Impact of good governance, economic growth and universal health coverage on COVID-19 infection and case fatality rates in Africa

Abstract

Background The coronavirus disease 2019 (COVID-19) pandemic has disrupted lives across all countries and communities. It significantly reduced the global economic output and dealt health systems across the world a serious blow. There is growing evidence showing the progression of the COVID-19 pandemic and the impact it has on health systems, which should help to draw lessons for further consolidating and realizing universal health coverage (UHC) in all countries, complemented by more substantial government commitment and good governance, and continued full implementation of crucial policies and plans to avert COVID-19 and similar pandemic threats in the future. Therefore, the objective of the study was to assess the impact of good governance, economic growth and UHC on the COVID-19 infection rate and case fatality rate (CFR) among African countries. Methods We employed an analytical ecological study design to assess the association between COVID-19 CFR and infection rate as dependent variables, and governance, economic development and UHC as independent variables. We extracted data from publicly available databases (i.e., Worldometer, Worldwide Governance Indicators, Our World in Data and WHO Global Health Observatory Repository). We employed a multivariable linear regression model to examine the association between the dependent variables and the set of explanatory variables. STATA version 14 software was used for data analysis. Results All 54 African countries were covered by this study. The median observed COVID-19 CFR and infection rate were 1.65% and 233.46%, respectively. Results of multiple regression analysis for predicting COVID-19 infection rate indicated that COVID-19 government response stringency index (β = 0.038; 95% CI 0.001, 0.076; P = 0.046), per capita gross domestic product (GDP) (β = 0.514; 95% CI 0.158, 0.87; P = 0.006) and infectious disease components of UHC (β = 0.025; 95% CI 0.005, 0.045; P = 0.016) were associated with COVID-19 infection rates, while noncommunicable disease components of UHC (β = −0.064; 95% CI −0.114; −0.015; P = 0.012), prevalence of obesity among adults (β = 0.112; 95% CI 0.044; 0.18; P = 0.002) and per capita GDP (β = −0.918; 95% CI −1.583; −0.254; P = 0.008) were associated with COVID-19 CFR. Conclusions The findings indicate that good governance practices, favourable economic indicators and UHC have a bearing on COVID-19 infection rate and CFR. Effective health system response through a primary healthcare approach and progressively taking measures to grow their economy and increase funding to the health sector to mitigate the risk of similar future pandemics would require African countries to move towards UHC, improve governance practices and ensure economic growth in order to reduce the impact of pandemics on populations.

Universal health coverage mitigated COVID-19 health-related consequences in Asia Oceania

“…This proves that the UHC score fulfills the objective of UHC, based on the coverage in the field of infectious diseases. Furthermore, the result of this study is in line with other studies [ 35 , 36 , 44 ], such that the higher the UHC score, the better the country can deal with the COVID-19 situation than countries with lower UHC scores.…”

“…The second method of analysis is a regression analysis. Recently, researchers have been focusing on the use of the UHC score as an independent variable and defining whether the UHC score has any influence on the infectious and death cases not [ 35 , 36 ]. Furthermore, some studies, including Coccia's [ 67 ], have analyzed the differences in the COVID-19 situation between countries with longer and shorter l lockdown periods.…”

“…WHO also created an index for assessing the fundamentals of health service delivery for each country called the universal health coverage (UHC) score. The was created to support in its provision of equal health access for all people [ 33 ] and as indicator 3.8.1 “Coverage of essential health services” for the Sustainable Development Goals (SDGs) [ 34 ], Several studies have sought to prove that a country with high-value scores will have a superior performance in dealing with the COVID-19 situation [ 35 , 36 ].…”

Trust and COVID precautionary measures during the early days of the COVID-19 pandemic: Evidence from two African countries

“…There were no significant associations between interpersonal trust and social distancing in Kenya. The different findings are consistent with the idea that communication from acquaintances become more important for protecting health as government action becomes less clear ( Alfano, 2022 ; Gebremichael et al, 2022 ), although additional research is necessary to pinpoint precisely why the two countries differ. Policymakers in Burkina Faso should consider spreading health messages through churches and personal networks because our research reveals those networks are associated with the adoption of healthy behaviors in that country.…”

“…This may be related to the less consistent response of the national government to the pandemic in that country ( Mishra, 2020 ). Previous research in Africa has shown that more stringent government action significantly reduced national COVID-19 infection rates ( Gebremichael et al, 2022 ).…”