A scoping review of the roles of stakeholders and coordination mechanisms for enhanced multi-sectoral and multi-level interventions in COVID-19 response in Nigeria.

Abstract

Background: Collaboration among multiple stakeholders from different sectors requires a coherent coordination mechanism in implementing responses to public health emergencies such as coronavirus disease 2019 (COVID-19) to improve the effectiveness and efficiency of countermeasures against the pandemic. The paper describes multi-stakeholder roles and the coordination mechanisms that were used at different levels of government in the COVID-19 response in Nigeria.

Methods: A scoping review of documents on COVID-19 was undertaken between March 2021 and October 2022. Databases including Google Scholar, PubMed, Medline and Google were searched using "COVID-19", "Nigeria", "response" and "government" as the keywords. We included articles published from 30 January 2020 to 1 October 2022. The literature was extracted into Excel spreadsheets and analysed using the adapted WHO framework for multi-stakeholder preparedness coordination.

Results: A total of 173 documents were reviewed. The review revealed that various stakeholders (state and non-state actors) at national and sub-national levels played complementary roles in the implementation of different countermeasures to COVID-19 in Nigeria. The multi-sectoral response to COVID-19 in Nigeria was coordinated through the Presidential and State Task Force Teams. However, there were very weak linkages between and across different task forces. In addition, the expert and advisory committees at national and sub-national levels apparently functioned independently without lines of communication amongst them to encourage information sharing and learning. More so, the processes of coordination of different actors and their activities were fragmented and constrained by poor communication of policies among stakeholders, poor planning and contextualization of response strategies, lack of data for evidence-informed planning and lack of accountability.

Conclusions: The coordination of multi-stakeholders and multi-sectoral response to COVID-19 at national and sub-national levels in Nigeria was weak. A systematic coordination framework involving multiple stakeholders working at varying capacities is needed for effective and efficient response during pandemics such as COVID-19, to reduce duplication of efforts, inequitable resource allocation and wastage of resources and time. It is recommended that a future systematic coordination framework and guidelines involve multiple stakeholders, including the private and non-health public sectors, working at varying capacities and levels, to ensure an effective and efficient response during pandemics.