With close to 1.4 million confirmed COVID-19 cases and over 32,000 recorded deaths in Africa as of mid-September the pandemic has exerted significant strain on already overstretched health systems across the region, further affecting the delivery of other essential health services - such as immunization and those for sexual and reproductive health. These critical services are vital to protecting the most vulnerable and marginalized populations yet are some of the most impacted by the pandemic.
Since the first case of COVID-19 was confirmed on the continent in February 2020, Africa’s response, led by the Africa Centres for Disease Control and Prevention (Africa CDC) has been commendable. Governments moved quickly to institute public health measures to curb its spread.
However, more is needed to ensure that Africa harnesses the urgency of the moment to shape more resilient and equitable systems equipped to withstand future threats and protect populations, especially the most vulnerable and marginalized.
Africa’s joint concerted response has brought together frontline health workers, policymakers, health system leaders and civil society from across the continent to share experiences, perspectives and best practices. Among the questions is how does Africa seize this opportunity to re-invent the health system and build better? Here are five possible quick wins:
Communities must own and co-create solutions
While all stakeholders must be involved in policy development and implementation, community engagement remains central to defining needs and deploying people-centered approaches to co-create solutions.
By engaging communities and frontline health workers as key stakeholders from the outset, Africa’s health systems will more likely deliver quality and sustainable primary health care services.
Strengthen quality and use of inclusive data to inform decisions
Health systems must improve the quality and use of inclusive data to drive policy decisions, investments and improvements in service delivery while minimizing inequities in service access across gender and other vulnerabilities.
The pandemic has highlighted the need for strong health information systems that collect and utilize quality, timely and reliable data, that is disaggregated by gender and other diversities, identifying gaps and bringing visibility to the plight of vulnerable populations, to inform responsive policies.
Invest more, invest smarter
African governments must invest more and invest smarter to build more equitable and resilient health systems. Furthermore, governments must remove financial barriers to accessing health services. The impact of the COVID-19 pandemic has demonstrated that every sector is dependent on the health system. This is an opportunity for the continent to prioritize public financing for health and invest in innovations that accelerate health equity.
Build strong primary health care systems and fix human resources for health
The pandemic has brought to the forefront the importance of primary health care and frontline providers in managing pandemic preparedness and response. Experiences from frontline health workers show that health workforce shortages, inadequate provision of personal protection equipment and overreliance on voluntary services of community health workers, have hampered addressing the indirect impacts of the pandemic on the delivery of essential health services.
Strengthen supply chains and harmonize regulatory systems
While we strive to develop and scale up health innovations, it is imperative that barriers to timely and equitable access to essential health commodities are removed.
Africa needs to ensure greater harmonization of regulatory systems across countries to fast track regulatory approvals and accelerate the availability of quality health products including vaccines, diagnostics, medicines, and digital solutions. Equitable access to health solutions should be built into forecasting, procurement, and supply chain systems and deploying innovative delivery models to reach the people in need.
As the pandemic evolves, we are reminded of the need for equitable policies that institutionalize access and availability of health for all. This is the moment for African leaders to rise to the occasion and tackle structural inequalities in health.
About the Authors:
Rachel Ndirangu is the Regional Policy and Advocacy Officer for PATH. She provides technical support to policy and advocacy initiatives in the Democratic Republic of the Congo (DRC), Kenya, South Africa and Uganda, as well as with regional bodies within the East Africa Community (EAC) and the Southern African Development Community (SADC) focusing on maternal, newborn, child health (MNCH), immunization, research and development, and other health policy areas led by PATH programmes.
Rosemarie Muganda-Onyando is the Regional Advocacy Director for Africa for PATH. She leads country teams working on reproductive, MNCH research, advocacy and public policy programmes in several African countries including the Democratic Republic of the Congo (DRC), Kenya, South Africa and Uganda, providing strategic leadership and technical guidance.