FY19 Semi-Annual Report: IMA World Health, OFDA funded EBOLA VIRUS DISEASE in North Kivu and Ituri: Strengthening community prevention, response, and recovery in the Democratic Republic of Congo project

The current outbreak, involving two provinces and 21 health zones, is the largest of all known outbreaks of EVD in the DRC and the second largest recorded globally, with over 1,330 confirmed cases and 834 deaths as of April 26th, 2019. The outbreak is occurring in an environment of widespread insecurity, with impeded access to interior health zones and increasing distrust of international NGO and relief agencies. This environment presents significant challenges in effective surveillance and monitoring of persons exposed to EVD, dissemination of key messages to reduce risk of transmission, and equipping rural health facilities with essential prevention measures such as WASH, waste management, and effective infection prevention and control (IPC) material and protocols. IMA World Health, in partnership with Tearfund and Program for the Promotion of Primary Health Care (PPSSP), has been implementing a comprehensive prevention and response program addressing the issues of impeded access, lack of trust and communication, and inadequate prevention and control measures in four health zones in the increasingly widespread outbreak of EVD in North Kivu and Ituri Provinces in DRC. The program's four-component strategy includes community outreach and mobilization, contact tracing, health facility-based IPC, and WASH and waste management in health facilities. The community outreach and mobilization approach has included deploying Community Health Workers (CHWs) for community-based messaging, contact tracing, and enhanced surveillance. The health facility-based IPC approach includes a rapid survey and gender analysis, provision of IPC material and applied protocols, and a monthly support package and checklist to ensure compliance. The impact of this approach has ensured that high-risk and difficult-to-access health areas and health facilities have the requisite training, financial support, equipment, and supplies to effectively address the outbreak of EVD. As of the end of the second quarter, 85 Community Health Workers (CHWs) were supported, with 50 involved in public health surveillance as members of the Contact Tracing team. Focus groups held in supported health areas showed that an average of 80% of participants were able to recall two or more protective measures in quarter one, increasing to 83% in quarter two. IMA initiated and supported two levels of training programs, including training for health facility personnel on EVD recognition, IPC, and supply chain management, and training for health facility outreach workers on communication and messaging. The project performance matrix, including baseline, quarterly targets, achievement to date, and performance rate, is presented in Annex A. Highlights of Q1 and Q2 (November 2018-March 2019) include the rapid assessment of 68 health facilities in 31 aires de santé, which was completed in affiliation with the Ministry of Health (BCZ) and IMA partners PPSSP and Tearfund. The assessment evaluated PCI and WASH needs in health areas that were accessible from a security perspective and had high numbers of reported cases.