Emergency preparedness of health facilities and health workers for viral hemorrhagic fevers in Ekiti State, Nigeria

Abstract

Introduction Viral hemorrhagic fever (VHFs) remains a serious public health concern in West Africa, with Nigeria reporting recurring outbreaks. Preparedness of health facilities is essential for effective surveillance, early detection, and rapid response. However, limited assessments exist that evaluate institutional and workforce readiness at sub-national levels. This study assessed the readiness of health facilities (HFs) and health workers (HWs) in Ekiti State, Nigeria, to respond to VHF outbreaks, including Lassa Fever. The objectives were to determine the proportion of health facilities with functional VHF preparedness protocols, assess training and knowledge levels of HCWs regarding VHF management, identify key institutional gaps, and make recommendations for improving outbreak response capacity. Methods A descriptive cross-sectional study was conducted in 59 randomly selected HFs in Ekiti State. Data was collected using a structured questionnaire adapted from the WHO hospital preparedness tool. HWs (n=136) were surveyed on their knowledge, training, and availability of emergency protocols. Statistical analysis was performed using SPSS version 26.0, and the level of significance, p-value, was set at < 0.05. Ethical approval was obtained from the Ekiti State Ministry of Health Ethics Committee. Results Most facilities had epidemic preparedness protocols (76.3%), epidemic management committee (93.2%), and budget for surveillance activity (72.9%). However, only 76.3% had specific VHF case management protocols. Among HWs, 78.0% had received training on VHF management, 96.6% on infection prevention and control (IPC), and 98.3% on disease surveillance. Good knowledge of VHF was found in 59.0% of HWs. A significant association was found between duration of employment (>10 years) and knowledge level p = 0.036). Conclusion While most HFs in Ekiti State demonstrated baseline preparedness for managing VHFs, critical gaps remain in training, surveillance protocols, and resource allocation. Improving preparedness through regular capacity building, investment in case management protocols, and sustained funding is crucial to strengthening outbreak readiness.