scholarly journals Responding to COVID-19 by building health workforce capacity across eleven countries in Sub-Saharan Africa

Author(s):  
Fatima Oliveira Tsiouris ◽  
Kieran Hartsough ◽  
Michelle Poimbouef ◽  
Claire Raether ◽  
Mansoor Farahani ◽  
...  

Abstract Background: The global spread of the SARS-CoV-2 virus highlights both the importance of frontline healthcare workers (HCW) in pandemic response and their heightened vulnerability during infectious disease outbreaks. Adequate preparation, including the development of human resources for health (HRH) is essential to an effective response. ICAP at Columbia University (ICAP) partnered with Resolve to Save Lives and MOHs to design an emergency training initiative for frontline HCW in 11 African countries, using a competency-based backward-design approach and tailoring training delivery and health facility selection based on country context, location and known COVID-19 community transmission. Methods: Pre and Post-test assessments were conducted on participants completing the COVID-19 training. Parametric and non-parametric methods were used to examine average individual-level changes from pre- to post-test, and compare performance between countries, cadres, sex and facility types. A post evaluation online training survey using Qualtrics was distributed to assess participants’ satisfaction and explore training relevance and impact on their ability to address COVID-19 in their facilities and communities. Results: A total of 8,797 HCW at 945 health facilities were trained between June 2020 and October 2020. Training duration ranged from 1 to 8 days (median: 3days) and consisted of in person, virtual or self guided training. Of the 8,105 (92%) HCW working at health facilities, the majority (62%) worked at secondary level facilities as these were the HF targeted for COVID-19 patients. Paired pre- and post-test results were available for 2,370 (25%) trainees, and 1,768 (18%) participants completed the post-evaluation training survey. On average, participants increased their pre- to post-test scores by 15 percentage points (95% CI: 0.14, 0.15). While confidence in their ability to manage COVID-19 was high following the training, respondents reported that lack of access to testing kits (55%) and PPE (50%), limited space in the facility to isolate patients (45%), and understaffing (39%) were major barriers. Conclusion: Ongoing investment in health systems and focused attention to health workforce capacity building is critical to outbreak response. The success of our short-term IPC training initiative was due both to the speed, rigor and flexibility of its design and delivery, and to the pre-existing systems, resources, and partnerships that enabled its rapid implementation

2019 ◽  
Vol 4 (Suppl 9) ◽  
pp. e001115 ◽  
Author(s):  
Doris Osei Afriyie ◽  
Jennifer Nyoni ◽  
Adam Ahmat

Many African countries have a shortage of health workers. As a response, in 2012, the Ministers of Health in the WHO African Region endorsed a Regional Road Map for Scaling Up the Health Workforce from 2012 to 2025. One of the key milestones of the roadmap was the development of national strategic plans by 2014. It is important to assess the extent to which the strategic plans that countries developed conformed with the WHO Roadmap. We examine the strategic plans for human resource for health (HRH) of sub-Saharan African countries in 2015 and assess the extent to which they take into consideration the WHO African Region’s Roadmap for HRH. A questionnaire seeking data on human resources for health policies and plans was sent to 47 Member States and the responses from 43 countries that returned the questionnaires were analysed. Only 72% had a national plan of action for attaining the HRH target. This did not meet the 2015 target for the WHO, Regional Office for Africa’s Roadmap. The plans that were available addressed the six areas of the roadmap. Despite all their efforts, countries will need further support to comprehensively implement the six strategic areas to maintain the health workers required for universal health coverage


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
G Ndziessi ◽  
R Bileckot

Abstract Background In order to achieve the Sustainable Development Goals (SDGs), equitable access to skilled and motivated health workers within a performing health system is need to be ensured. The health system in Congo is characterized by low quantity and quality of Human resources for health (HRH), which constitutes an important barrier to achieving to expanding coverage and integrated primary health care. Objectives To estimate needs of HRH in Congo from 2019 to 2030 and analysed the capacity of the country to address the estimated needs. Methods Cross-sectional study was conducted in Ministry of Health from June to November 2018. Data from 2011 national HRH Census was used as the baseline for projections. We performed annual projections based on current numbers of midwives, nurses and physicians. Health workforce-population ratios by year in national and department level were provided. Population estimations were computed using Spectrum software assuming a 3% growth rate. Mapping for distribution by department was performed used QSGI software. Results In 2019, Congo has 4849 midwives, nurses and physicians, including 465 doctors, 912 midwives and 3469 nurses. All of Congo departments have not surpassed the availability threshold of 4, 5 midwives, nurses and physicians per 1000 inhabitants in 2019. In overall, this ratio will rise from 0.9 per 1000 inhabitants in 2019 to 0.42 per 1000 inhabitants in 2030 due to the retirement. Needs for additional workforce were estimated at 29416 midwives, nurses and physicians by 2030, average of 2451 per year. However, current national production capacity of human resources for health is very low and will not cover the estimated needs as scheduled. Conclusions There is a crisis in the health workforce in Congo, expressed in acute shortage. Results highlight needs of building adequate policies to address production and management of the health workforce, to come close to reaching the MDGs for health. Key messages At current production capacity, Congo has not the number of physicians, nurses, and midwives it needs to address HRH shortages in the national Health system by 2030. The health human resources crisis in sub-Saharan Africa countries will be a major obstacle to achieving the Millennium Development Goals.


