Table 3 Summary of major findings
Response measures | Challenges |
|---|---|
Emergency planning and policy development • COVID-19 policy formulation process commenced from March 2020 • About ninety policies and guidelines were developed in the year 2020 | Lack of inclusive and equitable planning and governance • Active participation of provincial and local government during policy formulation was limited • Gender and equity not well considered in policy formulation, however, reactive management done when related issues started to get reported |
Strategic use of evidence • Policies guided by global evidence and learnings • Global guidelines actively reviewed and updated at federal level | Inadequate monitoring of the local context and needs; and lack of mechanisms to ensure accountability • Policies developed at federal level were not feasible in local contexts • No established mechanism to monitor and ensure policy compliance |
Dedicated leadership and distributed control; multi-sectoral collaboration and networks • Federal government led policy formulation, with technical leadership from MoHP and CCMC • Formation of committees and groups to respond COVID-19 at different tiers - strong multisectoral collaboration and partnership established at federal level • Use of decision space by provincial government to manage the pandemic response in the areas such as budget allocation, logistics procurement, human resource recruitment, etc. | Inadequate capacity of system stakeholders and health workers • Local governments mostly reliant on policies from federal and provincial government • Local adaptation of policies was rarely done due to lack of capacity and experience • Few examples of reactive adaptation of federal and provincial policies into local context, at municipality and health facilities |
Information dissemination and policy communication • Intensive use of various media channels by federal government such as press briefing, national websites, social medias, newspapers, radios and television to communicate COVID-19 policies and COVID-19 information to all • Use of phone call, email, and meetings to convey information at subnational levels | Information dissemination approaches not effective and targeted • Top-down approach to communication • Policy communications not targeted, same information and channels to communicate to diverse audiences– subnational policy makers, health managers, health workers and public - which was found to be ineffective • Lack of clarity on how to implement policy decisions among local government officials and health workers • Sudden changes in policies dictated from higher levels without timely communication |