The impact of COVID-19 on health system resilience to the cerebrospinal meningitis outbreak in the Upper West Region of Ghana: a qualitative study.

Background: The coronavirus disease 2019 (COVID-19) pandemic revealed significant weaknesses in global and national health systems. This study aims to assess the impact of the COVID-19 pandemic on health system resilience in responding to the cerebrospinal meningitis (CSM) outbreak in Ghana.

Methods: A qualitative study design and purposive sampling were used to select clinical, public health staff and community health volunteers. From October 2023 to January 2024, data were collected across five selected districts with the highest burden of meningitis cases in the Upper West Region facilitated by a semi-structured interview guide. To analyse the data, we adopted a thematic analysis approach guided by the new health systems resilience framework.

Results: The study revealed strengths and vulnerabilities across all six key domains of the resilience framework. These findings suggested that the health system was ill-prepared for the concurrent outbreaks, resulting in a suboptimal response. Key among the findings were the diverted attention towards COVID-19, inequitable distribution of resources and a delayed response to the meningitis outbreak.

Conclusions: This study offers a comprehensive understanding of the challenges and opportunities faced by the health system during the concurrent health crises. There is a need to integrate emergency preparedness and response plans during concurrent outbreaks and to set up a dedicated public health emergency fund at the national and subnational levels.