NTD programming in the COVID-19 era: How are we learning and adapting?
Implementing neglected tropical disease (NTD) programming during the COVID-19 pandemic has not been a simple task. Around the world, NTD activities are in various phases of stopping and restarting and sometimes stopping again, as communities find new ways of working. As a global flagship project for the control and elimination of NTDs, USAID’s Act to End NTDs | East (Act | East) program is supporting ministries of health to quickly adapt. Despite the many challenges, the Act | East program has remained committed to working together to achieve NTD elimination goals and to our fundamental tenet of doing no harm.
Long before the pandemic, Act | East relied heavily on USAID’s Collaborating, Learning and Adapting (CLA) framework to inform the learning agenda and drive programmatic adaptations. When COVID-19 hit, we knew that CLA would be crucial and paired closely with COVID-19 precautionary measures to ensure safe implementation of NTD programming. Below, we detail effective CLA approaches Act | East continues to leverage as we adapt to COVID-19.
4 Takeaways from Act | East’s CLA Approach to NTD Programming During COVID-19
1. Dive in, together. The enormous uncertainty was daunting at first, but we leaned into the depth and experience of our people. Act | East quickly established a COVID-19 working group, including representatives from across programmatic functions, technical areas, and locations. This group met weekly to brainstorm how to continue NTD activities in the safest way. This forum allowed participants to share ideas from their own experiences, introduce learnings from other disease areas, and constructively collaborate to develop a series of documents detailing practical “how to” approaches for implementing WHO guidance for NTD programming during COVID-19. Act | East, alongside USAID and Act to End NTDs |West, published these documents on the NTD toolbox which are now being used widely to support standard operating procedures (SOPs) for safe activity implementation.
2. Communicate, communicate, communicate. With the COVID-19 situation evolving rapidly and in different ways in each community and country, we knew we needed to rely on existing (and new) communication channels, quickly and consistently. This emphasis on communication has allowed for collaboration and further facilitated sharing learning across the project. When NTD activities initially stopped, Act | East utilized weekly calls to discuss updates to the national COVID-19 situation in each country supported by the program. These initial communication channels helped the team stay connected through the uncertainties that followed and that we continue to face. Teams continue to engage in formal and informal communication to share lessons learned in preparation for upcoming activities, but also to check in with one another and their personal wellbeing.
Picture Above: During routine survey in Viet Nam, a trachoma grader in examines the eyelid of a child for signs of trachoma. Grader wears a face shield, mask, and gloves as additional safety precautions during the COVID-19 pandemic.
3. Share lessons learned in real time. Drawing on the true benefits of a global program, Act | East launched a virtual platform to rapidly and informally share experiences across countries and consortium partners. During these monthly sessions, teams shared documented learnings from their implementation experience and valuable insights on what works, what doesn’t, and how to adapt to ensure safety. For example, the first country to restart trachoma surveys (which examine the eyelid to determine the presence of disease that can cause irreversible blindness) detailed how they used an innovative loupe-face shield to protect surveyors and community members when physical distance could not be maintained. Through this engagement, other countries planning trachoma surveys posed questions and shared their own expectations, ideas, and concerns. Additional topics included managing crowd control, addressing rumors and misinformation surrounding NTD activities, and implementing new activities such as handwashing and no-touch drug distribution.
4. Be prepared to do things differently. Adapting has been the name of the game this past year and will continue to be critical as we implement amidst an ongoing pandemic. For Act | East, adapting to accommodate necessary precautionary measures means increased planning at every stage. This started with the “how to” documents informing country-specific SOPs. Now, the heightened need for planning continues as teams implement differently than before. Together with health ministries, we are working to disseminate communication messages earlier than usual to share COVID-19 precautionary measures; dissuade rumors and misinformation; and prepare community members for a different treatment and survey processes than they have experienced in the past. The program continues to adapt standard processes to ensure implementation is safe and yet remains effective.
The CLA approach detailed here outlines some of Act | East’s initial response to the COVID-19 pandemic and how we are adapting to new realities. These lessons continue to support Act I East’s transition into the ‘new normal’ and detail a story of adaptation and resilience, the effects of which will hopefully be positive for NTD programming for years to come amidst any challenge that may arise.