Locally-Led Working Group Moves the Needle on Donor Efforts to Fight COVID in the DRC

The Democratic Republic of the Congo (DRC) is a fragile country that is frequently affected by epidemics of diseases like cholera, measles, and Ebola. Despite extensive experience with disease, COVID-19 has been a unique challenge that marked significant drops in service use and quality of care. The emergence of the disease exposed weaknesses in the country's human resource and logistical capacity. Programs funded by an array of international donors seek to mitigate these weaknesses, but with the urgency of COVID-19, it was remarkably inefficient for stakeholders to act in their own silos. Recognizing this need to coordinate efforts, the USAID-funded Integrated Health Program and the DRC's Ministry of Health developed COVID-19 working groups and diverse stakeholder networks to bring the system's bottlenecks and shortcomings to light. As a group, actors ranging from USAID implementing partners to UNICEF, and importantly local community organizations, all shared their experiences across a variety of epidemics and found ways to align their responses to COVID-19. Throughout this coordination, the Ministry of Health was in the driver's seat. During working group discussions, partners raised the frequent confusion that providers experience when attempting to understand the many duplicative or overlapping clinical guidelines shared by the Ministry of Health over time. Pulling from the collective institutional knowledge of the group, USAID IHP led a comprehensive literature review of all historic medical protocols and guidelines and convened sub-committees by technical area to consolidate and streamline them. The Ministry was able to clarify its guidance to health providers, learn from implementation what protocols are realistic, and adapt guidance to these learnings. Throughout this case study, we describe the process of convening a comprehensive working group to address COVID-19, integrating learnings from the Ebola epidemic, responding to failures, consolidating collective learnings, and passing knowledge to community organizations to continue epidemic response efforts into the future.