This World Health Day, key insights from Covid-19 to build a fairer, healthier world

April 7, 2021
A Covid-19 hand-washing station in Ethiopia. (Credit: Pact)

Everyone has a right to be healthy. This is at the heart of the global push for universal health care. The ongoing Covid-19 pandemic has shown that there are still deep disparities in health risks and access, rooted in socio-economic and structural inequalities that persist in many communities. While Pact’s commitment to supporting the most vulnerable remains as strong as ever, there is still so much more to do. Three areas that need special attention are flexibility in funding, rapid adaptation and inclusive community engagement. 

Flexibility in funding and adaptation to programming have been critical over the past year and will continue to be in the months ahead. Vertical health programs, typically focused on addressing one disease such as HIV or malaria, have been a staple of donor-funded development programs. But this year, donors allowed NGOs such as Pact to apply existing program funds to support the public health response to Covid-19, enabling the use of established and trusted community platforms to integrate basic yet essential interventions, such as Covid-19 education to help keep people safe and informed. Adaptation isn't new to the development sector, but this past year taught us just how important it is. To learn more, see our recent Guide to Adaptive Management

The pandemic required us to quickly customize information and interventions at the local level. For example, at the start of the pandemic, there was an emphasis on hand washing, but many communities do not have access to hand sanitizers, basic hand-washing facilities or clean water. Communities needed the information and prevention measures to be adapted to their context. In Eswatini, our team translated World Health Organization materials into the local language and designed instructions for creating makeshift "tippy taps" at home; within six months, 60% of families in Pact’s program reported having built their own tippy taps. In Zambia, our team set up 100 hand-washing stations in DREAMS centers for adolescent girls and young women and 60 stations in nearby health facilities, all of which are still in use today.  

Another fast adjustment we made was the switch from in-person engagement, such as in-house case management visits, to distanced support during the pandemic. Pact teams sought creative solutions to provide services remotely during periods of lockdown, and we still have a lot to learn about how to deliver interventions digitally. For example, in many of our programs that support orphans and vulnerable children, we switched to telephone-based case management for children and their caregivers and adapted previously in-person trainings for mobile delivery. Going forward, we’ll be assessing how to optimally balance in-person and digital engagement.

Pact teams sought creative solutions to provide services remotely during periods of lockdown, and we still have a lot to learn about how to deliver interventions digitally.

Through our collaborative work with communities and local partners, Pact is seen as a trusted source of information. We take this as both a privilege and a responsibility. With the global Covid-19 vaccine roll-out, we are actively looking for ways to support inclusive community participation and to increase confidence in the vaccine, especially as national strategies need to be adopted and adapted locally for diverse communities to be effective. This starts with understanding community perceptions, concerns and fears about the vaccine, as well as cultural and political barriers, and engaging with trusted community leaders and organizations on ways to effectively promote the benefits of the vaccine and improve access among vulnerable populations. To help us get there, we recently started a rapid assessment in three countries focused on community readiness for the Covid-19 vaccine, to provide insights on opportunities for community participation in the vaccine response. We look forward to sharing our learnings from this assessment in May. 

At Pact and across the health and development sector, we are re-thinking how people interact with health systems and the importance of trust in public health interventions. Vulnerable populations – those who are stigmatized or marginalized based on gender, ethnicity, age, religion or sexual orientation – often do not trust or engage with formal health care systems or traditional programs. In addition, Covid-19 has disrupted health services and gains that were made in health-related Sustainable Development Goals. We have yet to see the full impact of these declines. Even strong health systems need to be more resilient to shocks and need to more fully address disparities in service availability and access. We need to reflect on how we can better improve health systems capacity for crisis management and for equitable health care, especially at regional and local levels.  

As we leave the acute phase of the pandemic and enter the new normal that it has created, we are at an inflection point where we must reckon with multi-faceted challenges on the pathway to recovery. My hope is that our collective lived experience through Covid-19 will drive positive change. Pact is committed to building a fairer, healthier post-pandemic world, and we are eager to create it in partnership with local communities.