Pandemic In sub-Saharan Africa Research Articles

High pre-Delta and early-Omicron SARS-CoV-2 seroprevalence detected in dried blood samples from Kinshasa (D.R. Congo).

Studies on the impact of the COVID-19 pandemic in sub-Saharan Africa have yielded varying results, although authors universally agree the real burden surpasses reported cases. The primary objective of this study was to determine SARS-CoV-2 seroprevalence among patients attending Monkole Hospital in Kinshasa (D.R. Congo). The secondary objective was to evaluate the analytic performance of two chemiluminescence platforms: Elecsys® (Roche) and VirClia® (Vircell) on dried blood spot samples (DBS). The study population (N = 373) was recruited in two stages: a mid-2021 blood donor cohort (15.5% women) and a mid-2022 women cohort. Crude global seroprevalence was 61% (53.9%-67.8%) pre-Delta in 2021 and 90.2% (84.7%-94.2%) post-Omicron in 2022. Anti-spike (S) antibody levels significantly increased from 53.1 (31.8-131.3) U/mL in 2021 to 436.5 (219.3-950.5) U/mL in 2022 and were significantly higher above 45 years old in the 2022 population. Both platforms showed good analytic performance on DBS samples: sensitivity was 96.8% for IgG (antiN/S) (93.9%-98.5%) and 96.0% (93.0%-98.0%) for anti-S quantification. These results provide additional support for the notion that exposure to SARS-CoV-2 is more widespread than indicated by case-based surveillance and will be able to guide the pandemic response and strategy moving forward. Likewise, this study contributes evidence to the reliability of DBS as a tool for serological testing and diagnosis in resource-limited settings.

Seroprevalence of Transfusion-Transmissible Infections among Family Replacement Donors and Voluntary Non-Remunerated Blood Donors During the COVID-19 Pandemic in Sub Saharan Africa.

Introduction : According to WHO, regular, voluntary, unpaid blood donors are the safest group of donors, as they have the lowest prevalence of blood transmitted infections. However, family/replacement blood donors is widely used in sub Saharan Africa and this practice was exacerbated during the COVID 19 pandemic. This study aimed to compare the seroprevalence of infectious markers in family replacement blood donors and voluntary non-remunerated blood donors during the COVID 19 pandemic in a country of sub Saharan Africa. 
 Materials and Methods
 Blood donors received at the National Centre of Blood Transfusion (NBTC) of Dakar from August 1st to October 31th 2021, were included in this study. All donors completed a pre-donation questionnaire. Donors identity, epidemiological parameters, reasons for donation and laboratory results were collected in the Inlog® software of the NBTC. The serological tests for HBV, HIV and HCV were performed with chemiluminescence technology. The Rapid Plasma Reagent test was used to find out treponemal antibodies. The determination of ABO and Rh blood groups was performed using monoclonal antisera following classical hemagglutination test on a plate.
 Results
 A total of 5002 donors were collected during this COVID-19 pandemic period. Blood family/replacement donors represented 54.0% and new voluntary donors represented 52.6%. Comparison of HIV, HCV and syphilis markers seroprevalence showed no statistically significant difference between new voluntary donors and new family replacement donors (p>0.05). However, for HBV the seroprevalence was significantly higher in new family replacement donors (p=0,002).
 Conclusion 
 The proper supply of blood was impacted by the COVID-19 pandemic meanwhile replacement donations had contributed to limiting the damage observed with blood shortages. However, the significant differences noted on the seroprevalences of transfusion-transmissible infections between voluntary non-paid donors and family/replacement donors strengthens WHO recommendations for the selection of volunteer non-paid donors to lower transfusion-transmissible HBV in sub Saharan Africa.
 
 
 
 
 
 
 
 

Impact of Cash Transfers on Household Food Security: Evidence from Families with Orphans and Vulnerable Children in Kenya

ABSTRACT In response to the devastation of the 1990s and early 2000s AIDS pandemic in Sub-Saharan Africa, Kenya introduced the Cash Transfers for Orphans and Vulnerable Children (CT-OVC) program. The program aimed to encourage the fostering and retaining of Orphans and Vulnerable Children (OVCs) within communities and enhance their human capital development. This study uses cluster-randomized longitudinal trial data to examine the program’s household food security impact, using three measures of the accessibility dimension of food security: per adult equivalent food consumption, household food group shares, and the household dietary diversity score (HDDS). After performing difference-in-differences analysis, we find that the transfers had a positive and highly significant impact on HDDS but a statistically insignificant impact on per adult equivalent food consumption. The results are robust to alternative propensity-score-matched specifications. We further observe hidden food source substitution as transfers provided households with greater freedom of food choices from their own purchases and less reliance on food gifts or aid, thereby improving dietary diversity while aggregate food consumption remained largely unchanged. Our findings provide fresh insights to relevant stakeholders such as government agencies, Non-Governmental Organizations (NGOs) involved with social action, particularly for OVCs, and food security researchers.

