In pandemics, time is of the essence. Delayed diagnosis provides the opportunity for one case to multiply into tens, if not hundreds, of new cases when left undetected. Delayed care reduces an individual’s chance of survival, allowing their condition to progress rapidly. Muso’s experience during the West Africa Ebola outbreak in 2014 taught us that responding with speed is a critical factor in halting transmission. Our approach in responding to the COVID-19 pandemic is no different.
Muso works in partnership with governments to design health systems that cure delay. As an operational research partner to the government of Mali and a technical assistance partner to the Ivorian Ministry of Health, our proactive health care model helps reach patients faster through proactive health systems. When COVID-19 arrived in both countries in March, infectious disease experts predicted that African nations like Mali would each reach caseloads of 10,000 by June. With the potential for a health systems disaster on the horizon, Muso acted rapidly in coordination with our government partners to stand up a thorough pandemic response. We designed a system to outrace the virus: training health care providers on COVID-19 protocols, designing and implementing a national contact tracing and monitoring program, protecting frontline providers with PPE, strengthening health systems by building oxygen capacity, and continuing care beyond COVID-19. As of August 28th, Mali has recorded 2,730 COVID-19 cases and 126 deaths, less than 30% of the caseload predicted by researchers in March.*
Training Health Care Providers
Muso built COVID-19 training curricula that both our partner countries adapted to train frontline providers and establish new provider protocols. Muso effectively rolled out a multi-level training program for 208 doctors, nurses, and health workers in government district hospitals, and 1,224 CHWs and clinicians at the clinic and community level. In Mali, our trainings reached health providers charged with providing care to 80% of Mali’s 19 million people.
Contact Tracing and Monitoring
At the request of the Malian government, Muso built and facilitated the launch of Mali’s national contact tracing and monitoring program and curricula. This system aims to outrace the virus by testing patients the same day they develop their first symptom, evacuating patients for care the day they test positive, and isolating the contacts of new patients days before they develop their first symptom, to prevent asymptomatic transmission.
We trained and assembled teams composed of tracers, monitors, supervisors, and coordinators, each with defined roles for a coordinated and supportive response, and these teams have been deployed to affected districts. Additionally, all teams have been equipped with PPE, funding stipends and logistical support. Four laboratories in Mali have been equipped with 20,000 COVID-19 tests to diagnose patients.
Protecting Providers
Clinicians and Community Health Workers in Muso’s direct services sites have continued to reach patients quickly to provide care and detect cases within our direct sites because they were protected with PPE. While health systems around the world are facing PPE shortages, our team successfully procured enough PPE for all of our CHWs and facility providers. Providers now use low-touch protocols that allow safe and protected interactions as needed.
We also mobilized new sources of PPE for providers working beyond Muso sites within Mali and Cote d’Ivoire’s national health systems, and supported our government partners to build projections for national PPE supplies. In partnership with the COVID-19 Action Fund for Africa, we have secured a PPE donation to meet the needs of the over 14,000 CHWs across Mali and Côte d’Ivoire for 3 months.
Strengthened hospitals and clinics
To treat COVID-19 patients once detected, Mali created units within six hospitals in Bamako for patients to be isolated and supported. However, oxygen and ventilator access, key therapies for COVID-19, existed in limited capacity within the country at the start of the outbreak. Through an in-kind partnership, Muso successfully procured 54 multi-patient oxygen concentrator machines for deployment to hospitals across the country. We also built curriculum and training programs to accompany the rollout of oxygen therapy in these health facilities.
Continuing Care
Upon the arrival of the novel coronavirus in late March, we doubled on our core commitment: early access to care for all. COVID-19 threatens not only those who will become infected, but also those seeking out other essential health services. But this was not the case in Muso’s direct service sites where we continue to provide uninterrupted care for 350,000 patients, reaching our patients at speeds comparable to service delivery in prior years.
Muso will not falter in our commitment to health for all. The speed of our actions now will determine how many new people will be infected, and how many will survive. Investments made today towards universal care will prepare health systems for the future, and protect the most vulnerable not just during COVID-19 and future outbreaks, but to build a reality where every patient has access to the care they need, when they need it.
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