Namibia’s Reflections: Analyzing the Crimean Congo Haemorrhagic After-Action Review

Namibia Conducts Crimean Congo Haemorrhagic After-Action Review

Overview

The Ministry of Health and Social Services in Namibia, in collaboration with the World Health Organization (WHO), recently conducted an After-Action Review (AAR) meeting to evaluate Namibia‘s response to the Crimean Congo Haemorrhagic (CCHF) outbreak. The meeting, held in Windhoek from 1-3 August 2023, aimed to document the activities carried out during the outbreak and assess Namibia‘s preparedness and response capacity. The outbreak was confirmed in the Gobabis District of the Omaheke Region on 21 May 2023, with one confirmed case and one death. The AAR was conducted in accordance with the International Health Regulations (IHR 2005) Monitoring and Evaluation framework, which recommends conducting a review within three months after the end of a public health response.

Participants and Methodology

The AAR brought together fifty-eight multi-sectoral participants, including representatives from the Ministry of Health and Social Services, regional health directorates, health districts, public and private health facilities, and various health partners and organizations. The participants were divided into seven groups representing different areas of the CCHF outbreak response, such as coordination, surveillance, case management, infection and prevention control, risk communication, laboratory, and psychosocial support. The workshop involved recalling and documenting the preparedness and response activities in five steps by asking critical questions.

Lessons Learned and Best Practices

During the review, several best practices were identified, including the timely activation of management committees at all levels for a well-coordinated response, the utilization of a one-health approach involving human and animal health to limit further spread, the use of real-time communication platforms to implement resolutions and action plans, and strong collaboration with partners to mobilize resources. These practices contributed to the successful government response in ending the CCHF outbreak.

Action Plan and Capacity Building

The AAR concluded with the development of a comprehensive action plan to implement corrective actions, enhance preparedness, and improve future responses to CCHF and other emergencies. The plan includes prioritized activities, a timeline for implementation, and a follow-up mechanism. Participants emphasized the importance of viewing the AAR as a learning opportunity and capacity building, and stressed the need for continued engagement and collaboration with communities during outbreak responses. The World Health Organization will support the Ministry of Health and Social Services in finalizing the AAR report and developing the corrective action plan.

Impact and Capacity Building in Namibia

Namibia has previously conducted AARs for CCHF and Hepatitis E Virus outbreaks in 2017 and 2022. However, this AAR is notable as it was conducted with minimal support from the WHO Regional Office for Africa (WHO AFRO), highlighting the capacity built within the country. The successful implementation of the AAR reflects the growing ability of both the WHO country office in Namibia and the health ministry to independently conduct comprehensive evaluations of their response efforts. WHO Namibia expressed appreciation for the continuous support received from WHO AFRO in building the country’s capacity to conduct AARs with minimal external assistance.

Conclusion

The After-Action Review conducted by Namibia following the Crimean Congo Haemorrhagic outbreak exemplifies the country’s commitment to evaluating and improving its public health response capacity. By gathering stakeholders to assess the response activities and identify lessons learned and best practices, Namibia can better prepare for future outbreaks and emergencies. The comprehensive action plan developed during the review will further enhance preparedness and response efforts. The successful execution of this AAR highlights the capacity building achieved within Namibia‘s health system and demonstrates the country’s growing ability to independently conduct evaluations of its public health responses.