Working with community to detect and report suspected COVID-19 cases in Lao People’s Democratic Republic

Everyone has a role to play in the COVID-19 pandemic. It is important that individuals feel empowered to make decisions that protect themselves and their community.

The community is the front line for early identification of possible COVID-19 cases. As such, it is critical that there is a reporting system in place where community can report unusual incidents to the public health authorities. Once concerns about a possible case or cluster are identified, the community-based system needs to rapidly trigger the surveillance team to investigate, isolate, test and treat as needed, as well as monitor and quarantine contacts to reduce the chance of further transmission.

The Vientiane Capital Health Department, National Centre for Laboratory and Epidemiology (NCLE) and the World Health Organization (WHO), with the support of United States Agency for International Development (USAID), have been working to formalize and expand a system to help communities quickly and easily report concerns about possible COVID-19 cases. This system will also help ensure there is surge capacity to monitor close contacts of COVID-19 cases at the village level.

Following a provincial training for community leaders and health volunteers in Vientiane Capital, a field visit was conducted by NCLE and WHO staff to Sikhottabong and Xaythany District Health Offices.

The visit was to understand how the system of reporting health events by the community to health centres and then to district health offices was working. By speaking with the community leaders and village health volunteers, to understand the challenges they faced, the team was able to identify ways to improve the process for more efficient sharing of information on unusual events.

Visiting Sikhottabong District Health Office

The Sikhottabong District Health Office is located close to Wattay International airport and manages one hospital, one health centre and 60 villages. Dr Thonomsap Chanthalad, a district epidemiologist, is responsible for the reporting to Vientiane Capital Health Department of any unusual health events such as a cluster of villagers with flu-like symptoms, or an increase of funeral activities in the district.

Dr Thonomsap participated in the community engagement training on how to involve community health leaders and leaders in contact tracing and community surveillance. He noted the benefits of engaging the community, saying, “At first, the village level community leaders did not understand why they need to pay attention to events in their community and report on time, but after further guidance, they now understand the importance this has to the health of their community.”

At the Chansavang Health Centre, Mrs Lounmy, a health worker, shared with Dr Khonesavanh how the health centre is using mobile phone applications like Line and Whatsapp to get daily updates from village focal points, and she uses the same application to provide daily updates to Dr Thonomsap.

Next, the WHO and NCLE team joined Mrs Lounmy to meet Mrs Sisod Oudomsack at the village head office. The close collaboration with community leaders, such as by engaging unit leaders from schools, temples and factories, has made it easier for health workers to gather timely health information from those communities.

Mrs Oudomsack, a village health volunteer, shares how she meets with the community committee that is made up of focal points from the villages at least once a week. On other days, she calls the key community leaders like school directors and head monks to find out if there are any unusual events happening in the community. This information is then shared with the health centre, usually with the same mobile application.

Visiting Xaythany District Health Office

This was followed by a visit to a rural district health office at Xaythany, which manages 11 health centres and 104 villages. The NCLE and WHO team met Dr Vongsavanh Phomma who is responsible for compiling information from each health centre and reporting daily back to the Vientiane Capital Health Department.

At Xaythany District, Dr Phomma works with the community leaders like Mrs Viengkeo from the village head office. Mrs Viengkeo is responsible for COVID-19 reporting, which has been integrated into reports for notifiable infectious diseases. These reports are presented every Tuesday at the village head meeting, which is attended by the district governor.

Mrs Viengkeo shared how village health volunteers play an important role in community engagement in rural areas. The NCLE and WHO team met 5 village health volunteers gathered at the village head office to understand the practicalities of their work supporting health in their communities, including through contact tracing and reporting of unusual events.

Ms Chanthachone, a village health volunteer, is proud to be serving her community. She understands how her work contributes to keeping her family and community safe. She has also seen first-hand the importance of addressing discrimination and stigma around COVID through education of the community

Mrs Chanthachone shared how village health volunteers can make a difference, since they live in the community where they work, they know the families and the families know and trust them. Therefore, they often have insights into what is happening on the ground.

Dr Mark Jacobs, WHO Representative stated that “We all have a role to play in helping keep our communities safe from COVID-19. As part of this, it is important that everyone from the provincial, district and down to the village level, understands how they can help identify COVID and other outbreaks early. Early identification can lead to faster response, reducing the impact of the outbreak, which will be crucial for the next phase of COVID-19.”