{
  "abstract": "Primary healthcare (PHC) is the first point of contact with communities and essential for epidemic preparedness. The COVID-19 pandemic exposed gaps in PHC resilience. Epidemic Ready Primary Healthcare (ERPHC) was designed to bridge these gaps by strengthening PHC to prevent, detect and respond to outbreaks while maintaining essential services. An ERPHC pilot was initiated in December 2023 in 654 PHC facilities across Ethiopia, Nigeria, Sierra Leone and Uganda. The approach improves connection to local communities, detection and reporting of cases, healthcare worker protection and patient treatment. Interventions include integrating Infection Prevention and Control (IPC), surveillance and case management functions, monthly mentorship visits, data-driven quality improvement assessments and enhanced communication between facilities and public health authorities.After 11 months, facility epidemic readiness scores improved from 55% to 87%. Reports of suspected reportable diseases increased from 184 to 290 per month, with 94% reported within 24 hours. A total of 75 cases of epidemic-prone diseases were detected across 17 facilities, with 99% of cases meeting the 7-1-7 target for detection and 100% meeting the target for notification. IPC scores improved from 56% to 94%, and correct donning and doffing of personal protective equipment by HCWs improved from 34% to 87%. Bottlenecks included inconsistent supply chains and inadequate infrastructure.ERPHC has demonstrated rapid improvements in performance, emphasising the impact of integration across technical disciplines and targeted mentorship in boosting epidemic readiness. Early results of the ERPHC approach show potential to accelerate the detection and reporting of epidemic-prone diseases and improve HCW and patient safety.",
  "authors": [
    {
      "affiliations": [
        "Prevent Epidemics, Resolve to Saves Lives, Alexandria, Virginia, USA"
      ],
      "name": "Stacey Leanne Mearns"
    },
    {
      "affiliations": [
        "African Field Epidemiology Network, Abuja, Nigeria"
      ],
      "name": "Moreen Kamateeka"
    },
    {
      "affiliations": [
        "Disease Prevention and Health Promotion, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria"
      ],
      "name": "Tochi Okwor"
    },
    {
      "affiliations": [
        "Department of Community Health Services, National Primary Health Care Development Agency (NPHCDA), Abuja, Nigeria"
      ],
      "name": "Aisha Abba"
    },
    {
      "affiliations": [
        "Resolve to Save Lives, Nigeria Country Office, Abuja, Nigeria"
      ],
      "name": "Celestina Obiekea"
    },
    {
      "affiliations": [
        "Resolve to Save Lives, Nigeria Country Office, Abuja, Nigeria"
      ],
      "name": "Jenom Danjuma"
    },
    {
      "affiliations": [
        "Resolve to Save Lives, Ethiopia Country Office, Addis Ababa, Ethiopia"
      ],
      "name": "Arone M Haile"
    },
    {
      "affiliations": [
        "Public Health Research and Emergency Management Directorate, Addis Ababa City Administration Health Bureau, Addis Ababa, Ethiopia"
      ],
      "name": "Daniel Damtew"
    },
    {
      "affiliations": [
        "Office of the Director General, Sidama Public Health Institute, Hawassa, Ethiopia"
      ],
      "name": "Damene Debalke"
    },
    {
      "affiliations": [
        "University of Sierra Leone College of Medicine and Allied Health Sciences, Freetown, Western Area, Sierra Leone",
        "National Public Health Agency, Ministry of Health and Sanitation, Freetown, Western Area, Sierra Leone"
      ],
      "name": "Joseph Kanu"
    },
    {
      "affiliations": [
        "National Infection Prevention and Control Unit, Ministry of Health and Sanitation, Freetown, Western Area, Sierra Leone"
      ],
      "name": "Ramatu Ngauja"
    },
    {
      "affiliations": [
        "Mailman School of Public Health, ICAP at Columbia University, New York, New York, USA"
      ],
      "name": "Susan Michaels-Strasser"
    },
    {
      "affiliations": [
        "Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda"
      ],
      "name": "Abdullah Wailagala"
    },
    {
      "affiliations": [
        "Integrated Epidemiology, Surveillance and Public Health Emergencies, Ministry of Health, Kampala, Uganda"
      ],
      "name": "Allan Muruta"
    },
    {
      "affiliations": [
        "Integrated Epidemiology, Surveillance and Public Health Emergencies, Ministry of Health, Kampala, Uganda"
      ],
      "name": "Atim Dansan"
    },
    {
      "affiliations": [
        "Prevent Epidemics, Resolve to Saves Lives, Alexandria, Virginia, USA"
      ],
      "name": "Amy Elizabeth Barrera-Cancedda"
    },
    {
      "affiliations": [
        "Prevent Epidemics, Resolve to Saves Lives, Alexandria, Virginia, USA"
      ],
      "name": "Samantha Kozikott"
    },
    {
      "affiliations": [
        "Prevent Epidemics, Resolve to Saves Lives, Alexandria, Virginia, USA"
      ],
      "name": "Justine Landegger"
    },
    {
      "affiliations": [
        "Prevent Epidemics, Resolve to Saves Lives, Alexandria, Virginia, USA"
      ],
      "name": "Leena N Patel"
    },
    {
      "affiliations": [
        "Prevent Epidemics, Resolve to Saves Lives, Alexandria, Virginia, USA"
      ],
      "name": "Amanda McClelland"
    }
  ],
  "title": "Progress in epidemic-ready primary health care: early pilot results from four African countries (Ethiopia, Nigeria, Sierra Leone and Uganda), December 2023 – October 2024",
  "uid": "38ab74cf-a1bd-59de-826d-dec16cafa04e"
}