Namibia’s In-depth Analysis: Unraveling the Crimean Congo Haemorrhagic Fever Aftermath

Namibia Conducts Crimean Congo Haemorrhagic After-Action Review

Introduction

The Ministry of Health and Social Services in Namibia, in collaboration with the World Health Organization (WHO), recently conducted an After-Action Review (AAR) to evaluate the country’s response to the Crimean Congo Haemorrhagic (CCHF) outbreak. The AAR meeting, held in Windhoek from 1-3 August 2023, brought together various stakeholders to document the activities carried out during the outbreak and assess Namibia‘s preparedness and response capacity.

The CCHF Outbreak

The CCHF outbreak was confirmed in the Gobabis District of the Omaheke Region on 21 May 2023, after one person who was infected with CCHF died three days prior. Following this confirmation, the Minister of Health and Social Services, Dr Kalumbi Shangula, declared the outbreak on 22 May 2023. Only one confirmed case was reported during the outbreak, which according to the National Integrated Disease Surveillance and Response (IDSR) guidelines, constitutes an outbreak.

During the outbreak, fifty-six contacts were identified and monitored, and fortunately, no infections were recorded among them. As a result, Dr Shangula declared an end to the CCHF outbreak on 19 June 2023. Subsequently, an AAR was conducted, as recommended within three months after the end of a public health response, to identify gaps, learn lessons, and determine best practices.

The After-Action Review

The AAR methodology involved fifty-eight multi-sectoral participants, including representatives from the Ministry of Health and Social Services, regional health directorates, health facilities, and partner organizations such as the WHO country office, Namibia Red Cross Society, and Ministry of Agriculture, Water, and Land Reform. These participants were divided into seven groups, representing different response areas of the CCHF outbreak.

The AAR workshop focused on recalling and documenting the preparedness and response activities before and during the outbreak. Participants were asked critical questions such as “What happened during the response?” and “What went well?” to evaluate the effectiveness of the response. Through this process, several best practices were identified, including the timely activation of management committees, the implementation of a one-health approach that considers both human and animal health, the utilization of real-time communication platforms, and strong collaboration with partners and stakeholders for resource mobilization.

The Action Plan and Way Forward

The AAR concluded with the development of a comprehensive action plan that highlights prioritized activities to institutionalize the best practices and address the challenges identified during the review. The action plan includes a timeline for implementation and a follow-up mechanism to ensure corrective actions are taken. The Ministry of Health and Social Services emphasized the importance of learning from this experience and building capacity for future public health events. They also stressed the need for continuous engagement and collaboration with communities during outbreak responses.

The World Health Organization (WHO) will support Namibia in developing the corrective action plan and finalizing the AAR report. It is worth noting that this is the first time Namibia conducted an AAR with minimal support from the WHO Regional Office for Africa (WHO AFRO). This accomplishment reflects the capacity built within the country, both at the WHO country office in Namibia and the health ministry, to conduct AARs independently.

Conclusion

Namibia‘s After-Action Review (AAR) for the Crimean Congo Haemorrhagic (CCHF) outbreak has provided valuable insights into the country’s preparedness and response capacity. Through this review, best practices were identified, and an action plan was developed to enhance future responses to CCHF and other emergencies. The importance of collaboration with partners and stakeholders, as well as community engagement, was emphasized during the AAR.

This successful review highlights the progress made by Namibia in building its capacity to conduct AARs independently. With the support of the World Health Organization, Namibia is moving towards strengthening its public health systems and ensuring effective responses to future outbreaks. The lessons learned from this AAR will undoubtedly contribute to better preparedness and response efforts in the future.