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# Background E-learning plays a key role in bridging competency gaps among the public health workforce to prevent, detect, and respond to public health emergencies. However, its implementation remains a challenge in resource-limited settings. In this study, we assessed the contextual fit and feasibility of a multi-communication online training (MOT) for its effective implementation. # Methods A mixed-methods study was conducted among public health workers in 16 West African countries between Aug 10, 2023, and Oct 10, 2023. Data were collected through an online survey and in-depth interviews. Through a One Health forum and subregionally coordinated efforts, participants were sampled for the survey and interviews using virtual snowball and voluntary response techniques respectively. Contextual fit was measured with MOT preference and acceptability, while feasibility was measured with MOT willingness to use and workplace ICT availability using a novel tool. Statistical weighting was applied, and interviews were thematically analysed. Quantitative data were analysed using SAS version 9.4 with inverse probability weights and post-stratification weights at the country level. Descriptive statistics were summarized as unweighted and weighted frequencies and weighted proportions. Rao-Scott Chi-square test and Fisher’s exact test were used to identify factors with prognostic potential that were subjected to bivariate and multivariate analyses with a binary logit regression model to assess associations. Qualitative data were managed using Microsoft Excel and MAXQDA 10. # Results A total of 231 survey responses were collected and seven interviews conducted. MOT was found to be of “somewhat” contextual fit with population estimates of (preference: 29.61%, CI= 23.96-35.27; acceptability: 95.99%, CI= 93.79-98.18), and “strong” feasibility (willingness to use: 95.56%, CI= 93.78-97.35; workplace ICT availability: 82.09%, CI= 77.50-86.68). Work area was found as a major predictor of MOT contextual fit and feasibility, where the probabilities of MOT preference, acceptability, willingness to use, and workplace ICT availability were 42% lower (CI= 0.58-0.59), 99% lower (CI= 0.01-0.14), 95% lower (CI= 0.01-0.40), and 2.57 (CI= 1.22-5.40) times higher respectively for public health workers in rural areas compared to those in urban areas. Triangulating the quantitative and qualitative data showed issues around training resources accessibility, training characteristics, and training environment as factors that contributed to the contextual fit and feasibility ratings. # Conclusions This study findings provided evidence for the contextual fit and feasibility of MOT with geographic disparities, including associated factors that could inform prioritization, adaptation, and scale up of e-learning interventions through the equity lens towards improving the public health workforce capacity for global health security.

Abstract Background Since the declaration of the 10th Ebola Virus Disease (EVD) outbreak in DRC on 1st Aug 2018, several neighboring countries have been developing and implementing preparedness efforts to prevent EVD cross-border transmission to enable timely detection, investigation, and response in the event of a confirmed EVD outbreak in the country. We describe Uganda’s experience in EVD preparedness. Results On 4 August 2018, the Uganda Ministry of Health (MoH) activated the Public Health Emergency Operations Centre (PHEOC) and the National Task Force (NTF) for public health emergencies to plan, guide, and coordinate EVD preparedness in the country. The NTF selected an Incident Management Team (IMT), constituting a National Rapid Response Team (NRRT) that supported activation of the District Task Forces (DTFs) and District Rapid Response Teams (DRRTs) that jointly assessed levels of preparedness in 30 designated high-risk districts representing category 1 (20 districts) and category 2 (10 districts). The MoH, with technical guidance from the World Health Organisation (WHO), led EVD preparedness activities and worked together with other ministries and partner organisations to enhance community-based surveillance systems, develop and disseminate risk communication messages, engage communities, reinforce EVD screening and infection prevention measures at Points of Entry (PoEs) and in high-risk health facilities, construct and equip EVD isolation and treatment units, and establish coordination and procurement mechanisms. Conclusion As of 31 May 2019, there was no confirmed case of EVD as Uganda has continued to make significant and verifiable progress in EVD preparedness. There is a need to sustain these efforts, not only in EVD preparedness but also across the entire spectrum of a multi-hazard framework. These efforts strengthen country capacity and compel the country to avail resources for preparedness and management of incidents at the source while effectively cutting costs of using a “fire-fighting” approach during public health emergencies.

