Abstract
Despite predictions that the number of deaths in Africa due to COVID-19 will reach 10 million, overall, the continent has reported relatively few cases compared to the rest of the world. Many African countries have been successful in containing initial outbreaks by rapidly using evidence-based interventions through implementation strategies adapted from other countries’ COVID-19 response as well as from prior epidemics. However, it is unclear whether these interventions will lead to long-term and complete success in stopping COVID-19 spread. Implementation research is a tool that can be used by countries to learn how to identify and understand contextual factors impacting COVID-19 prevention and control and select evidence-based interventions and strategies known to reduce spread of the virus. We identify seven key contextual factors that are facilitators or barriers to implementation of these interventions, and several strategies that can be leveraged if the factor is present or ones to strengthen if weak to improve implementation. These factors are: a culture of accountability, national coordination, financial stability of the population, culture of innovation, culture and capacity for research, health systems strength, and cross-border economies. Implementation science methods can serve to develop knowledge at a country and regional level on how to identify, utilize, and address these and other contextual factors, and inform relevant evidence-based interventions and implementation strategies. This approach can support African countries’ ability to address key challenges as they arise, both in fighting COVID-19 and future health systems challenges.
Highlights
Despite predictions that the number of deaths in Africa due to COVID-19 will reach 10 million, overall, the continent has reported relatively few cases compared to the rest of the world
Especially limited testing capacity, are concerns across the continent [6]. These explanations do not tell the full story of the diverse and often successful responses across Africa to prevent the spread of COVID-19
Many African countries have been successful in containing the initial outbreaks because they are rapidly and effectively implementing evidenced-based interventions including promoting and facilitating: handwashing, social distancing, testing, contact tracing, and lockdowns [7]
Summary
The presence of an existing chain of accountability for any health threat is a major contextual factor to be regularly assessed for COVID-19. Strategies of donor coordination and stakeholder engagement can help facilitate a comprehensive implementation of evidence-based interventions, including to the most vulnerable populations, and to map and understand where resources are available (i.e. laboratory capacity to conduct tests or provide oxygen to patients) and where additional resources are needed. Integrating these strategies to build coordination can be further facilitated by a culture of accountability, which is important for successful and timely implementation
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