2021 ◽  
Author(s):  
Pamela A. McQuide ◽  
Amy Finnegan ◽  
Katherine M Terry ◽  
Andrew Nelson Brown ◽  
Cheick Oumar Toure ◽  
...  

Abstract BackgroundThe COVID-19 pandemic has increased the burden on health systems, particularly in low- and middle-income countries where health systems already struggle. To meet health workforce planning needs during the pandemic, IntraHealth International used two tools created by the World Health Organization (WHO) Regional Office for Europe. The Health Workforce Estimator (HWFE) allows the estimation of the quantity of health workers needed to treat patients during a surge, and the Adaptt Surge Planning Support Tool helps to predict the timing of a surge in cases and the number of health workers and beds needed for predicted caseload. These tools were adapted to fit the African context in a rapid implementation over five weeks in one region in Mali and one region in Kenya with the objective to test the feasibility of adapting these tools, which use a Workload Indicators of Staffing Need (WISN)-inspired human resources management methodology, to obtain daily and surge projections of COVID-19 human resources for health needs.Case presentationUsing a remote team in the US and in-country teams in Mali and Kenya, IntraHealth enacted a phased plan to gather stakeholder support, collect data related to health systems and COVID-19 cases, populate data into the tools, verify modeled results with results on the ground, enact policy measures to meet projected needs, and conduct national training workshops for the ministries of health.ConclusionsThis phased implementation in Mali and Kenya demonstrated that the WISN approach applied to the Health Workforce Estimator and Adaptt tools can be readily adapted to the local context for African countries to rapidly estimate the number of health workers and beds needed to respond to the predicted COVID-19 pandemic caseload. The results may also be used to give a proxy estimate for needed health supplies—e.g., oxygen, medications, and ventilators. Challenges included accurate and timely data collection and updating data. The success of the pilot can be attributed to the adapted WHO tools, the team composition in both countries, access to human resources data, and early support of the ministries of health, with the expectation that this methodology can be applied to other country contexts.


2015 ◽  
Vol 3 (2) ◽  
Author(s):  
Edna Berhane

Although Africa has made significant progress in public health over the past several decades, it still faces a very high burden of disease compared to the rest of the world. This overwhelming disease burden is further aggravated by a lack of adequate financial and human resources for health, inequitable distribution of health services, and other social, economic and political factors. Given these constraints, it has become critical for African countries to ensure that health interventions are selected based on evidence and implemented efficiently and effectively to ensure desired outcomes and impact. This has led to an increasing appreciation for monitoring and evaluation as an integral element of programme planning, implementation and scale-up. The importance of M&E within the health sector was recently reflected in the fact that the health evaluation strand was the largest at AfrEA’s 7th Biennial International Conference, held over 3 days in March 2014 in Yaoundé, Cameroon. The health strand, which had nine sub-themes, was sponsored, managed, and supported by the USAID-funded AfricanStrategies for Health (ASH) project. This review summarises the health strand presentations, and panel and roundtable discussions. The evaluations featured in the strand were diverse interms of health area focus, evaluation methodology, language and authors’ affiliation. More than 21 African countries from all regions of sub-Saharan Africa were represented. Among thekey recurrent messages highlighted during the conference were the importance of: data use for planning and improving health programmes, data quality, well-functioning M&E systems and identifying and sharing best/good practices.


Author(s):  
Oathokwa Nkomazana ◽  
Wim Peersman ◽  
Merlin Willcox ◽  
Robert Mash ◽  
Nthabiseng Phaladze

Background: Botswana is a large middle-income country in Southern Africa with a population of just over two million. Shortage of human resources for health is blamed for the inability to provide high quality accessible health services. There is however a lack of integrated, comprehensive and readily-accessible data on the health workforce.Aim: The aim of this study was to analyse the existing databases on health workforce in Botswana in order to quantify the human resources for health.Method: The Department of Policy, Planning, Monitoring and Evaluation at the Ministry of Health, Ministry of Education and Skills Development, the Botswana Health Professions Council, the Nursing and Midwifery Council of Botswana and the in-country World Health Organization offie provided raw data on human resources for health in Botswana.Results: The densities of doctors and nurses per 10 000 population were four and 42,respectively; three and 26 for rural districts; and nine and 77 for urban districts. The average vacancy rate in 2007 and 2008 was 5% and 13% in primary and hospital care, respectively, but this is projected to increase to 53% and 43%, respectively, in 2016. Only 21% of the doctors registered with the Botswana Health Professions Council were from Botswana, the rest being mainly from other African countries. Botswana trained 77% of its health workforce locally.Conclusion: Although the density of health workers is relatively high compared to the region, they are concentrated in urban areas, insuffiient to meet the projected requirements and reliant on migrant professionals.


