TY - JOUR
T1 - The COVID-19 pandemic and healthcare systems in Africa
T2 - A scoping review of preparedness, impact and response
AU - Tessema, Gizachew A.
AU - Kinfu, Yohannes
AU - Dachew, Berihun Assefa
AU - Tesema, Azeb Gebresilassie
AU - Assefa, Yibeltal
AU - Alene, Kefyalew Addis
AU - Aregay, Atsede Fantahun
AU - Ayalew, Mohammed Biset
AU - Bezabhe, Woldesellassie M.
AU - Bali, Ayele Geleto
AU - Dadi, Abel Fekadu
AU - Duko, Bereket
AU - Erku, Daniel
AU - Gebrekidan, Kahsu
AU - Gebremariam, Kidane Tadesse
AU - Gebremichael, Lemlem Gebremedhin
AU - Gebreyohannes, Eyob Alemayehu
AU - Gelaw, Yalemzewod Assefa
AU - Gesesew, Hailay Abrha
AU - Kibret, Getiye Dejenu
AU - Leshargie, Cheru Tesema
AU - Meazew, Maereg Wagnew
AU - Mekonnen, Alemayehu
AU - Mirkuzie, Alemnesh H.
AU - Mohammed, Hassen
AU - Tekle, Dejen Yemane
AU - Tesfay, Fisaha Haile
N1 - Funding Information:
Funding GAT was supported with funding from the Australia National Health and Medical Research Council (NHMRC) Investigator Grant #1195716.
Publisher Copyright:
© 2021 Author(s).
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/12/1
Y1 - 2021/12/1
N2 - Background: The COVID-19 pandemic has overwhelmed health systems in both developed and developing nations alike. Africa has one of the weakest health systems globally, but there is limited evidence on how the region is prepared for, impacted by and responded to the pandemic. Methods: We conducted a scoping review of PubMed, Scopus, CINAHL to search peer-reviewed articles and Google, Google Scholar and preprint sites for grey literature. The scoping review captured studies on either preparedness or impacts or responses associated with COVID-19 or covering one or more of the three topics and guided by Arksey and O'Malley's methodological framework. The extracted information was documented following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension checklist for scoping reviews. Finally, the resulting data were thematically analysed. Results: Twenty-two eligible studies, of which 6 reported on health system preparedness, 19 described the impacts of COVID-19 on access to general and essential health services and 7 focused on responses taken by the healthcare systems were included. The main setbacks in health system preparation included lack of available health services needed for the pandemic, inadequate resources and equipment, and limited testing ability and surge capacity for COVID-19. Reduced flow of patients and missing scheduled appointments were among the most common impacts of the COVID-19 pandemic. Health system responses identified in this review included the availability of telephone consultations, re-purposing of available services and establishment of isolation centres, and provisions of COVID-19 guidelines in some settings.Conclusions: The health systems in Africa were inadequately prepared for the pandemic, and its impact was substantial. Responses were slow and did not match the magnitude of the problem. Interventions that will improve and strengthen health system resilience and financing through local, national and global engagement should be prioritised.
AB - Background: The COVID-19 pandemic has overwhelmed health systems in both developed and developing nations alike. Africa has one of the weakest health systems globally, but there is limited evidence on how the region is prepared for, impacted by and responded to the pandemic. Methods: We conducted a scoping review of PubMed, Scopus, CINAHL to search peer-reviewed articles and Google, Google Scholar and preprint sites for grey literature. The scoping review captured studies on either preparedness or impacts or responses associated with COVID-19 or covering one or more of the three topics and guided by Arksey and O'Malley's methodological framework. The extracted information was documented following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension checklist for scoping reviews. Finally, the resulting data were thematically analysed. Results: Twenty-two eligible studies, of which 6 reported on health system preparedness, 19 described the impacts of COVID-19 on access to general and essential health services and 7 focused on responses taken by the healthcare systems were included. The main setbacks in health system preparation included lack of available health services needed for the pandemic, inadequate resources and equipment, and limited testing ability and surge capacity for COVID-19. Reduced flow of patients and missing scheduled appointments were among the most common impacts of the COVID-19 pandemic. Health system responses identified in this review included the availability of telephone consultations, re-purposing of available services and establishment of isolation centres, and provisions of COVID-19 guidelines in some settings.Conclusions: The health systems in Africa were inadequately prepared for the pandemic, and its impact was substantial. Responses were slow and did not match the magnitude of the problem. Interventions that will improve and strengthen health system resilience and financing through local, national and global engagement should be prioritised.
KW - COVID-19
KW - health policy
KW - health services research
KW - health systems
UR - http://www.scopus.com/inward/record.url?scp=85121244837&partnerID=8YFLogxK
U2 - 10.1136/bmjgh-2021-007179
DO - 10.1136/bmjgh-2021-007179
M3 - Review article
C2 - 34853031
AN - SCOPUS:85121244837
SN - 2059-7908
VL - 6
SP - 1
EP - 14
JO - BMJ Global Health
JF - BMJ Global Health
IS - 12
M1 - e007179
ER -
