Responding to COVID-19: Health sector preparedness, response and lessons learnt

The Ministry of Health and Population (MoHP) has published a report on Health sector preparedness, response and lessons learnt during COVID -19 Pandemic. The report consists of following chapters;

Chapter 1: Testing times

Chapter 2: The frontliners

• The good doctor
• Carrying on in the face of adversity
• To the point of exhaustion
• Managing a isolation centre
• How hospitals responded to the Covid crisis
• Response by a local body: Yasodhara Rural Municipality

Chapter 3: Responding to the virus

• Multi-partner engagement
• Communicating timely, actionable, reliable information about COVID-19
• Points of entry

Chapter 4: Pillars of response to the corona virus disease

• Case investigation and contact tracing, testing and case management
• Dealing with deaths
• Information management: A vital tool
• Responding to a novel disease
• Health services management and clinical management
• From person to community
• Maintaining essential services
• Research and development
• Working with the three-tier government
• Health system financing

Chapter 5: LESSONS LEARNT AND KEY SUCCESS
Chapter 6: THE ROAD AHEAD

Lessons learnt and key successes (Ref. page. xxiii)

• Although necessary preparations were made in the health system to cope with the COVID-19 pandemic, things did not go as they should have. The government had enough time to establish laboratories and prepare isolation and quarantine sites, but work moved at a slow pace. This showed the limited intersectoral coordination and the lack of clarity in the roles of the three tiers of government.
  The government could also have taken steps to increase public confidence in its health system. This could have been done early on by establishing testing laboratories and isolation sites, purchasing or producing essential items, and fulfilling the requirements of health workers. However, this did not happen. Local level budget and authority allocation in preparation for the pandemic could also have been carried out in advance, but this too took time.
• In order to address the pandemic, a test-trace- isolate strategy should be strictly and effectively implemented and conceived as a priority action. The testing capacity should be expanded to the vulnerable population as well as to people presenting signs and symptoms and their contacts.
  Coping with the pandemic—from the local to the federal level—will require proper training, a strong reporting and communication system, and strengthened capacity to increase testing services and contact tracing.
• The clinical management of cases needs to be effective, with a focus on hospital beds, ICU ventilators, and other medical supplies. Proper planning with different stakeholders is required while preparing infrastructure to combat COVID-19. At the same time, non-COVID patients should not be ignored by the health system.
• The MoHP should collaborate with the private sector to produce PPE, masks, and medical equipment, among others items. Industries and businesses, who have been severely impacted by the pandemic, should be given financial recovery packages as well.
• Compliance—in terms of social distancing, mask wearing, and sanitiser use—needs to increase among the public. To engage the public and increase compliance, respected personalities should be brought in to build community trust.
• The COVID-19 pandemic has shown the importance of international collaboration. International organisations should therefore be involved in training health workers and creating awareness about COVID-19 transmission. Diverting their regular programmes towards combating the coronavirus is the need of the hour.
• A fast and strong health response is critical for containing any pandemic. In the wake of the COVID-19 outbreak, the authorities need to show commitment towards refining the national health system—by enhancing surveillance and warning systems for contagious diseases and enriching the capacity of health workers—which will prepare Nepal for possible future health emergencies. Consistency and transparency are vital in information sharing. The sharing of real-time information about pandemic updates via advanced mobile technology is of utmost importance.
• A functional logistics system needs to be a top priority for the timely delivery of medical supplies. It is absolutely essential to procure sufficient quantities (while certifying quality) of medical supplies, and ensure a secure supply chain. Stable supply chains are necessary to make sure that supplies are provided on time during crises.

[Excerpts of Executive summary]

MoHP. (2021). Responding to COVID-19: Health sector preparedness, response and lessons learnt. Kathmandu: Ministry of Health and Population.