Africa's fragile health system hit hard by Covid-19

Dr Matshidiso Moeti, regional head, Africa, World Health Organisation

These include outpatient consultation, inpatient admission, skilled birth attendance, treatment of confirmed malaria cases and the provision of the combination pentavalent vaccine, the World Health Organisation (WHO) says.

The widest gaps were in May, June and July, when many countries enforced hard lockdown, with movement restrictions to curb the spread of the coronavirus.

According to WHO, during the three months, services in the five monitored areas dropped on average by more than 50% in the 14 countries, compared with the same period in 2019.

“The Covid-19 pandemic has brought hidden, dangerous knock-on effects for health in Africa. With health resources focused heavily on COVID-19, as well as fear and restrictions on people’s daily lives, vulnerable populations face a rising risk of falling through the cracks,” says WHO Regional Director for Africa, Dr Matshidiso Moeti.

She believes that the continent’s health systems must do better to withstand future shocks.

“A strong health system is the bedrock for emergency preparedness and response. As countries ease Covid-19 restrictions, we must not leave the door open for the pandemic to resurge.

“A new wave of Covid-19 infections could further disrupt life-saving health services, which are only now recovering from the initial impact,” says Moeti.

Maternal mortality

Even before the pandemic, maternal mortality in sub-Saharan Africa was unacceptably high, accounting for about two-thirds of global maternal deaths in 2017, WHO says

Preliminary findings indicate that Covid-19 is likely to exacerbate women’s health challenges, while skilled birth attendance in the 14 countries dropped.

For instance, in Nigeria, 362,700 pregnant women missed antenatal care between March and August 2020, while over 97,000 women gave birth away from health facilities, and over 193,000 missed postnatal care within two days of giving birth.

Recent data also revealed 310 maternal deaths in Nigerian health facilities in August 2020 -- nearly double the figure in August 2019.

Children and vaccines

Meanwhile, 1.37 million children across the African region missed the Bacille Calmette-Guerin (BCG) vaccine, which protects against tuberculosis (TB).

In addition, an additional 1.32-million children aged under one missed their first dose of measles vaccine between January and August 2020, when compared with the same period in 2019.

At least 15 African countries this year postponed immunisation campaigns covering measles, yellow fever, polio and other diseases, while the introduction of new vaccines has been halted and countries reporting running out of stocks.

“Now that countries are easing their restrictions, it’s critical that they implement catch-up vaccination campaigns quickly.

“The longer, large numbers of children remain unprotected against measles and other childhood diseases, the more likely we could see deadly outbreaks flaring up and claiming more lives than Covid-19,” says Moeti.

According to WHO, some countries are now playing catch up, like the Central African Republic and Ethiopia, which have already carried out vaccination campaigns.

Thirteen other African countries aim to restart immunisation drives for measles, polio and human papillomavirus in the coming months.

WHO is guiding Covid-19 prevention measures to keep health workers and communities safe, and says it is determined to ensure the continuity of other essential health services by optimising service delivery settings, redistributing health workforce capacity and proposing ways to ensure uninterrupted supply of medicine and other health commodities.