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The COVID-19 pandemic has dealt a severe blow to key health services in Africa, raising concerns that some of the main health challenges on the continent may worsen.
Preliminary analysis by the World Health Organization (WHO) of five key indicators of essential health services including outpatient consultation, hospital admission, skilled attendance at delivery, treatment of confirmed cases of malaria, and provision of the combined pentavalent vaccine in 14 countries finds a sharp decrease in these services between January and September 2020 compared to the previous two years. The gaps were widest in May, June and July, which corresponds to when many countries had established and enforced restrictions on movement and other social and public health measures to control the spread of COVID-19. During these three months, services in the five monitored areas fell on average more than 50% in the 14 countries compared to the same period in 2019.
“The COVID-19 pandemic has brought hidden and dangerous side effects to health in Africa. With healthcare resources heavily focused on COVID-19, as well as fear and restrictions in people’s daily lives, vulnerable populations face an increasing risk of being forgotten, ”said Dr. Matshidiso Moeti, WHO Regional Director for Africa.
“We must strengthen our health systems to better withstand future crises. A strong health system is the foundation for emergency preparedness and response. As countries ease restrictions on COVID-19, we must not leave the door open for the pandemic to resurface, ”said Dr. Moeti. “A new wave of COVID-19 infections could further disrupt life-saving health services, which are only now recovering from the initial shock.”
Even before the COVID-19 pandemic, maternal mortality in sub-Saharan Africa was unacceptably high, accounting for around two-thirds of global maternal deaths in 2017. Preliminary data indicates that COVID-19 is likely to exacerbate health problems of women and the new The analysis found that skilled attendance at birth in all 14 countries decreased. In Nigeria, 362,700 pregnant women did not receive prenatal care between March and August 2020. More than 97,000 women gave birth outside of health centers and more than 193,000 did not receive postnatal care in the two days after delivery. There were 310 maternal deaths in Nigerian health facilities in August 2020, almost double the number in August 2019.
Another 1.37 million children in the African region did not receive the Bacille Calmette-Guerin (BCG) vaccine that protects against tuberculosis (TB) and 1.32 million more children under one year of age did not receive their first dose of the vaccine. against measles between January and August 2020, when compared to the same period in 2019.
This year, immunization campaigns for measles, yellow fever, polio and other diseases have been postponed in at least 15 African countries. The introduction of new vaccines has stopped and several countries have reported that vaccine stocks have been depleted.
“Now that countries are easing their restrictions, it is critical that they quickly implement upgrade vaccination campaigns,” said Dr. Moeti. “The longer and large numbers of children remain unprotected against measles and other childhood illnesses, the more likely we are to see deadly outbreaks unleashing and claiming more lives than COVID-19.”
The WHO has published guidance on how to provide safe immunization services, including how to conduct a careful risk assessment before implementing mass preventive vaccination, paying attention to appropriate protective measures to prevent transmission of COVID-19. The Central African Republic, the Democratic Republic of the Congo and Ethiopia have already carried out measles vaccination campaigns to catch up. Thirteen other African countries are aiming to restart immunization campaigns against measles, polio and human papillomavirus in the coming months and WHO is providing guidance on COVID-19 prevention measures to keep workers in health and communities.
WHO has also provided guidance to countries on how to ensure the continuity of other essential health services by optimizing service delivery environments, redeploying the capacity of health workers, and proposing ways to ensure the uninterrupted supply of medicines and other health products.
As part of the COVID-19 response, healthcare workers have received training in infection, prevention and control, laboratories have been strengthened, and data collection and analysis has been improved. These efforts support the fight against the virus while strengthening health systems.
Dr. Moeti spoke during a virtual press conference today facilitated by APO Group. She was joined by Professor Ifedayo Adetifa, Clinical Epidemiologist, KEMRI-Wellcome Trust Research Program and Associate Professor, London School of Hygiene and Tropical Medicine; and Regina Kamoga, Executive Director, Community Health and Information Network and President of the Uganda Alliance of Patient Organizations.