1.C. Workshop: COVID-19 and strategies to improve pandemic preparedness in Africa: Results of 4 systematic reviews

Abstract Background The COVID-19 pandemic has had a massive impact on mortality and health service utilisation globally. However, its impact in low- and lower middle-income countries (LLMIC), in particular in sub-Saharan Africa, remains poorly understood. The German West-African Centre (G-WAC) for Global Health and Pandemic Prevention aims to contribute to a better understanding of the pandemic and to strengthen pandemic preparedness in the region. Objectives The workshop aims to provide an overview of available research on four aspects that are key for understanding the COVID-19 pandemic in sub-Saharan Africa and to support improved pandemic preparedness in the region: (1) the impact of the pandemic on excess mortality, (2) the changes in health services utilisation, (3) the different strategies that support community engagement, and (4) the role of mHealth tools for community-based disease surveillance. Together with workshop participants, we intend to discuss challenges and opportunities for research on the COVID-19 pandemic in sub-Saharan Africa and the potential for research to contribute to better pandemic preparedness. We also wish to receive input for the further research agenda of G-WAC. Added value The workshop will bring together the findings of four systematic reviews that provide complementary evidence contributing to a better understanding of the COVID-19 pandemic in sub-Saharan Africa. It will provide a platform for researchers engaged in related work in Africa or Europe to share their experiences and to contribute to shaping the future research agenda of G-WAC. Coherence of workshop Following a brief introduction explaining the underlying research concept that links the four systematic reviews, results will be presented for: (1) a systematic review and meta-analysis of excess mortality, reporting pooled excess mortality estimates; (2) a scoping review illustrating the range of approaches and settings where research has been conducted on health service utilisation during the pandemic; (3) a scoping review of the various strategies that have been used to foster community engagement to strengthen infection control activities; and (4) a scoping review of different mobile phone-based tools that support Community Health Workers engaged in infectious disease surveillance. Format This is a regular workshop consisting of four brief (7 mins) presentations. Each presentation will be followed by 5 mins discussions, giving room to the audience for questions and comments that relate findings to previous research experiences. Another 10 mins are reserved at the end to discuss further research needs. Several polling rounds will engage the audience and collect input on (a) research experiences in sub-Saharan Africa, (b) reflections about the relevance of presented results, and (c) suggestions for further research. Key messages • The workshop will summarise existing evidence on the impact of the COVID-19 pandemic on mortality and health service utilisation in sub-Saharan Africa. • Community participation may support improved pandemic preparedness and response by contributing to early detection of outbreaks and the successful implementation of infection control activities.

The HIV/AIDS responses pre and during the COVID-19 pandemic in sub-Saharan Africa: A basis for sustainable health system strengthening post–COVID-19

In May 2023, the World Health Organization announced that COVID-19 was no longer a global emergency. The impact of COVID-19 on the provision of HIV/AIDS services was not that severe due to the reprogramming of key resources. For health systems in sub-Saharan Africa to become resilient to future pandemics, lessons should be learned from the successful HIV/AIDS response in the region, and how the HIV/AIDS services were successfully adapted to the COVID-19 pandemic. In this article, we reviewed the 6 World Health Organization health system building blocks on how the best practices from the provision of HIV/AIDS services and the services’ response to the COVID-19 pandemic can be used as a basis for restoring and strengthening health systems to offer universal access to quality essential health services. The success of the leadership and governance for universal access to anti-retroviral therapy can be a blueprint for the realization of universal health coverage. Significant efficiencies that resulted in the reduction in anti-retroviral therapy costs can be leveraged to ensure cheaper essential drugs while differentiated service delivery models can be used to improve health service accessibility. New technologies that have proven to be successful in HIV/AIDS care can also be used in the care of other diseases, including disease outbreaks. The strong health information systems developed for HIV programs can be used as a foundation for developing health information systems for the whole health sector while the healthcare professionals trained for the provision of HIV/AIDS services can be trained to provide services for a variety of other conditions.

