IntroductionHealthcare systems in Africa suffer from neglect and underfunding, leading to severe challenges across the six World Health Organization (WHO) pillars of healthcare delivery. We conducted this study to identify the principal challenges in the health sector in Africa and their solutions for evidence-based decisions, policy development and program prioritization.MethodsThe study was conducted as part of a recent African Epidemiological Association Meeting in Maputo, Mozambique with participants drawn from 11 African countries, Cuba, Portugal and the United Kingdom. Participants were divided into 10 groups, consisting of 7 to 10 persons each. Brainstorming approaches were used in a structured, modified nominal group process exercise to identify key challenges and strategies to mitigate healthcare service challenges in Africa. Identified challenges and solutions were prioritised by ranking 1–5, with 1 most important and 5 being least important.ResultsThe first three challenges identified were inadequate human resources (34.29%), inadequate budgetary allocation to health (30%) and poor leadership and management (8.45%). The leading solutions suggested included training and capacity building for health workers (29.69%), increase budgetary allocation to health (20.31%) and advocacy for political support and commitment (12.31%).ConclusionThe underdeveloped healthcare systems in Africa need radical solutions with innovative thought to break the current impasse in service delivery. For example, public-private initiatives should be sought, where multinational companies extracting resources from Africa might be encouraged to plough some of the profits back into healthcare for the communities providing the workforce for their commercial activities. Most problems and their solutions lie within human resources, budget allocation and management. These should be accorded the highest priority for better health outcomes.
Introduction The Nigeria government, supported by its development partners conducted several vaccination campaigns involving various antigens across the country in 2019. Majority of the states in the North including the Federal Capital Territory (FCT) implemented the Integrated Measles and Men A vaccination campaign (IVC) which itself was an innovation given that both campaigns were initially planned as stand-alone campaigns. The integration of these campaigns came with additional planning, new implementation strategies and challenges. This paper aims to highlight the key drivers of FCT’s performance in achieving greater than 90% vaccination coverage for both antigens and the challenges of the integrated campaign in FCT. Methods A baseline review of previous campaign reports, micro plans and tally sheet data was conducted to identify challenges of previous SIAs in FCT, best practices and lessons learnt. A preliminary analysis of available data revealed a shortfall in resources early enough in the planning phase. Notably, was a shortfall of about 300 vaccination teams for the implementation of the Measles vaccination campaign (as a standalone campaign) as well as shortfall in cold chain equipment and logistic funds. We leveraged on the thrice weekly technical coordination meetings to review these challenges to seek ways to mitigate them. Result Strategic efforts to address the identified gaps led to the state sponsoring an additional 354 vaccination teams to support implementation by leveraging on the SOML funds. Staggering the campaign was key to ensuring adequacy of CCEOPs to address the increase in the number required due to the integration. The additional state sponsored team vaccinated 121777 and 123588 children who otherwise would have been missed with the Measles antigen with the Men A antigen respectively. Conclusion Strategic resolution of identified challenges was pivotal to FCT’s performance of greater than 90% vaccination coverages for both antigens. Key words Measles, Meningitis A, Integrated, Vaccination, Campaign
Background Nigeria, in 2019, implemented an Integrated Measles and Meningitis A vaccination campaign (IVC) majorly in the northern part of the country including the Federal Capital Territory (FCT), Abuja. The campaign was necessary to interrupt the transmission of these diseases in unimmunized under-fives. FCT aligned with this novel approach to reach its target population of 692697 children aged 9-59 months and 651951 children aged 1-5 years with the Measles and Men A vaccines respectively. Given the integration, FCT was going to generate twice the volume of wastes compared to previous stand-alone campaigns. This paper aims to document the best practices FCT used to incinerate the large volume of sharp wastes generated during the IVC as well as outstanding wastes generated during routine immunization (RI) services. Methods A waste management working group was inaugurated at the state level to coordinate all waste management activities in FCT. They developed a waste management plan outlining the expected amount of wastes to be generated, cost implications, mapping of incineration sites and modalities of evacuation and incineration. Result A total of 20000 safety boxes generated from the integrated Measles and Men A vaccination campaign (17645) and RI (2355) were incinerated. Conclusion FCT has incinerated all sharps generated during the 2019 integrated Measles and Men A vaccination campaign as well as outstanding routine immunization wastes. Key message Coordinated waste management activities are required to continuously manage RI wastes.
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