Abstract:The COVID‐19 pandemic has proven the need for countries worldwide to implement strategies that promote health systems strengthening and ensure epidemic preparedness. Many African countries are burdened by fragile healthcare systems, hence, this paper emphasises the need for African policymakers to improve healthcare quality in their countries. Through a brief review of various online literatures concerning health systems strengthening in Africa, this paper focuses on the nature of healthcare in Nigeria amidst … Show more
“…63,98 Low health workforce and limited health facilities are also contributing indirectly to weak COVID-19 surveillance in Africa. [98][99][100] It is therefore important that the African government should continue to combat this defiance in order to improve the overall healthcare systems on the continent.…”
Background: Surveillance forms the basis for response to disease outbreaks, including COVID-19. Herein, we identified the COVID-19 surveillance systems and the associated challenges in 13 African countries. Methods: We conducted a comprehensive narrative review of peer-reviewed literature published between January 2020 and April 2021 in PubMed, Medline, PubMed Central, and Google Scholar using predetermined search terms. Relevant studies from the search and other data sources on COVID-19 surveillance strategies and associated challenges in 13 African countries (Mauritius, Algeria, Nigeria, Angola, Cote d’Ivoire, the Democratic Republic of the Congo, Ghana, Ethiopia, South Africa, Kenya, Zambia, Tanzania, and Uganda) were identified and reviewed. Results: Our findings revealed that the selected African countries have ramped up COVID-19 surveillance ranging from immediate case notification, virological surveillance, hospital-based surveillance to mortality surveillance among others. Despite this, there exist variations in the level of implementation of the surveillance systems across countries. Integrated Disease Surveillance and Response (IDSR) strategy is also being leveraged in some African countries, but the implementation across countries remains uneven. Our study also revealed various challenges facing surveillance which included shortage of skilled human resources resulting in poor data management, weak health systems, complexities of ethical considerations, diagnostic insufficiency, the burden of co-epidemic surveillance, and geographical barriers, among others. Conclusion: With the variations in the level of implementation of COVID-19 surveillance strategies seen across countries, it is pertinent to ensure proper coordination of the surveillance activities in the African countries and address all the challenges facing COVID-19 surveillance using tailored strategies.
“…63,98 Low health workforce and limited health facilities are also contributing indirectly to weak COVID-19 surveillance in Africa. [98][99][100] It is therefore important that the African government should continue to combat this defiance in order to improve the overall healthcare systems on the continent.…”
Background: Surveillance forms the basis for response to disease outbreaks, including COVID-19. Herein, we identified the COVID-19 surveillance systems and the associated challenges in 13 African countries. Methods: We conducted a comprehensive narrative review of peer-reviewed literature published between January 2020 and April 2021 in PubMed, Medline, PubMed Central, and Google Scholar using predetermined search terms. Relevant studies from the search and other data sources on COVID-19 surveillance strategies and associated challenges in 13 African countries (Mauritius, Algeria, Nigeria, Angola, Cote d’Ivoire, the Democratic Republic of the Congo, Ghana, Ethiopia, South Africa, Kenya, Zambia, Tanzania, and Uganda) were identified and reviewed. Results: Our findings revealed that the selected African countries have ramped up COVID-19 surveillance ranging from immediate case notification, virological surveillance, hospital-based surveillance to mortality surveillance among others. Despite this, there exist variations in the level of implementation of the surveillance systems across countries. Integrated Disease Surveillance and Response (IDSR) strategy is also being leveraged in some African countries, but the implementation across countries remains uneven. Our study also revealed various challenges facing surveillance which included shortage of skilled human resources resulting in poor data management, weak health systems, complexities of ethical considerations, diagnostic insufficiency, the burden of co-epidemic surveillance, and geographical barriers, among others. Conclusion: With the variations in the level of implementation of COVID-19 surveillance strategies seen across countries, it is pertinent to ensure proper coordination of the surveillance activities in the African countries and address all the challenges facing COVID-19 surveillance using tailored strategies.
