Emergency Preparedness and Response Cluster, WHO Regional Office for Africa, Brazzaville, Congo
Department of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape, South Africa.
BMJ Open. 2022 May 2;12(5):e056896. doi: 10.1136/bmjopen-2021-056896.
We conducted a review of intra-action review (IAR) reports of the national response to the COVID-19 pandemic in Africa. We highlight best practices and challenges and offer perspectives for the future.
A thematic analysis across 10 preparedness and response domains, namely, governance, leadership, and coordination; planning and monitoring; risk communication and community engagement; surveillance, rapid response, and case investigation; infection prevention and control; case management; screening and monitoring at points of entry; national laboratory system; logistics and supply chain management; and maintaining essential health services during the COVID-19 pandemic.
All countries in the WHO African Region were eligible for inclusion in the study. National IAR reports submitted by March 2021 were analysed.
We retrieved IAR reports from 18 African countries. The COVID-19 pandemic response in African countries has relied on many existing response systems such as laboratory systems, surveillance systems for previous outbreaks of highly infectious diseases and a logistics management information system. These best practices were backed by strong political will. The key challenges included low public confidence in governments, inadequate adherence to infection prevention and control measures, shortages of personal protective equipment, inadequate laboratory capacity, inadequate contact tracing, poor supply chain and logistics management systems, and lack of training of key personnel at national and subnational levels.
These findings suggest that African countries' response to the COVID-19 pandemic was prompt and may have contributed to the lower cases and deaths in the region compared with countries in other regions. The IARs demonstrate that many technical areas still require immediate improvement to guide decisions in subsequent waves or future outbreaks.
我们对非洲国家应对 COVID-19 大流行的内部行动审查（IAR）报告进行了回顾。我们重点介绍了最佳实践和挑战，并为未来提供了一些观点。
在 10 个准备和应对领域（即治理、领导和协调；规划和监测；风险沟通和社区参与；监测、快速反应和病例调查；感染预防和控制；病例管理；入境点的筛查和监测；国家实验室系统；物流和供应链管理；以及在 COVID-19 大流行期间维持基本卫生服务）进行了主题分析。
符合条件的研究对象为世卫组织非洲区域的所有国家。对截至 2021 年 3 月提交的国家 IAR 报告进行了分析。
我们从 18 个非洲国家检索到 IAR 报告。非洲国家的 COVID-19 大流行应对措施依赖于许多现有的应对系统，如实验室系统、以往高传染性疾病暴发的监测系统以及物流管理信息系统。这些最佳实践得到了强有力的政治意愿的支持。主要挑战包括公众对政府的信心低、对感染预防和控制措施的遵守不足、个人防护设备短缺、实验室能力不足、接触者追踪不足、供应链和物流管理系统不佳、以及国家和国家以下各级关键人员缺乏培训。
这些发现表明，非洲国家对 COVID-19 大流行的反应是迅速的，这可能是该区域与其他区域相比病例和死亡人数较低的原因之一。IAR 表明，许多技术领域仍需要立即改进，以指导随后几波或未来暴发的决策。
