October 13, 2020

IM DRC Receives Certificate of Excellence for Work Curbing COVID-19 Spread in DRC

Certificate of Excellence awarded to IM DRC

“Failure is not an option.” - Apollo 13 (1995)

The Impact Malaria (IM) team in the Democratic Republic of the Congo (DR Congo, or Congo) received a certificate of excellence from Haut-Katanga province regarding its work strengthening the capacity of laboratory technicians and clinicians to curb the spread of COVID-19 within the country. IM DRC is the only organization in the DRC who successfully maintained constant communication and support to the province’s health zones within the Haut Katanga province during the globally disruptive COVID-19 pandemic. MCD thanks all who made this happen and honors the courage as well as effort undertaken to receive this award.

In the Democratic Republic of Congo (DRC), the Ministry of Health (MoH) declared the first case of COVID-19 in March 2020. In May 2020, IM DRC received additional funds from PMI/USAID for supporting DRC’s COVID-19 response, focusing on strengthening the capacity of laboratory technicians and clinicians to collect, process, and transport respiratory samples; and to practice appropriate fever diagnosis, triage, referral and case management, including enhanced biosafety and personal protection procedures. These activities are taking place in the same nine provinces that IM supports in strengthening malaria microscopy diagnosis quality. Key Accomplishments of IM DRC within the country include:

Supporting the update and of clinical and laboratory guidelines

IM DRC supported the DRC COVID-19 Response Coordinating Committee to update and disseminate laboratory and clinical guidelines and checklist to integrate COVID-19 module. These documents were printed and disseminated in the nine PMI provinces to improve the COVID-19 knowledge and skills of laboratory technicians and clinicians, guiding the adaptation of laboratory and health facility activities for COVID-19 case management.

Supporting the update of guidelines on diagnosis, triage, referral, and case management of fevers and biosafety procedures, and training on the new guidance.

IM DRC supported the DRC COVID-19 Response Coordinating Committee to strengthen laboratories at the provincial level to collect, process, and transport respiratory samples, and practice enhanced biosafety and personal protection procedures. IM DRC supported the same Response Coordination Committee to conduct a training of trainers (TOT) for 20 trainers on clinical guidelines, including diagnosis, triage, referral, and case management of fevers and biosafety procedures, who then rolled the training out to the 109 supported health facilities. IM surpassed the initial target to train 218 participants due to high demand, and a total of 243 laboratory technicians were trained

IM DRC also supported the Response Coordination Committee to conduct the training of 20 clinical trainers on the updated guidelines on fever diagnosis, triage, referral and case management, including enhanced biosafety and personal protection procedures. These trainers then facilitated the training of 216 provincial-level clinicians. With COVID-19 restrictions in place, the provincial-level trainings took place using a hybrid approach, whereby the facilitators based in Kinshasa used video conferencing to provide training to each province, who were able to meet in person and follow social distancing guidelines to watch the webinar, and receive direct in-person support from the provincial trainers to review and discuss the training in order to apply it to each province.

Strengthening the NMCP’s ability to assess health facility preparedness to manage COVID-19 through enhanced supportive supervision (OTSS+)

IM DRC supported the update of the malaria diagnosis OTSS+ checklist to adapt it to the COVID-19 context, particularly related to collecting and conserving samples, and assessing basic biosecurity procedures. IM DRC supported the NMCP and DRC COVID-19 Response Coordinating Committee to conduct a two-day briefing of 24 provincial supervisors on the COVID-19 integrated supervision checklist.

After the training, IM DRC supported the MoH to conduct an additional round of OTSS+ visits, using the malaria OTSS+ and COVID-19 integrated checklist. These visits covered a total of 109 health facilities in 9 PMI provinces, and reached general referral hospitals (GRH) and reference health facilities (RHF), which also conduct malaria microscopy. IM DRC worked with the national and provincial levels of the NMCP on all aspects of conducting the OTSS+ to follow all activities during field visits. The national supervisors coordinated the COVID-19 data, and supported the provincial supervisors to conduct the supervision correctly.

Supporting the procurement and distribution of key sanitization supplies to 109 health facilities

Due to a shortage of sanitization supplies critical for the prevention of COVID-19 transmission at the facility level, IM DRC supported Provincial Health Offices to procure enhanced personal protection materials and sanitization supplies for 109 health facilities.

Supporting the development and dissemination of the COVID-19 Laboratory Quality Assurance Manual

Supporting the collection, processing and transport of respiratory samples for COVID-19 testing

IM DRC works closely with WHO to support Provincial Health Offices and General Hospitals in COVID-19-affected provinces to collect and transport respiratory samples for COVID-19 testing from the field to the central laboratory in Kinshasa. This is done through a WHO-approved freight company, who can safely move hazardous biological samples. IM DRC supported INRB to assess the Lubumbashi provincial lab capacity for COVID-19 diagnosis in order to be able to conduct diagnoses locally, however due to the shortage of some critical supplies, transportation to Kinshasa has still been necessary.

Lessons Learned

The use of a hybrid approach of combining remote and in-person training not only circumvented COVID-19 restrictions, but actually strengthened linkages between provinces, and between the national and provincial level. Feedback from participants on this approach was extremely positive, as typically, provincial participants do not usually have the opportunity to meet each other, and they appreciated the opportunity to learn from other provinces. The fact that the group decided to stay in touch via WhatsApp further demonstrates how valuable this connection is, and this communication has helped participants implement what they learned from the training to ensure that capacity building is reinforced and shared.

Given the new and rapidly evolving nature of the pandemic, involving all stakeholders in decision making and problem solving to adapt interventions to the COVID-19 context is critical to bringing multiple perspectives to the table, and ensuring understanding and support of the decisions made.

Strengthening the role of provincial NMCPs to serve as bridge between the IM project and field providers for logistics coordination, data collection and reporting was very important.

The use of mobile money to fund field activities.

COVID-19 has dismantled and disrupted many global supply chains, so we as global health organizations must work extra hard to develop creative solutions to continue offering critical services to our beneficiaries. Especially in a pandemic like COVID-19, failure to do so is not an option. Explore more creative solutions from IM and experience its continued successes amid the novel coronavirus pandemic.

Matthew S. Lynch is the Assistant Communications Officer at Medical Care Development International (MCDI) Maryland, USA, office

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