EVALUATING THE EFFECTIVENESS OF GOVERNANCE AND PUBLIC HEALTH STRATEGIES IN CONTROLLING LASSA FEVER OUTBREAKS IN SOUTHEAST NIGERIA: A RETROSPECTIVE ANALYSIS

Abstract

Lassa fever, an acute viral hemorrhagic disease endemic to West Africa, continues to challenge Nigeria’s public health system, with Southeast states contributing substantially to the national caseload. This retrospective study evaluated the effectiveness of governance and public health strategies in controlling Lassa fever outbreaks in Anambra, Ebonyi, and Imo States from 2018 to 2024. Drawing on NCDC surveillance data, state health records, key informant interviews, and focus group discussions with 1,200 stakeholders, the mixed-methods analysis revealed moderate successes in national coordination and rapid response protocols, alongside persistent weaknesses in funding allocation, diagnostic infrastructure, and community engagement. Case numbers fluctuated, with peaks in 2020 and 2023, and case fatality rates (CFR) in Southeast Nigeria often exceeded the national average of approximately 18%. Governance gaps, including fragmented state-federal coordination and low budget prioritization for infectious disease control, limited intervention impact, particularly in rural areas. Socio-cultural factors, such as delayed health-seeking behavior and unsafe burial practices, further undermined efforts. The study proposes a strengthened policy framework emphasizing decentralized funding, enhanced One Health approaches, and culturally tailored sensitization. These findings offer actionable insights for reducing outbreak frequency and mortality, contributing to Nigeria’s health security goals.