Bonjour tout le monde

Dr SEMLALI from Morocco

Je n'enttends pas la voix de la traduction en Français

très bein, ça marche

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Thank you panelists!

This is going to be interesting. You are all so knowledgeable!!!

Thank you for joining today's session! Please share your questions and comments using the Q&A and chat functions

We would also like to hear your views on the following questions: 1) What challenges/bottlenecks have you experienced in policy dissemination during the pandemic? how do these compare to challenges in disseminating policies prior to the pandemic?2) What examples can you share of overcoming these bottlenecks toward successful policy dissemination (during pandemic or not)?

1) Quels défis avez-vous rencontrés dans la diffusion des politiques pendant la pandémie ? comment se comparent-ils aux défis de diffusion des politiques avant la pandémie ?2) Quels exemples pouvez-vous partager pour surmonter ces barrières pour une diffusion réussie des politiques (pendant une pandémie ou non) ?

It may be easier to have policy dissemination when the policies come from one central place, as Kenya had before devolution. Currently, under the devolved system, county governments can easily develop their own policies which may not be helpful in a pandemic. The COVID National Taskforce was helpful in that it could develop policies for the whole county and helped to harmonise response by all counties

Meant the whole country...

Q:Thanks, Dr Agatha. It is great to hear about the mechanisms you used in disseminating this policy to the counties. Some further sharing of interest will be:1. How did the method of dissemination affect the implementation and speed of implementation of these policies at the county level?2. Were the counties expected to adapt this policy to their own settings or implement as is?3. Were the counties represented at the policy formulation level and how did this affect implementation success at the county level?4. Finally, what is the level of success of implementation at the county level, where there differences among different counties and if so, what were the factors responsible?

We had to work with a lot of circulars and guidelines being sent out t the county from National government….(since there was a central command system, there was a lot of speed in Implementing these policies at the county level). At first the counties were expected to adapt the policies. These included aspects such as starting their own county task forces. Many did so well enough due to involvement of the high level politicians- Governors, CECs for health. At first there was minimal involvement of the county level but as counties starting putting their plans in place, they were more involved in the policy development through the TWGs

Different counties are at different levels in their implementation, the benefit is that the response is tailored to the specific area

The National Task Force had several Technical working groups that dealt with different aspects eg the Community engagement Twg had direct input from communities and was able to raise challenges being faced during the COVID response. Also HCW had input to the Continuity of services Twg and were able to feed in their challenges m, which were then raised in the larger Taskforce. There were actions that resulted from the feedback eg ensuring that people who needed emergency help could get it

Despite lockdowns and restrictive measures

In many places, at the initial stage health care provision including health worker's times and resources were diverted to Covid 19 care, but after the policies were made on preserving essential care, and essential care commenced in facilities, the patients were not showing up! This showed a gap in dissemination of this policy at the community level showing that policy dissemination is very essential to both implementers of the policy as well as community members. In addition, other reasons or barriers to patients accessing care during the pandemic period should also be identified and addressed.

For Indoor residual spraying, we designed a tool called the policy implementation barometer with questions to ascertain the extent of knowledge of the stakeholders of the strategies within the malaria control strategy. We talked to public and non state actors at the national level. district level and facility. We were able to assess the variations among levels of knowledge of the actors and this informed an advocacy agenda on IRS.

There is need for resources to bring the actors together. Coordination among and across levels is costly. Many times, there is limited appreciation of this reality and inadequate investment into this process.

We need to design projects/interventions that focus on governance and management capacities in health systems as we do for service delivery. This is often a vague areas and paid lip service.

Please could you elaborate on the role that the academia played?

Our guidelines and COVID response, at first, were mainly guided by academia

The technical committees in Uganda had membership from academia. The president openly referred to his guidance as informed by scientists

Thank you very much panelists.

Thank you all, really educative session for me! Fantastic work….