Designing and implementing equity-based pandemic preparedness and response learning modules: lessons from a multi-country short-course

Figures & data

Table 1. Core approaches for the development and delivery of the pandemic preparedness and response course.

Approach	Description
Meet Basic Needs	It is impossible to adhere to prevention strategies if you have no food, money, or housing.
Prioritize the Vulnerable	Target resources at vulnerable communities.Examples: assure food security & housing, provide transportation & cash
Engage Those Most Affected	Community members who are most affected and have a central role to play in responding to crises. Example: Contact tracing helps to stop the spread of epidemics and is best done by community members. When this work is adequately compensated, it fulfills a double purpose of reaching the most vulnerable and adding jobs in a difficult financial environment.
Healthcare as a Right	Support for the public provision of healthcare prior to, during, and after an epidemic is the most durable form of pandemic preparedness.
Accountable Leadership	Leadership should be accountable for the outcomes of the most vulnerable and listen to communities to understand what is needed.Leaders need to build trust over time with their communities.

Table 2. Course content overview.

Session	Learning objectives
Session 1: The 21st Century Pandemic: Covid-19 And Health Equity7 July 2020	This session provided an overview of the equity-based lens and how it can be used to guide COVID-19 response. Review the origin, evolution, and early warning indicators of COVID-19 and global inequality. Understand the legacy of inequality within and among countries past pandemics Discuss leadership dimensions for effective preparedness and response to Covid-19 and other pandemics Understand the relationship of clinical care, social support and public health in pandemic preparation and response Understand basic principles for developing and sustaining an equitable and effective pandemic response.
Session 2: Contact Tracing and Equity: the Role Of Wrap-Around Support in MassachusettsJuly 9, 2020	This session described the process of establishing a contract tracing program in Massachusetts, USA. With the onset of COVID-19, the Massachusetts Department of Public Health partnered with PIH to develop a robust contact tracing program that has a strong emphasis on CRC. The MA CTC program is a model for other programs in the U.S.A. Review the pillars of effective contact tracing and understand the importance of wrap-around supports Understand the role of public health leaders in planning pandemic response founded in equity Discuss preliminary lessons, successes, and challenges of Covid-19 contact tracing Understand the types of social support needed for safe and effective isolation and quarantine Describe clinical care referral pathways for contact tracing and their role in promoting equity
Session 3: Covid-19 & Health Equity: Perspectives of Frontline Implementers in the US and the Navajo NationJuly 14, 2020	The Navajo Nation was among the communities hardest hit by COVID-19. In the Navajo Nation, PIH has partnered with tribal leadership and other partners to prioritize resources and address pressing community needs, such as elder support and supportive isolation for multigenerational housing. Review the current state of equity and its implications on public health response to Covid-19 in the US. Discuss a potential theory of change to strengthen health equity integration in the US and globally Understand the impacts of history and COVID-19 on the Navajo Nation, and the ways in which the Nation has organized itself to protect its people and combat the pandemic Describe and discuss the role of public health implementers, policy makers, and civil society Understand the roles and responsibilities of current and future leaders in eliminating social disparities in the context of pandemic preparedness and response
Session 4: Equity & Innovation: The Response to Covid-19 in RwandaJuly 16, 2020	The session was led by response leaders in Rwanda and described Rwanda’s successful response to Ebola and now COVID-19. Illustrate the critical importance of interdisciplinary collaboration and coordination to address problems in global health delivery Discuss how Rwanda used community education to contain COVID-19.. Critically evaluate the challenges facing low-resource settings during the pandemic and after it through an equity lens Discuss the significance of data-driven decision-making and response. Investigate the strategic investments needed to continue care Recognize the importance of social mobilization to support the marginalized. Evaluate the Government of Rwanda’s response to emerging infectious diseases

Figure 1. Evaluation and sampling frame.

Figure 2. Participant country.

Table 3. Participant session attendance.

Session	Live Viewers (zoom report tracking viewers)	Viewed Recording (self-reported in post session survey)	Successfully Completed Post Session Survey	Course completion rate
Session 1: The 21stCentury Pandemic:Covid-19 And HealthEquity	1,292	324	1,449	90%
Session 2: Contact Tracing and Equity: MA	1,002	332	1,116	84%
Session 3: COVID-19, Inequity and Racism in the U.S and How the Navajo National is fighting COVID-19	862	371	1,102	89%
Session 4: Equity and Innovation: The Response to COVID-19 in Rwanda	818	366	1,062	90%

Table 4. Demographic characteristics of course participants (N = 1062).

Position	Number of participants	% of participants
Students
Undergraduate	112	10.5%
Masters	80	7.5%
Medical School	70	6.6%
Doctoral	15	1.4%
Secondary School	4	0.4%
Other students	250	23.5%
Medical Professional
Physician	98	9.2%
Nurse	30	2.8%
Paramedic professional	19	1.8%
Clinical Officer	6	0.6%
Physician’s Assistant	4	0.4%
Other medical professionals	64	6.0%
Implementers	183	17.2%
Public health leaders	113	10.6%
Policy makers	15	1.4%

Source: Self-reported on 4^th session