Lessons Learned from the Catalyzing COVID-19 Action Project

Overview

In 2021, the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) was awarded the Catalyzing COVID-19 Action (CCA) project, an initiative funded by FIND and UNITAID. The goal of CCA project is to accelerate end-to-end access to novel solutions in the COVID-19 pandemic response by adapting testing, isolation, care, and treatment approaches to meet the needs of three countries – Cameroon, Kenya, and Zimbabwe. The CCA project aims to propel innovation and access to these tailored solutions through five work areas: evidence generation, catalytic implementation, advocacy, demand generation, and transition to national programs for sustainable impact.

Lessons Learned for M&E of Future Pandemics

Adaptation and flexibility are critical in an emergency health situation. When CCA began, there were no overarching M&E frameworks to refer to for COVID-19 indicators at the site level. Unlike other established diseases, the knowledge base around COVID-19 was very limited. Therefore, we had to develop systems without a complete understanding of what may work on the ground. As the pandemic progressed, the project and subsequent M&E system had to adapt to the changing policy and epidemiological context. This meant that the CCA team had to constantly iterate in order to
meet the changing landscape.

Another lesson is that it is important to utilize and adapt to the M&E systems that are already in place for rapid roll out and buy-in. In the case of CCA, the project leveraged the Kenya EMR to facilitate data collection through a COVID-19 module. This was not without challenges, but the digital infrastructure was already in place and health care sites were familiar enough with the EMR that the project could build upon what already existed. In the case of Cameroon and Zimbabwe, there was no existing infrastructure and therefore, the project had to adapt paper forms or registers that were already available at the site level. Even though this resulted in delays for project staff in using data for decision making, it was the best solution given the urgency of rolling out the tools.
Finally, during a pandemic, timely generation and use of data are critical. An emergency health situation can change drastically on a daily and weekly basis. Accurate data should be quickly available to the key stakeholders and users responsible for pandemic response. Ultimately, we found that the Kenya point-of-care EMR was the optimal system for generating data that could respond quickly enough to the rapidly changing pandemic context. This is because the data were available to the project team and site level staff in near real time upon entry into the system.

The CCA project holds many lessons for M&E during health emergencies. The project was able to build a resilient and adaptive M&E system while also contributing to the evidence on COVID-19 services. To prepare for future pandemics, EGPAF will continue to strengthen digital health systems and capacity in the countries that we support and apply the lessons learned during CCA both internally and externally.