2020 ◽  
Author(s):  
Ngozi A Erondu ◽  
Sagal A Ali ◽  
Mohamed Ali ◽  
Schadrac C Agbla

BACKGROUND In sub-Saharan Africa, underreporting of cases and deaths has been attributed to various factors including, weak disease surveillance, low health-seeking behaviour of flu like symptoms, and stigma of Covid-19. There is evidence that SARS-CoV-2 spread mimics transmission patterns of other countries across the world. Since the Covid-19 pandemic has changed the way research can be conducted and in light of restrictions on travel and risks to in-person data collection, innovative approaches to collecting data must be considered. Nearly 50% of Africa’s population is a unique mobile subscriber and it is one of the fastest growing smart-phone marketplaces in the world; hence, mobile phone platforms should be considered to monitor Covid-19 trends in the community. OBJECTIVE We demonstrate the use of digital contributor platforms to survey individuals about cases of flu-like symptoms and instances of unexplained deaths in Ethiopia, Kenya, Nigeria, Somalia, and Zimbabwe. METHODS Rapid cross-sectional survey of individuals with severe flu and pneumonia symptoms and unexplained deaths in Ethiopia, Kenya, Nigeria, Somalia and Zimbabwe RESULTS Using a non-health specific information platform, we found COVID-19 signals in five African countries, specifically: •Across countries, nearly half of the respondents (n=739) knew someone who had severe flu or pneumonia symptoms in recent months. •One in three respondents from Somalia and one in five from Zimbabwe respondents said they knew more than five people recently displaying flu and/or pneumonia symptoms. •In Somalia there were signals that a large number of people might be dying outside of health facilities, specifically in their homes or in IDP or refugee camps. CONCLUSIONS Existing digital contributor platforms with local networks are a non-traditional data source that can provide information from the community to supplement traditional government surveillance systems and academic surveys. We demonstrate that using these distributor networks to for community surveys can provide periodic information on rumours but could also be used to capture local sentiment to inform public health decision-making; for example, these insights could be useful to inform strategies to increase confidence in Covid19 vaccine. As Covid-19 continues to spread somewhat silently across sub-Saharan Africa, regional and national public health entities should consider expanding event-based surveillance sources to include these systems.


2014 ◽  
Vol 2 (2) ◽  
Author(s):  
Shuaib Lwasa

Africa’s urbanization rate has increased steadily over the past three decades and is reported to be faster than in any other region in the world . It is estimated that by 2030, over half of the African population will be living in urban areas . But the nature of Africa’s urbanization and subsequent form of cities is yet to be critically analyzed in the context of city authorities’ readiness to address the challenges . Evidence is also suggesting that urbanization in African countries is increasingly associated with the high economic growth that has been observed in the last two decades . Both underlying and proximate drivers are responsible for the urbanization, and these include population dynamics, economic growth, legislative designation, increasing densities in rural centers, as well as the growth of mega cities such as Lagos, Cairo and Kinshasa, that are extending to form urban corridors . With the opportunities of urbanization in Sub–Saharan Africa, there are also challenges in the development and management of these cities . Those challenges include provision of social services, sustainable economic development, housing development, urban governance, spatial development guidance and environmental management, climate change adaptation, mitigation and disaster risk reduction . The challenge involves dealing with the development and infrastructure deficit, in addition to required adaption to and mitigation of climate change . This paper examines the current state of urban management in Africa .


Having broadly stabilized inflation over the past two decades, many policymakers in sub-Saharan Africa are now asking more of their monetary policy frameworks. They are looking to avoid policy misalignments and respond appropriately to both domestic and external shocks, including swings in fiscal policy and spikes in food and export prices. In many cases they are finding current regimes—often characterized as ‘money targeting’—lacking, with opaque and sometimes inconsistent objectives, inadequate transmission of policy to the economy, and difficulties in responding to supply shocks. At the same time, little existing research on monetary policy is targeted to low-income countries. What do we know about the empirics of monetary transmission in low-income countries? (How) Does monetary policy work in countries characterized by a huge share of food in consumption, underdeveloped financial markets, and opaque policy regimes? (How) Can we use methods largely derived in advanced countries to answer these questions? And (how) can we use the results to guide policymakers? This book draws on years of research and practice at the IMF and in central banks from the region to shed empirical and theoretical light on these questions and to provide practical tools and policy guidance. A key feature of the book is the application of dynamic general equilibrium models, suitably adapted to reflect key features of low-income countries, for the analysis of monetary policy in sub-Saharan African countries.


Author(s):  
Peter Kayode Oniemola ◽  
Jane Ezirigwe

To achieve universal energy access will attract huge capital investments. If sub-Saharan Africa is to realize anything close to the ambitious goals set for its energy access, then new actors, innovative funding mechanisms and sustainable technologies will have to be attracted. Finance is needed for activities such as rural electrification, clean cooking facilities, diesel motors and generators, other renewable energy technologies, oil and gas infrastructures, etc. Finance is also needed in research and development of suitable technologies and funding options as well as investment in the capacity to formulate and implement sound energy policies. This chapter examines the varied financing options for energy access in sub-Saharan Africa. It argues that with appropriate laws in place and effective mechanism for implementation, African countries can significantly engage private sector financing, international financial institutions and foreign donors. The role of the law here will be in creating an enabling environment for financing.


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