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COVID-19 posed a serious threat to health systems worldwide, but particularly in countries where health systems are least developed. Africa still faces important gaps in financing for health and as it was evidenced even in first-world countries across the World, was not in a position to match the challenges posed by the COVID-19 emergency, hence funds from donors were much needed. The funds are used to support the New Public Health Order in Africa that includes strengthening manufacturing capacity for vaccines, COVID-19 testing and tracing, and expanding the health workforce, Some of these funds were used to further strengthen the community-based services to support the emergency response.

As of 24th May 2022, in the Kingdom of Eswatini, there have been 72,202 confirmed cases of COVID-19 with 1,404 deaths, reported according to Africa CDC. As of 30th April 2022, a total of 535,393 vaccine doses had been administered. There was thus a need for urgent intervention and engagement of more people to offer community-based services through community mobilization. The Community Health Workers (CHWs) have played an integral role in investing in community health. They are frontrunners with the primary responsibility of mobilizing communities to participate in COVID-19 related activities at the grassroots level.

A lot of the positive outcomes in community mobilization have been through collaboration between the Ministry of Health and the Baphalali Eswatini Red Cross Society. In a meeting with the Ministry of Health officials led by the Minister of Health in the Kingdom of Eswatini, Senator Lizzy Nkosi, she stated that the Kingdom’s priority was to ensure proper public health processes were in place and accessible for all. “For the COVID-19 vaccine, we are doing massive campaigns encouraging people to be vaccinated as well as fighting misinformation. The Red Cross CHWs have really been instrumental in ensuring community mobilization and engagement.”

The CHW programme was started in 1976 in Eswatini making it the oldest in Africa. Men and women selected by the communities themselves are trained by health experts. As Part of the COVID-19 response, Africa-CDC launched the Partnership to Accelerate COVID-19 Testing (PACT) to facilitate implementation of the Africa Joint Continental Strategy for COVID-19, endorsed by African Ministers of Health on February 22, 2020, in Addis Ababa, Ethiopia. So far, 250 CHWs have been trained under the PACT program and they are currently working in the four regions of Eswatini. The CHWs, who are part of the community, understand the dynamics around respect, cultural traits, dress code, language and understanding of the many homesteads in the areas they come from having been born and raised there.

Sidumo Lukhele in Health Promotions with the Ministry of Health works hand-in-hand with Red Cross, “We train the volunteers on how to execute their tasks by public participation. We also trained them on the use of Personal Protective Equipment (PPE) and maintaining proper hygiene which is essential for ensuring their health and safety and protecting them from contracting COVID-19.”

“We had two phases of implementation. First, we started with those with comorbidities (other important associated health problems they already suffer from), especially the elderly. They were engaged to understand what COVID-19 is and how it can affect them, the importance of testing and why they should alert us if anyone in their precincts is suspected to have the virus”, adds Dr. Bongiwe Malinga, Senior Medical Officer for Public Health in the Ministry.

She continued, “For phase two, we had the armed forces, teachers, bankers and anyone working at the time when the Government had effected lockdown.”

“We are cognizant of the important role the CHWs have played through PACT in the pandemic response, particularly in surveillance, to create awareness and facilitate referral to testing, vaccination, and needed health services. The support from Africa CDC will come in handy as they are experts in strengthening the capacity and capability of Africa’s public health institutions” Permanent Secretary Dr. Zwane Simon reiterated.

Dr. Lul Riek, Regional Collaboration Center Coordinator, Southern Africa, Africa CDC added, “Africa CDC
has facilitated more than 20,754 CHWs in Africa in over 29 countries for the COVID-19 response to conduct active case findings, contact tracing, risk communication and community engagement for vaccine uptake. There are also over 230 rapid responders in 25 countries.”

Dr. Herlilinda Temba who is a Medical Epidemiologist and the Africa CDC PACT CHW Initiative Coordinator added, “Through our ongoing collaboration, public health initiatives will get better especially in pandemic preparedness and response, and the continuation of essential health services
beyond the pandemic.”