“…However, these figures might still not be the real figures due to the weak national healthcare infrastructures in detecting all cases and also due to many people abandoning reporting in fear of being stigmatized by their infection. In fact, COVID-19 has amplified problems of the fragile health care systems in Africa—a continent that has been found unprepared to deal with this pandemic (Elebesunu et al, 2021 ). Fig.…”
Section: Results: Assessing and Outlining The Distinctive Covid-19 Ca...mentioning
confidence: 99%
“…At the same time, evidence shows that malnutrition and lack of food access have aggravated the health crisis (Mertens & Peñalvo, 2021 ). Therefore, more efforts and rigid preliminary healthcare plans are important to save citizens’ life, especially the vulnerable groups like children, pregnant women, old people and patients with chronic diseases (Dasgupta & Robinson, 2021 ; Elebesunu et al, 2021 ). COVID-19 has also shown that these efforts need to incorporate sustainable and more comprehensive approaches such as One Health strategies addressing multi-sectoral and multidisciplinary health issues, i.e., linking human health to environmental and animal healths (Ayobami et al, 2021 ).…”
Section: Discussionmentioning
confidence: 99%
“…It is likely that the real number is far above these official statistics. Meanwhile, donor organizations have been sounding the alarm about the impact of the COVID-19 crisis while few academic studies have highlighted the compounded health and economic impacts in Africa (e.g., Obayelu et al, 2021 ; Elebesunu et al 2021 ). Although the number of COVID-19 cases in the Sahel region has been lower than in other regions, it imposed hard pressure on health systems (Molyneux et al, 2020 ; Dasgupta & Robinson, 2021 ), with impacts extending to other areas such as the food sector.…”
The African Sahel countries are inherently fragile, environmentally insecure and economically weak. This paper underscores the compounded impacts brought about by the COVID-19 pandemic on resource supply security and, hence, the long-term development of the region. It outlines the Sahel-specific COVID-19 scenario by firstly highlighting the underlying vulnerabilities and later linking the health sector outcomes to increased political instability and environmental insecurity, particularly the deterioration of food security. In this sense, this paper shows from a region-wide perspective how COVID-19 in the Sahel is associated with enlarged sociopolitical developmental perils. Lower remittance sent by expatriates, violent conflicts, increased cross-border terrorism and migration, discriminant mobility restrictions of people and goods, weak national healthcare infrastructures, bottlenecks in international aid, pressures on the education system and recent climate extremes are some revealing examples of aggravators of the impacts on the supply of vital resources, such as food. This paper also shows the importance of considering the close interlinks between health, food and political stability in the Sahel. There is a paramount need for more comprehensive approaches linking human health to other sectors, and for re-considering local sustainable agriculture. To avoid prolonged or recurrent humanitarian crises, the Sahel countries need to strengthen response capacities through public sector-led responses. Examples of these responses include reinforced national disaster programs for the vulnerable, support to sustainable agriculture and food markets, improved performance and communication of public sector relief, state-based cooperation, building of regional alliances and peacemaking efforts.
“…PPPs can play an essential role in LMICs health system strengthening 9 , particularly during outbreaks and epidemics, where a coordinated, rapidly scalable approach is required. Strengthening and coordination of public and private health systems is needed to ensure progress towards UHC and global health security 18 . The challenge is to combine private and public efforts in healthcare delivery in a mutually supportive and collaborative manner.…”
INTRODUCTION: SARS-CoV-2 testing is one of the options to combat COVID-19 in Kenya. In the first COVID-19 year there was limited tapping of the private sector's potential to scale up testing in Kenya. In April 2020, we initiated a unique public-private partnership (PPP) project in Kisumu County connecting the private sector to centralized testing supported by the ministry of health (MoH), COVID-Dx, to accelerate the local response to COVID-19. Within COVID-Dx, we aimed to demonstrate this PPP's performance as a replicable model for effective public-private collaboration in responding to the COVID-19 pandemic in similar settings.
METHODS: KEMRI, Department of Health Kisumu County, PharmAccess Foundation, and local faith-based and private healthcare facilities collaborated in COVID-Dx. COVID-Dx was implemented from June 01, 2020, to March 31, 2021, in Kisumu County, Kenya. Trained laboratory technologists in participating healthcare facilities collected nasopharyngeal and oropharyngeal samples from patients meeting the MoH COVID-19 case definition. Samples were tested at the central laboratory in KEMRI via SARS-CoV-2 RT-PCR. Healthcare workers in participating facilities collected data using the digitized MoH COVID-19 Case Identification Form. We shared aggregated results from these data via (semi-) live dashboard to all relevant stakeholders. We did descriptive statistical analyses using Stata 16 to inform project processes.
RESULTS: Nine facilities participated in the project. A total of 4,324 PCR tests for SARS-CoV-2 were done, with 425 positives. We noted differences in positivity rates between the facilities. Healthcare workers were the largest group tested in the project, 1009, representing 43% of the Kisumu healthcare workforce.
CONCLUSION: COVID-Dx can serve as a model for PPPs scale-up testing, especially LMICs, and digitizing the MoH case report form improved reporting efficiency, demonstrating that digital is the way forward. The COVID-Dx PPP has led to another collaboration with Kisumu County aimed towards extending the COVID-Dx model to other counties.
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