Nigeria

Building local capacity for emergency coordination: establishment of subnational Public Health Emergency Operations Centres in Nigeria

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Oyeronke Oyebanji, Fatima Ibrahim Abba, Oluwatosin Wuraola Akande, Everistus Chijioke Aniaku, Anwar Abubakar, John Oladejo, Olaolu Aderinola, Emmanuel Benyeogor, Femi Owoeye, Patrick M Nguku, Valerie Nkamgang Bemo, Chikwe Ihekweazu

Abstract

Public Health Emergency Operations Centres (PHEOCs) provide a platform for multisectoral coordination and collaboration, to enhance the efficiency of outbreak response activities and enable the control of disease outbreaks. Over the last decade, PHEOCs have been introduced to address the gaps in outbreak response coordination. With its tropical climate, high population density and poor socioeconomic indicators, Nigeria experiences large outbreaks of infectious diseases annually. These outbreaks have led to mortality and negative economic impact as a result of large disparities in healthcare and poor coordination systems. Nigeria is a federal republic with a presidential system of government and a separation of powers among the three tiers of government which are the federal, state and local governments. There are 36 states in Nigeria, and as with other countries with a federal system of governance, each state in Nigeria has its budgets, priorities and constitutional authority for health sector interventions including the response to disease outbreaks. Following the establishment of a National PHEOC in 2017 to improve the coordination of public health emergencies, the Nigeria Centre for Disease Control began the establishment of State PHEOCs. Using a defined process, the establishment of State PHEOCs has led to improved coordination, coherence of thoughts among public health officials, government ownership, commitment and collaboration. This paper aims to share the experience and importance of establishing PHEOCs at national and subnational levels in Nigeria and the lessons learnt which can be used by other countries considering the use of PHEOCs in managing complex emergencies.

Summary box

  • The annual occurrence of infectious disease outbreaks in Nigeria requires the development of adequate and resilient response capacity at national and subnational levels.

  • The establishment of Public Health Emergency Operations Centres (PHEOCs) at national and subnational level in Nigeria has contributed to improved coordination of outbreak preparedness and response activities.

  • The increased investment in public health interventions may lead to political interference as an unintended consequence; therefore, the development and implementation of such interventions should involve government advocacy and cooperation.

  • The establishment of PHEOCs has allowed for effective coordination and efficient resource management including rapid reporting of surveillance data, organisation of resources, deployment of rapid response teams, risk and crisis communications.