Research Articles

Lessons learnt from decentralization of COVID-19 response in a southwest state of Nigeria



Introduction: This report shows the outcomes and lessons learnt from a 3-month intervention focused on decentralization of COVID-19 coordination, testing and contact tracing activities in three hotspot local government areas (LGAs) of a state in the southwest of Nigeria.


Methods: A description of COVID-19 outbreak response from the occurrence of the index case was documented. A health facility and community-based intervention implemented in three hotspots LGA as part of response to COVID-19 pandemic from 24th May to 22nd August, 2021 was described. The interventions implemented focused on integrating COVID-19 testing into routine healthcare services in 103 health facilities, engagement of community-based volunteers to conduct contact tracing, and improving coordination of the response through the conduct of incident management meetings at state and LGA levels.  The COVID-19 dataset from 22nd February to 22nd August, was obtained from the State Ministry of Health and analyzed. Data were summarized using charts and maps.


Results: A higher number of cases (3879) were tested between 24th May to 22nd August, 2021 (during intervention) compared to 1667 cases tested between 23 February to 23 May, 2021 (before intervention) across the three LGAs. Generally, there was a decline in the cumulative number of contacts traced and line-listed during the intervention (778) compared to the period before the intervention (1170) in two of the three LGAs. The number of weekly incident management meetings held improved by 25% at State level, while 83% of weekly LGA meetings were held at the three hot spot LGAs during the intervention compared to the period before the intervention, where no meeting was held at LGA level.


Conclusions: The decentralization of the COVID-19 outbreak response from a central approach to the LGA level improved only testing numbers and the number of incident management meetings conducted across the three hot spot LGAs. The number of contacts line-listed, positivity rate and reported cases reduced following the interventions. The need to supplement contact tracing activities using information technology for self-report as done in other climes, as well as engaging community, religious leaders and key community groups as integral members of the contact tracing team was emphasized.   


COVID-19OutbreakDecentralizationIntegrationHotspot LGA
  • Year: 2022
  • Volume: 4
  • DOI: 10.31646/gbio.158
  • Submitted on 15 Apr 2022
  • Published on 30 Sep 2022
  • Peer Reviewed