided an opportunity for stakeholders to review Namibia’s preparedness and response capacities to the CCHF outbreak.

On 21 May 2023, an outbreak was confirmed in the Gobabis District of the Omaheke Region. This comes after one person with CCHF died three days prior. Moreover, the Minister of Health and Social Services, Hon Dr Kalumbi Shangula declared the CCHF outbreak on 22 May.

According to a statement by APO Group on behalf of WHO, the National Integrated Disease Surveillance and Response (IDSR) 3rd Edition Technical Guidelines notes that a single confirmed case of CCHF constitutes an outbreak.

“56 contacts were identified and monitored during this outbreak, and no infection was recorded among the contacts, prompting the Minister to declare an end to the CCHF outbreak on 19 June 2023. Subsequently, an AAR needed to be conducted, as it is one of four International Health Regulations (IHR 2005) Monitoring and Evaluation framework components recommended within three months after the end of a public health response,” read the WHO statement.

Additionally, they noted that through the AAR methodology, 58 multi-sectoral participants conducted a qualitative review of actions taken to respond to the CCHF outbreak to identify gaps, lessons learnt, and best practices. They added that the AAR was a critical step in bringing together all parties who contributed to the “government’s successful” response to the CCHF outbreak.

Participants in the AAR workshop attended in numbers from national-level directorates, regional health directorates, health districts, public health facilities, and private facilities under the Health Ministry. Other participants included WHO’s country office, the Namibia Red Cross Society, the Namibia Institute of Pathology, the City of Windhoek, the Namibia Field Epidemiology and Laboratory Programme, the Robert Koch Institute, the Farmers Union, and the Ministry of Agriculture, Water, and Land Reform.

Furthermore, the participants were divided into several groups, each representing various areas of the CCHF outbreak response: coordination, surveillance, case management, infection and prevention control (IPC), risk communication and community engagement (RCCE), laboratory, psychosocial support, and Safe dignified burial.

“The workshop required participants to recall and document the preparedness and response activities in place before and during the outbreak in five steps by asking critical questions. ‘What was in place before the response?’ ‘What happened during the response?’ ‘What went well?’ What did not go so well? ‘What can we do better next time?’ ‘What is the Way Forward?’ Some of the best practices identified during the response include timely activation of management committees at all levels to ensure a well-coordinated response of activities; outbreak response interventions through one health approach of human and animal to limit the further spread of the outbreak; strong collaboration with partners and stakeholders in mobilizing of resources for the response; and the utilization of real-time communication platforms to ensure resolutions and action plans of the response.”

Subsequently, the review concluded with participants developing a comprehensive action plan to implement corrective actions to enhance future responses to CCHF and other emergencies, highlighting prioritized activities to institutionalize best practices and address challenges, a timeline for action implementation, and a follow-up mechanism.

“During the AAR, participants from the Ministry of Health emphasized the importance of ensuring that the AAR participants take this as another learning opportunity and capacity building and ensure that corrective actions developed are implemented for any other future possible public health event. Emphasis was on the need for the government, partners, and stakeholders to engage and work in partnership with the communities during outbreak response. WHO will support the Ministry of Health in developing the corrective action plan according to the gaps identified during the AAR and to finalize the AAR report,” they concluded.

Namibia previously conducted after-action reviews for CCHF and Hepatitis E Virus outbreaks in 2017 and 2022. “This is the first time the country has conducted an AAR with minimal support from the World Health Organization Regional Office for Africa (WHO AFRO).”


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