As the world hunkered down under the onslaught of COVID-19 and rushed to implement containment measures, this tiny country in the Horn of Africa was already prepared with a prevention and response plan. Even before the first positive case was detected on 21 March, UNICEF Eritrea and other UN agencies including WHO, were supporting the government's efforts on the National COVID-19 Response Plan.
By the time major transport hubs announced lockdown measures, UNICEF Eritrea's internal contingency plan had identified bottlenecks to transport and supplies, and immediately began looking within the country for alternative channels of supply and production.
Innovative strategy helps augment prevention and offsets delays from external suppliers
"We anticipated delayed deliveries and our team identified a factory, and in coordination with the Ministry of Health (MoH), we worked to produce a local version of hand sanitizer, based on WHO guidelines," says David Tsetse, the WASH Manager for UNICEF Eritrea.
Within three weeks more than 12,000 bottles of locally produced hand sanitizers had been produced and disseminated, in addition to the 86,000 bars of soap to the MoH, the Ministry of Education (MoE) and the Ministry of Labour and Social Welfare (MoLSW) for health facilities, schools and vulnerable populations.
UNICEF continues to work with MoH, MoE, MoLSW and the Ministry of Information (MoI), and applies an integrated approach to support the governments' efforts to prevent, mitigate and contain the virus. Critical medical supplies and PPE items were immediately ordered; UNICEF supported MoE with guidelines and textbooks were made available to the Zobas for distribution to schools, and technical support on remote distance learning for children on radio and television; and MoLSW on plans for social transfers in cash and kind to vulnerable families affected by COVID-19.
UNCEF's risk communication and community engagement (RCCE) team worked with the WHO, MoH, MoE and the MoI to create more than 270 public service announcements (including sign language) in nine ethnic languages with over 70% of airtime on national TV and radio devoted to COVID-19. More than 2 million posters, pamphlets and stickers on food hygiene, handwashing and COVID-19 prevention messages were disseminated to schools, communities, institutions and health facilities. Job aids such as contact tracing materials were also provided to health professionals working on quarantine sites and treatment centres. Three 24/7 toll free numbers provided information on health and hygiene and prevention, and to report symptoms; and handled approximately 200 calls per day.
Innovative strategy to restructure the management of child under-nutrition to prevent malnutrition among children
As the country prepared to announce a 21-day stay at home order which would be extended later, UNICEF's Eritrea's nutrition section swung into action. Using the facility and community-based therapeutic treatment centres as the pivot, the nutrition programme worked with the MoH on how best to sustain preventive actions to address severe acute malnutrition among children under five, and to support pregnant and lactating women under the blanket supplementary feeding programme.
"Ministry of Health and UNICEF decided to extend the provision of therapeutic feeding products from one week to one month for severe acute malnutrition (SAM) cases, and of supplementary foods from one month to three months for moderate acute malnutrition (MAM) cases," says Samson Desie, UNICEF's Nutrition Manager.
This expanded approach was lauded by health workers and UNICEF worked with MoH colleagues to adapt and develop appropriate guidelines into local languages, which is now being implemented by health workers, while maintaining the quality of treatment services.
Additionally, UNICEF supported MoH to continue to provide routine immunization services even while the COVID-19 response measures are in place: to prevent any resurgence of common childhood illnesses such as measles, and also to maintain the high rates of routine immunization coverage. Support was also provided to ensure that Vitamin A supplements are integrated with every upcoming immunization session or opportunity.
"UNICEF's strength and purpose is derived not just from the provision of supplies and equipment alone, but the technical expertise and the innovative ideas among our staff and partners that enables UNICEF to go the extra mile - to ensure that all vulnerable children and women are protected, and that no child is left behind," says UNICEF Representative, Shaheen Nilofer.
**Meanwhile, UNICEF is awaiting the delivery of 84 oxygen concentrators, additional PPE items and medical equipment, and the arrival of an air charter which will bring critical vaccines to support Eritrea's Expanded Programme for Immunization.