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Epidemic-Ready Primary Health Care
Enabling primary health care systems to prevent, detect, and respond to outbreaks while maintaining essential health services.
Epidemics start and end in communities, making primary health care the first point of contact for individuals seeking care—and therefore vital for epidemic preparedness and response. The COVID-19 pandemic placed immense pressure on primary health care systems globally, revealing critical gaps in their readiness and capacity, and underscoring the urgent need for more robust and resilient primary health care systems capable of managing future health crises.
Epidemic Ready Primary Health Care (ERPHC) meets this need by strengthening primary health care systems to prevent, detect, and respond to outbreaks while maintaining essential health services. The approach centers on connecting and integrating the public health functions of epidemic preparedness and response, with clinical health services, at the point of health service delivery. ERPHC enables frontline health care workers to connect to local communities, promptly detect and report cases, protect themselves and others by applying the correct infection prevention and control precautions, treat cases, and continue to deliver essential health services for their populations.
ERPHC contributes to prompt detection and early response to outbreaks (supporting the attainment of the 7-1-7 target), protects frontline health care workers who are vulnerable to infection, and ensures the continuity of essential health services during outbreaks, leading to overall reduced mortality, morbidity, and the socioeconomic costs of outbreaks.
How We Do It
We’re implementing ERPHC with partners at 766 primary health facilities across Ethiopia, Nigeria, Sierra Leone and Uganda, which includes:
Continuous capacity strengthening through regular mentorship to build the knowledge, skills and confidence of health care workers to detect, protect and treat.
Just-in-time training to ensure health care workers have access to update information during times of increased risk. Delivered through our innovative mobile phone-based training package Clinical Integrated Disease Surveillance and Response (cIDSR).
Strengthening public health emergency management approaches at the health facility and subnational level to ensure the continuity of essential health services in the event of a health threat.
Regular assessment of capacities and use of data to inform action planning and performance improvements across levels of the health system.
Improving bidirectional communication and coordination between primary health facilities and public health authorities at subnational level to facilitate rapid detection, notification and response.
Ensuring a safe and protected health workforce, and safe health service delivery through strengthening national infection prevention and control programs and advocacy for increased domestic financing.
How We Do It
We’re implementing ERPHC with partners at 766 primary health facilities across Ethiopia, Nigeria, Sierra Leone and Uganda, which includes:
Continuous capacity strengthening through regular mentorship to build the knowledge, skills and confidence of health care workers to detect, protect and treat.
Strengthening public health emergency management approaches at the health facility and subnational level to ensure the continuity of essential health services in the event of a health threat.
Just-in-time training to ensure health care workers have access to update information during times of increased risk. Delivered through our innovative mobile phone-based training package Clinical Integrated Disease Surveillance and Response (cIDSR).
Regular assessment of capacities and use of data to inform action planning and performance improvements across levels of the health system.
Improving bidirectional communication and coordination between primary health facilities and public health authorities at subnational level to facilitate rapid detection, notification and response.
Ensuring a safe and protected health workforce, and safe health service delivery through strengthening national infection prevention and control programs and advocacy for increased domestic financing.
ERPHC in Action
Publications and Resources
A new model for integrating public health and health care delivery— epidemic-ready primary health care—that can identify and stop outbreaks, maintain essential services during disruptions, strengthen population resilience, and ensure health worker and patient safety. For the Lancet Global Health, we argue that strengthening primary health-care capacities for detection, vaccination, treatment, and coordination with public health would improve health security significantly. We anticipate that progress will be stepwise, driven by agreements on core services, optimized funding mechanisms, and health improvement incentives. Advocacy from health workers and civil society will be essential, as is political consensus. To achieve robust epidemic-ready primary health care, we must commit to substantial financial and structural reforms, ensuring that we are prepared for future health challenges.
While an infection prevention and control initiative improved COVID-19 infection rates for health care workers in Africa, ongoing challenges demonstrated the need for long-term investments in sustainable IPC programs. In BMJ Global Health, Resolve to Save Lives examines an infection prevention and control (IPC) initiative implemented in 22 African countries from April 2020 to January 2021. The initiative provided training, personal protective equipment (PPE) and ongoing supervision to over 42,000 frontline health care workers at 8,444 facilities. Despite achieving short-term improvements in IPC practices, suspected health care worker infections peaked at 41.5% during the pandemic’s first wave in July 2020. The study emphasizes that protecting health care workers requires comprehensive IPC programs, integrated training approaches, enhanced data systems, and sustained investment in PPE.
A modular, self-paced, mobile-friendly online course on foundational infection prevention and control (IPC) was developed for health workers (HWs) in Africa, addressing challenges in accessing training. Evaluated in Nigeria, the course comprised 10 modules utilizing IPC vignettes and short assessment questions. Of the 372 learners who enrolled, 59% completed all modules, demonstrating significant pre-test (29%) to post-test (54%) score improvements (effect size 1.22). User experience was rated positively, with a Net Promoter Score of +62. These results suggest that scalable online training can effectively bridge IPC knowledge gaps among HWs in the region.