Challenges of healthcare delivery in the context of COVID-19 pandemic in Sub-Saharan Africa

Abstract

Introduction: Public health security is concerned with infection prevention and control worldwide. These measures are the concern of all and sundry to ensure prevention of any outbreaks of diseases that has epidemic potential. Africa may be uniquely positioned to have the most severe and under-detected outcomes related to COVID-19 infection. This article seeks to highlight such challenges of healthcare delivery systems in the context of the COVID-19 pandemic in sub-Saharan Africa. The communique also suggests possible strategies for improvement in such settings. Method: We identified relevant articles to date using a manual library search, journal publications on the subject, and critically reviewed them. Results: We identified and exhaustively discussed the main limitations to public health security in sub-Saharan Africa as follows i) Continuing deterioration of the public health infrastructure for disease control, ii) The changing outlooks of contagious diseases, iii) Private sector reforms like the managed care, iv) Relatively weak health care systems, and v) Poor organizational structures. Conclusion: Most Africans are eager to see the desired transformation in our public health systems. Unfortunately, the political will to invest in public health infrastructure is lacking. Also, the system is characterized by human resources shortage and diverted resources, which significantly impacted the provision for emerging COVID-19 pandemic –related care. Interestingly the monumental breakthroughs in research development for bio-therapeutics and vaccines in African countries appear a mirage even with extensive past study experience with such products from China and the Western world. Finally, notwithstanding these challenges in our public health systems as elaborated, the facts are that enormous capacities exist that can be harnessed in African countries for the COVID-19 preparedness and response.

Experiences of nurses on COVID-19 preventive protocols implementation in Tamale Metropolis, Ghana: A qualitative exploration

“…The inadequate PPEs and increased work demand has been reported in other countries [ 27 , 28 ]. COVID-19 brought unforetold challenges to healthcare delivery with increasing admissions and a corresponding need to utilize more consumables [ 29 ]. Logistic inadequacy became pronounced in the peak of the pandemic.…”

Social determinants of health in non-communicable diseases prevention policies in South Africa

“…With secondary prevention focusing on early detection of hearing loss, procedures adopted to detect and halt the development of hearing loss before it presents clinically and progresses to levels that lead to adverse outcomes for the individual affected also require contextual awareness and contextual responsiveness (AFMC 2013; WHO 2020). The measures that allow for earlier diagnosis and treatment of hearing loss require political will and therefore mandating by the government -a requirement that requires buy-in by the end-user (the population receiving the service) (Alegbeleye & Mohammed 2020;). If the preventive audiology service delivery does not take careful cognisance of patients' language and culture, challenges with advocacy might arise.…”

Assessment of hospitalisation costs and their determinants among Covid-19 patients in South Central Ethiopia

“…Additionally, a report from an Iranian hospital revealed that the hospital’s revenue declined by 9%, its costs increased by 70% and the hospital’s balance was reported to be −$607,143 [ 20 ]. Furthermore, African economies were reduced by about 1.4% in gross domestic product (GDP) and faced a contraction of up to 7.8% due to the pandemic, which reduced the capacity of governments to extend the public services necessary to respond to the crisis [ 9 , 21 ]. Furthermore, poor healthcare systems, lack of skilled healthcare professionals, low awareness of disease control and prevention, scarce intensive care units (ICUs) and mechanical ventilators and a high prevalence of underlying diseases were challenges in controlling and preventing the pandemic in low- and middle-income countries, including Ethiopia [ 21 – 23 ].…”