Locally based community health workers, who bring vital primary health care to underserved populations across sub-Saharan Africa, will join the battle against the deadly Ebola virus through a partnership between the government of Guinea and The Earth Institute.
Under an agreement announced last week, Professor Jeffrey Sachs of Columbia University will lead a team at the NGO Millennium Promise to support the Government of Guinea in its rapid Ebola response. Millennium Promise has pioneered the introduction of community health care workers backed by advanced broadband technology in the Millennium Villages Project.
The work, which begins immediately, will focus on four core activities:
- The rapid design and implementation of a real-time, national-scale informatics system. Based on the use of smartphones by community health workers, the system will help Guinea track Ebola cases and trace contacts of infected people to help control the spread of the disease.
- The deployment of thousands of community health workers specially trained to support communities impacted by Ebola, including case detection, contact tracking, community information and awareness, and other functions;
- Strategic planning, costing and implementation design for the rapid scale-up of all facets of epidemic control: surveillance, case detection, treatment, contact tracking, behavioral change, training and upgrading facilities, and others.
- Promotion of global collaboration by international organizations and the business sector that is highly responsive and targeted to Guinea’s urgent needs.
“To catch up with and beat Ebola, we need to substantially scale up our response,” said Guinean President Alpha M. Condé. “The immediate deployment of community health workers trained and equipped through an initiative of Professor Jeffrey Sachs from Columbia University will accelerate and strengthen our national response to Ebola, as well as structure a response at the level of our local communities, who will be empowered to fight back and understand how to contain [such] diseases.”
Other partners will include the telecommunications company Ericsson, a long-standing partner of the Millennium Villages Project. The organizations will work closely with UNICEF and other UN agencies under the auspices of the UN Mission on Ebola.
Ebola viral disease is a severe, often fatal illness that is transmitted by direct contact with blood, body fluids and tissues of infected animals or people. As of Sept. 23, 6,574 people were believed to have contracted the disease in West Africa, according to the World Health Organization, though that number is widely believed to be underestimated. WHO has traced the outbreak to December 2013.
More than 1,000 cases have been reported in Guinea, with others in Liberia, Sierra Leone, Nigeria and Senegal — the biggest outbreak of the disease on record.
Controlling the outbreak requires identifying infected people and suspected cases before they can expose other people. This requires identifying all people who may have been exposed to a person with Ebola and checking for signs of illness every day for 21 days – the maximum number of days of Ebola’s incubation period. Those who begin to develop Ebola symptoms should then be isolated to avoid further transmission.
Community health workers are often trusted members of their community, allowing them to play a key role in disseminating accurate information about Ebola and counsel on protective methods. That would include instructions on proper burial method (60 percent of the Ebola cases in Guinea have been traced to traditional burial practices), the urgency of going to a treatment center if symptoms emerge, early detection of symptoms among community members, and basic infection control measures.
As Guinea moves beyond the epidemic, community health worker responsibilities will shift to strengthening essential primary health services. This will include work on: surveillance of danger signs and referrals; healthy behavior counseling around nutrition, sanitation, and bed-net usage; curative care for diarrhea, malaria and pneumonia; and counseling of pregnant women around antenatal care visits, postnatal care visits, institutional delivery and healthy pregnancy.
These responsibilities reflect significant evidence around community health workers’ effectiveness in reducing morbidity and mortality through preventive and curative services at the community level. This platform of local health workers will help strengthen primary health care systems to avoid future health crises.
The Earth Institute will serve as technical advisor to build the Community-Based Ebola Response Program. This will include design and building of the initial community health worker materials and mobile software, and training of local trainers to set up and manage deployment. Earth Institute technical advisors will monitor and advise on deployment and initial management of the system.
UNICEF Guinea is currently funding 1,000 community health workers in the Nzérékoré Region. These will be the first set of health workers that will be leveraged in the Community-based Ebola Response.
Ericsson will be procuring smartphones for the health workers and serve a key role in negotiating data, SMS, and voice packages with local telecommunications operations. Ericsson will also provide software such as mobile surveys and content hubs for low bandwidth usage. Ericsson will also support the development of a mobile wallet system to increase timeliness and efficiency of community health worker payment, and will contribute to the software development of user-friendly dashboards for local management teams.