While some countries have enough doses to vaccinate their populations three times over against COVID-19, many lower-income countries struggle to access enough to serve their most at-risk groups. As the World Health Organization’s (WHO) director-general recently opined, vaccine inequity is pervasive, and the rising global vaccination numbers in wealthier countries have been met by an equally powerful surge of COVID cases in those with fewer means. Living Goods has actively been working to ensure that CHWs have the PPE and resources to safely continue delivering essential, life-saving maternal and child health services.
Initial Emergency Response
In March 2020, Living Goods began responding to the COVID-19 pandemic alongside government and NGO partners in Kenya, Uganda, Burkina Faso, and Sierra Leone. During 2020:
- Living Goods-supported community health workers (CHWs) maintained essential health services to over eight million people and saved nearly 20,000 lives.
- In Living Goods’ areas of operation, our review of government data revealed declines of up to 35% in the number of people who sought facility-based care for common childhood diseases in 2020, while CHW treatments for those illnesses more than doubled from the previous year.
In 2021, Living Goods is building on our existing COVID-19 response including our continued focus on maintaining essential services, and adding in the below elements:
- Working to strengthen health systems as the COVID-19 pandemic has moved from an acute to a prolonged emergency. We are emphasizing ongoing protection and support for CHWs, thus allowing them to care for themselves while they continue to maintain essential health service delivery to communities.
- Encouraging early uptake of vaccination among frontline health workers and other high-risk populations.
- Supporting governments to prepare for the successful and equitable distribution of COVID-19 vaccines when they become much more widely available in the countries in which we work (tentatively projected for Q1 2022).
- Remaining innovative and responsive, recognizing opportunities to leverage existing competencies for flexible approaches as needs arrive (i.e. adapting CHW training & digital app workflows originally developed for two-dose childhood immunization tracking to serve COVID-19 vaccination rollout).
Ongoing Response + Delivering Vaccines for All
Though the COVID-19 context continues to shift rapidly, we project that widespread access to COVID-19 vaccines in the countries where we work will take place beginning ~Q1 2022. At that time, while we will continue to focus on maintaining essential services and health systems strengthening, we will also layer on the following activities:
- Combatting vaccine hesitancy and ensuring high levels of uptake, particularly as health systems race to utilize procured doses before expiration dates.
- Supporting government operations for widespread vaccine rollout to the individuals in the rural communities we serve.
Learn How to Support our COVID Response
By supporting Living Goods’ Ongoing Emergency Response + Systems Strengthening efforts, you will directly contribute to frontline health worker and community health systems resilience, which is necessary to minimize lives lost this year and in the future. By supporting our Vaccine Uptake Work, you will help ensure that nationality, geography, and economic status do not continue to serve as barriers to care. Together, we can ensure that as many people as possible maintain access to healthcare and gain access to the COVID-19 vaccine. No one is safe until everyone is safe!
What we’ve been doing since the beginning to respond:
Protecting CHWs & Living Goods Staff.
- Trained Living Goods-supported government CHWs in adjusted “low and no-touch” protocols so that they can safely continue their core work and supervisors in remote performance management techniques.
- Providing CHWs with PPE including gloves, masks, and portable sanitizer so that they can safely support COVID prevention work and other limited services. We’re also advocating that governments include CHWs in their PPE procurement calculations.
- Increasing compensation to the CHWs we support to reflect their increased workload and risk, as well as the likelihood that their other sources of income have been disrupted. We’re also continuing our engagement with governments we’ve had all along about the importance of compensating all CHWs. This is more important now than ever.
- Assisting in the implementation of daily symptom checks for government-supported CHWs, Living Goods staff, and their families.
- Integrated new COVID workflows into our existing SmartHealth app and adjusting existing workflows to account for the new no-touch
Maintaining Essential Health Service Delivery.
- Providing CHWs in our catchment areas with free and essential health commodities including ACTs, paracetamol, amoxicillin, and zinc/ORS in formulations appropriate for sick children.
- Living Goods will provide these through our supply chain to ensure national supply chains remain stocked.
- Increased cell phone data and airtime stipends to the CHWs we support to make up for the additional bandwidth required for remote communication.
Interrupting COVID-19 Transmission.
- We have now trained all Living Goods staff and the CHWs we support in COVID prevention, early case detection, reporting procedures, and personal safety measures. In addition, we have provided similar training to an additional 12,700 CHWs across 7 Kenyan counties where we currently operate.
- Creating an e-learning platform for Living Goods-supported CHWs, our staff, and those of partners and government, to minimize travel and contact while simultaneously exploring how we might support training for national COVID responses.
- Working to develop an effective two-way SMS messaging platform to reach the CHWs we support with COVID-related information, with the potential to be scaled nationally in the future.
- Assisting in government efforts to deploy physical information, education, communication (IEC) materials (e.g., posters) in CHWs’ communities, and helping to train CHWs in IEC strategies.
- Exploring options for customizing and testing an automated SMS/messaging self-help tool for patients who suspect they may have COVID.
- Where needed, supporting governments at the national and sub-national levels to integrate COVID data into their existing health databases.
- Supporting government in procuring and deploying sanitation improvements for CHW and their communities, including handwashing stations. In Kenya, we have provided triage tents at health facilities to enable better separating people with suspected COVID symptoms from other patients, an effort we hope to extend to Uganda.
Supporting MOH and Local Government Efforts.
- Seconding staff to health ministries in Uganda, Kenya, Burkina Faso, and previously Sierra Leone to support their responses.
- Supporting Ministries in devising guidelines that enable CHWs to play an effective role in national and local responses, as well as guidance on their communications strategies.
- Coordinating locally and globally with other health organizations to share COVID data, best practices, etc.
We fundamentally believe that effective, digitally-driven community-based primary health saves lives. It is essential for quelling this pandemic and future pandemics, and to building stronger more resilient health systems.
We will continue to keep you apprised as our plans take shape. We are proud and humbled to be part of this community. We are in this together.
Photo: This illustration, created at the Centers for Disease Control and Prevention in the United States, reveals ultrastructural morphology exhibited by coronaviruses.
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