Public health emergency (PHE) response in sub-Saharan Africa is constrained by inadequate skilled public health workforce and underfunding. Since 2005, the African Field Epidemiology Network (AFENET) has been supporting field epidemiology capacity development and innovative strategies are required to use this workforce. In 2018, AFENET launched a continental rapid response team: the AFENET Corps of Disease Detectives (ACoDD). ACoDD comprises field epidemiology graduates and residents and was established to support PHE response. Since 2018, AFENET has deployed the ACoDD to support response to several PHEs. The main challenges faced during ACoDD deployments were financing of operations, ACoDD safety and security, resistance to interventions and distrust of the responders by some communities. Our experience during these deployments showed that it was feasible to mobilise and deploy ACoDD within 48 hours. However, the sustainability of deployments will depend on establishing strong linkages with the employers of ACoDD members. PHEs are effectively controlled when there is a fast deployment and strong linkages between the stakeholders. There are ongoing efforts to strengthen PHE preparedness and response in sub-Saharan Africa. ACoDD members are a competent workforce that can effectively augment PHE response. ACoDD teams mentored front-line health workers and community health workers who are critical in PHE response. Public health emergence response in sub-Saharan Africa is constrained by inadequacies in a skilled workforce and underfunding. ACoDD can be utilised to overcome the challenges of accessing a skilled public health workforce. To improve health security in sub-Saharan Africa, more financing of PHE response is needed.

Introduction: The Ebola virus disease (EVD) outbreak in Nigeria began when an infected diplomat from Liberia arrived in Lagos, the most populous city in Africa, with subsequent transmission to another large city. Methods: First-, second-, and third-generation contacts were traced, monitored, and classified. Symptomatic contacts were managed at Ebola treatment centers as suspected, probable, and confirmed EVD cases using standard operating procedures adapted from the World Health Organization EVD guidelines. Reverse transcription PCR tests confirmed EVD. Socio-demographic, clinical, hospitalization, and outcome data of the July–September 2014 Nigeria EVD cohort were analyzed. Results: The median age of the 20 EVD cases was 33 years (interquartile range 26–62 years). More females (55%), health workers (65%), and persons

INTRODUCTION: in July 2014, Nigeria experienced an outbreak of Ebola virus disease following the introduction of the disease by an ill Liberian Traveler. The Government of Nigeria with the support of Technical and Development Partners responded quickly and effectively to contain the outbreak. The epidemiological profile of the outbreak that majorly affected two States in the country in terms of person, place and time characteristics of the cases identified is hereby described. METHODS: using field investigation technique, all confirmed and probable cases were identified, line-listed and analysed using Microsoft Excel 2007 by persons, time and place. RESULT: a total of 20 confirmed and probable cases; 16 in Lagos (including the index case from Liberia) and 4 in Port Harcourt were identified. The mean age was 39.5 12.4 years with over 40% within the age group 30-39 years. The most frequent exposure type was direct physical contact in 70% of all cases and 73% among health care workers. The total case-fatality was 40%; higher among healthcare workers (46%) compared with non-healthcare workers (22%). The epidemic curve initially shows a typical common source outbreak, followed by a propagated pattern. CONCLUSIONS: investigation revealed the size and spread of the outbreak and provided information on the characteristics of persons, time and place. Enhanced surveillance measures, including contact tracing and follow- up proved very useful in early case detection and containment of the outbreak.

health workforce that can operate multi-disease surveillance and response systems.

The concept of animal and human health experts working together toward a healthier world has been endorsed, but challenges remain in identifying concrete actions to move this one health concept from vision to action. In 2008, as a result of avian influenza outbreaks in West Africa, international donor support led to a unique opportunity to invest in Field Epidemiology and Laboratory Training Programs (FELTPs) in the region that engaged the animal and human health sectors to strengthen the capacity for prevention and control of zoonotic diseases.The FELTPs mixed 25% to 35% classroom and 65% to 75% field-based training and service for cohorts of physicians, veterinarians, and laboratory scientists. They typically consisted of a 2-year course leading to a master's degree in field epidemiology and public health laboratory management for midlevel public health leaders and competency-based short courses for frontline public health surveillance workers. Trainees and gradu-ates work in multidisciplinary teams to conduct surveillance, outbreak investigations, and epidemiological studies for disease control locally and across borders. Critical outcomes of these programs include development of a cadre of public health leaders with core skills in integrated disease surveillance, outbreak investigation, vaccination campaigns, laboratory diagnostic testing, and epidemiological studies that address priority public health problems. A key challenge exists in identifying ways to successfully scale up and transform this inno-vative donor-driven program into a sustainable multisectoral one health workforce capacity development model. [ABSTRACT FROM AUTHOR]