Guatemala COVID-19 Response

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The Project will be comprised of two components to support the government’s strategic plan to prevent, control and respond to the spread of COVID-19 and strengthen health system preparedness to respond to emergencies . In addition, climate change adaptation and mitigation measures will be incorporated throughout the sub-components, as applicable. The specific activities financed by the Project fit into the overall government strategy to: (i) rapidly address the COVID-19 emergency by identifying, isolating and providing care for patients with COVID-19 to minimize disease spread, morbidity and mortality; (ii) implement effective communication campaigns for mass awareness and education of the population to prevent the spread of COVID-19; and (iii) strengthen the capacity of the public health system to provide intensive care. Component 1: Emergency Response to COVID-19 [US$ 19.5 million]. This component will include 3 subcomponents and will finance the rollout of the national communication strategy, the distribution of sanitary kits and training for community health care providers in basic COVID-19 protocols through the communications and outreach campaign to the population in high-risk with little or no access to healthcare services, medical and non-medical equipment and supplies, development of triage and isolation areas through remodeling work within existing health facilities, ambulances for a safe transport of COVID-19 patients, transportation services of COVID-19 patients from and to healthcare facilities, and consultant and non-consultant services.Subcomponent 1.1: Prevention and Communication Activities [US$ 2.5 million]: The Project will support the actions of the national communication, coordination and social participation plan to control the spread of COVID-19. This subcomponent contributes to financing the national communication plan, which will be tailored and culturally adapted with the aim of raising awareness within the community of community members’ fundamental role in slowing down the spread of the disease and thus avoiding the rapid increase in the demand for critical health services. The campaign will incorporate messages and information on support resources for stakeholders that are facing other risks such as domestic violence and mental and emotional stress induced from the pandemic and the shelter-in-place policies. This subcomponent will also finance sanitary kits including cleaning alcohol, chlorine, hand washing soap, powdered soap and soap bars to wash clothes; Sanitary napkins, gloves etc. that will be distributed to vulnerable populations (e.g. with little or no access to water and sanitation) during events for the communications campaign. Finally, consulting services will ensure the inter-institutional coordination of communication across different levels of care. There will also be specific communication activities for health workers that include the preparation and delivery of specific guidelines for health care workers on self-care and mental health practices as well as protocols for prevention, detection and management of cases for community health workers, mid-wives and other traditional healers that are often the Indigenous populations’ first resources for health advice and support. Funding includes consulting and non-consulting services for four main activities: (i) support in developing materials and messages for the general public to increase the awareness of the risks and impacts of the pandemic and the population’s understanding about what to do when feeling sick, where to seek care and how to follow-up, taking into account Guatemala’s cultural and linguistic diversity; (ii) support to the strategy of conscious social participation in controlling the epidemic, including the distribution of preventative sanitary kits to communities at high risk that lack access to health care services; (iii) preparation and delivery of guidelines for health workers on self-care and mental health practices, including community health care providers and midwives; and (iv) production and dissemination of materials to support homes in compulsory self-isolation.The target population includes the general population with the confrontation in those groups of highest risk. Furthermore, this strategy is adapted to ensure a sustained effort to control transmission and to ensure that prevention and control measures are accepted and controlled by the population in the medium and long term as well. In addition to COVID-19, the health messages and materials disseminated will cover important advice to keep the population healthy during times of health system stress and during self-isolation. Since older age groups, those with pre-existing conditions and co-morbidities and the poor are particularly at risk from COVID-19, they will be specifically targeted for this advice and more likely to be self-isolating. These are also key climate-vulnerable groups, hence providing this wider health advice as well as advice on climate related-risks such as extreme heat will enhance population resilience.Subcomponent 1.2: Case Detection, Confirmation, Contact Tracing, Recording, Reporting [US$ 9.0 million]. The Project will support the national epidemiological surveillance system and strengthen the diagnostic capacity for emerging diseases by strengthening the laboratory network, early identification, monitoring, notification and control of outbreaks. Support will be provided to form rapid response teams and develop mechanisms of immediate notification after case detections. Strengthening disease surveillance systems for COVID-19 will also enhance the wider ability of the system to adapt and respond to climate-related communicable disease threats. Where possible, solar refrigeration for vaccine/drug cold chain storage and solar-powered mobile laboratories will be used to reduce net GHG emissions. The subcomponent will finance laboratory equipment, supplies and reagents for the diagnosis of COVID-19.Subcomponent 1.3: Support of Patient Care and Improved Safety [US$ 8.0 million]: The Project will strengthen critical aspects of health service delivery to face the increased demand for services posed by emergencies. This subcomponent will increase the availability of triage rooms, isolation areas, and outpatient screening areas at existing facilities through minor remodeling work, and it will address the health system's immediate needs for medical supplies and medical devices so that health workers can safely treat severe cases affected by the COVID-19 emergency. In addition, it will also include measures and activities to improve the safety of health workers, for instance through the provision of guidelines and training for health worker safety including the use and standards of personal protective equipment (PPE), patient referral and transport and measures of environmental health and sanitation.This subcomponent will promote the use of climate-smart technologies; procurement and mobilization of energy efficient equipment will be considered. Improving selected ICUs will also consider a longer-term approach to strengthen hospitals' ability to provide intensive care treatments, which is essential to deal with the COVID-19 emergency and other emergencies that may arise in the future. The training of health facility staff and front-line workers will also cover wider risk mitigation measures making them better prepared for other health threats including climate related risks. The provision of protective equipment and hygiene materials will protect staff against other climate-related disease, in particular unforeseen emerging zoonoses. The strengthened clinical care capacity will enhance adaptive capacity, making the health system better able to respond to other health threats including climate-related diseases and events. The use of solar refrigeration for drug storage when available and utilizing solar-powered mobile health facilities where required will reduce ne