The Nigerian Military Public Health Response to COVID-19: A 14-Month Appraisal

Abstract

The COVID-19 pandemic has caused significant morbidity and mortality since its emergence in December 2019. In Nigeria, the government inaugurated the Presidential Task Force on COVID-19 to coordinate resources while the Nigeria Centre for Disease Control led the public health response. The Nigeria Ministry of Defence Health Implementation Programme (MODHIP), in partnership with the US Army Medical Research Directorate – Africa/Nigeria, responded immediately to the pandemic by establishing a public health emergency operations center to coordinate the military response in support of national efforts. MODHIP has 5 functional units and 6 pillars that coordinate testing, surveillance, case management, risk communication, logistics, research, and infection prevention and control. It developed an incident action plan and each pillar had its own terms of reference to guide specific response activities while preventing duplication of efforts within the military and the Nigeria Centre for Disease Control. In addition, awareness and sensitization sessions were conducted on preventive practices for COVID-19 and infrastructure was provided for hand hygiene and screening at all military facilities. Military laboratories were configured for SARS-CoV-2 testing while selected military health facilities were equipped and designated as COVID-19 treatment centers. Research proposals aimed at better understanding the disease and controlling it were also developed. The traditional combat role of the military was redirected to complement this public health emergency response. In this article, we highlight gaps, opportunities, and lessons to improve military participation in public health emergency response in the future. More funding and multisectoral collaboration with civilian institutions are key to strengthening military public health emergency preparedness and response capabilities.

A Systematic Literature Review of the Determinants of a Good National Civil-Military Partnership for Rapid Management and Response of Health Emergencies: Lessons for Africa

“…Background/Introduction: Civil-military collaboration in response to an epidemic or health crisis could strengthen countries' capacities to provide adequate medical care and limit casualties. Many countries have received the support of military medical services during an emergency, 1 guided by their multi-disciplinary human resources, with a strong background in rapid deployment, logistics and trauma management, and the civilian teams with a good capacity in epidemic management. 1,2 Objectives: This study analyzes the determinants of a good civil-military partnership for rapid management of health emergencies on the African continent.…”

“…Many countries have received the support of military medical services during an emergency, 1 guided by their multi-disciplinary human resources, with a strong background in rapid deployment, logistics and trauma management, and the civilian teams with a good capacity in epidemic management. 1,2 Objectives: This study analyzes the determinants of a good civil-military partnership for rapid management of health emergencies on the African continent. Method/Description: We conducted a systematic review of literature from published (PUBMED, Hinari, and Google Scholar) and grey databases guided by the PRISMA guideline.…”

“…Results/Outcomes: A good collaboration requires a formal agreement with a defined institutional anchor structure between the two institutions. 1,3 The coordination should remain flexible with the co-leadership of each institution. 1,3,4 The roles of all participating teams should be defined at the onset, [1][2][3][4][5] and plans instituted based on the type of emergency to enhance cooperation.…”

“…1,3 The coordination should remain flexible with the co-leadership of each institution. 1,3,4 The roles of all participating teams should be defined at the onset, [1][2][3][4][5] and plans instituted based on the type of emergency to enhance cooperation. Both civilian and military teams need to know and understand the approved management protocols.…”

“…Military health services are better experienced in trauma management, while civilians are more equipped to manage epidemics. 1,4 Besides, there is a need for periodic evaluation of patient outcomes, resource management, challenges, and lessons learned after the response. Conclusion: Civil-military teams jointly responding to emergencies can be challenging but should be built around four defined pillars: collaboration, coordination, capacity building, and evaluation to capitalize on the teams' strengths.…”