From Ebola to COVID-19: emergency preparedness and response plans and actions in Lagos, Nigeria.

BACKGROUND: Lagos state is the industrial nerve centre of Nigeria and was the epicentre of the 2014 Ebola outbreak in Nigeria as it is now for the current Coronavirus Disease (COVID-19) outbreak. This paper describes how the lessons learned from the Ebola outbreak in 2014 informed the emergency preparedness of the State ahead of the COVID-19 outbreak and guided response. DISCUSSION: Following the Ebola outbreak in 2014, the Lagos State government provided governance by developing a policy on emergency preparedness and biosecurity and provided oversight and coordination of emergency preparedness strategies. Capacities for emergency response were strengthened by training key staff, developing a robust surveillance system, and setting up a Biosafety Level 3 laboratory and biobank. Resource provision, in terms of finances and trained personnel for emergencies was prioritized by the government. With the onset of COVID-19, Lagos state was able to respond promptly to the outbreak using the centralized Incident Command Structure and the key activities of the Emergency Operations Centre. Contributory to effective response were partnerships with the private sectors, community engagement and political commitment. CONCLUSION: Using the lessons learned from the 2014 Ebola outbreak, Lagos State had gradually prepared its healthcare system for a pandemic such as COVID-19. The State needs to continue to expand its preparedness to be more resilient and future proof to respond to disease outbreaks. Looking beyond intra-state gains, lessons and identified best practices from the past and present should be shared with other states and countries.

Embedding value-for-money in practice: A case study of a health pooled fund programme implemented in conflict-affected South Sudan.

In recent times, there has been an increasing drive to demonstrate value for money (VfM) for investments made in public health globally. However, there is paucity of information on practical insights and best practices that have helped implementing organisations to successfully embed VfM in practice for programming and evaluation. In this article, we discuss strengths and weaknesses of approaches that been used and insights on best practices to manage for, demonstrate, and compare VfM, using a health pooled fund programme implemented in conflict-affected South Sudan as case study supported by evidence reported in the literature while critiquing adequacy of the available approaches in this setting. An expanded and iterative process framework to guide VfM embedding for health programming and evaluation is then proposed. In doing so, this article provides a very relevant one-stop source for critical insight into how to embed VfM in practice. Uptake and scale-up of the proposed framework can be essential in improving VfM and aid effectiveness which will ultimately contribute to progress towards achieving the Sustainable Development Goals by 2030.