Integrated services can transform public health security

In recent years, the world has witnessed an increase in public health emergencies, with their complexity intensifying due to climate change, pandemics and social inequality.[FILE]

In recent years, the world has witnessed an increase in public health emergencies, with their complexity intensifying due to climate change, pandemics and social inequality. One of the most glaring lessons from the Covid-19 pandemic is the critical need for a cohesive, integrated approach to health service delivery.

The “panic and forget” cycle, where society reacts only in the face of an immediate crisis and then forgets to prepare for future risks, has shown us the consequences of fragmented health systems. To break this cycle and ensure long-term health security, we must embrace integrated health services.

Integration means breaking down traditional silos and fostering collaboration across various sectors —public health, healthcare, water and sanitation, education and even the environment. When health systems work together, they become more resilient, efficient and better equipped to respond to emergencies. Resources are used effectively, redundancy reduces and quality of care for vulnerable populations improves.

This becomes more critical in the context of climate change, a growing threat to global health security. Last year, flooding during the March-April-May rainy season resulted in widespread displacement, property destruction and the marooning of 13 health facilities in Tana River County. Health and well-being of over 21,000 households were affected. Cholera outbreak left 160 people infected and three dead. The lack of access to clean water, sanitation and healthcare services in displaced populations led to an escalation in preventable diseases.

What happened next is a lesson on health services integration. Amref Health Africa, county and national governments, and other stakeholders came together to address the immediate health crisis and build long-term resilience. The partnership had three objectives: control the cholera outbreak and reduce the risk of further spread, ensure continuity of essential healthcare services for displaced and isolated populations, and enhance resilient and preventive health campaigns through Risk Communication and Community Engagement.

Community-based outreach services helped deliver preventive and curative healthcare to displaced populations in IDP camps and isolated villages. Amref deployed mobile clinics to provide a wide range of services, including nutritional screening for under-five children and pregnant women, curative services for minor and major illnesses, psychosocial support, HIV testing and other laboratory services, screening for NCDs and family planning services.

Using the One Health approach, people were treated and their animals received veterinary care. To stop infections due to disrupted sanitation systems, contaminated water sources and increased open defecation among the displaced, the programme supported the distribution of WASH (water, sanitation and hygiene) commodities, including chlorine and water purification tablets, to prevent waterborne diseases. Innovative solutions like SaWa Bags, which use solar UV rays to purify drinking water, were also distributed.

Working with community health promoters, critical education on prevention measures, proper hygiene and sanitation improvement reached the affected communities, helping them understand the risks they faced, how to prevent further disease outbreaks, and how to protect themselves and their families.

The writers are senior managers at Amref Health Africa