Fitting Birth and Death Queuing Models using Maximum Likelihood Estimation with Application to COVID-19 Pandemic in Sub-Saharan Africa

The COVID-19 pandemic has revealed facts about deficiencies in health resource planning of some countries having relatively high case count and death toll. The virus has undergone an observed increase of cases that led to a global pandemic. Many authors have developed different models for predicting or observing the current trend of COVID-19 pandemic.

School closures and well-being-related topic searches on Google during the COVID-19 pandemic in Sub-Saharan Africa

BackgroundFollowing the outbreak of the 2020 coronavirus, governments adopted non-pharmaceutical interventions (NPIs) to save lives. The NPIs have been deemed to have unintended consequences on mental health and well-being. This study aimed to estimate the impact of the COVID-19 pandemic-induced school closures on the relative search volumes (RSVs) of well-being-relevant topics in 30 low and lower- middle income countries in Sub-Saharan Africa.MethodsGoogle Trends search data, difference-in-differences and event study methods were used to evaluate the impact on the related search volume (RSV) of well-being related topic queries in Sub-Saharan Africa.ResultsThe results suggest positive and significant increases in the search intensity for anger, boredom, fear, sleep, exercise, and prayer. Contrary to other studies, we find no discernible effects on the relative search volumes (RSVs) on loneliness, sadness, and suicide.ConclusionOur findings suggest that the pandemic and the associated restrictions had a mixed effect on well-being-related searches. We recommend increased vigilance and proactive communication from the government and policy makers with the general population in times of emergencies when social policies that restrict lives and liberties need to be adopted.

The COVID-19 pandemic in sub-Saharan Africa: The significance of presumed immune sufficiency.

A novel coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in China in 2019 and later ignited a global pandemic. Contrary to expectations, the effect of the pandemic was not as devastating to Africa and its young population compared to the rest of the world. To provide insight into the possible reasons for the presumed immune sufficiency to coronavirus disease 2019 (COVID-19) in Africa, this review critically examines literature published from 2020 onwards on the dynamics of COVID-19 infection and immunity and how other prevalent infectious diseases in Africa might have influenced the outcome of COVID-19. Studies characterising the immune response in patients with COVID-19 show that the correlates of protection in infected individuals are T-cell responses against the SARS-CoV-2 spike protein and neutralising titres of immunoglobin G and immunoglobin A antibodies. In some other studies, substantial pre-existing T-cell reactivity to SARS-CoV-2 was detected in many people from diverse geographical locations without a history of exposure. Certain studies also suggest that innate immune memory, which offers protection against reinfection with the same or another pathogen, might influence the severity of COVID-19. In addition, an initial analysis of epidemiological data showed that COVID‑19 cases were not severe in some countries that implemented universal Bacillus Calmette-Guerin (BCG) vaccination policies, thus supporting the potential of BCG vaccination to boost innate immunity. The high burden of infectious diseases and the extensive vaccination campaigns previously conducted in Africa could have induced specific and non-specific protective immunity to infectious pathogens in Africans.

Invisible in Plain Sight? Grandfathers Caring for Orphaned Grandchildren in Rural Malawi

ABSTRACT Millions of orphans, created by parental deaths due to the HIV/AIDS pandemic in sub-Saharan Africa, live with, and are cared for, by grandparents. Little research has considered how grandparents and, in particular, grandfathers, are caring for orphans. Here, we employ the analytical concept of generative grandfathering to analyse rural grandfathers’ roles in orphan care within communities of Zomba District, Southern Malawi. Using an ethnographic approach to investigate orphan care, we engaged children, young people and adults in multiple qualitative research activities, including interviews, focus group discussions, stakeholder and dissemination meetings. The findings suggest that although grandfathers’ contributions to orphan care are on the periphery of research and policy concerned with grandparenting in Malawi and other regions of sub-Saharan Africa, grandfathers are incontrovertibly at the epicentre of their orphaned grandchildren’s everyday lives. Grandfathers are providers for their orphaned grandchildren, they support their formal education, and are integral to the intergenerational transmission of both knowledge and values. However, despite performing myriad caring roles in plain sight of their communities, grandfathers remain largely invisible due to gendered (mis)conceptions of care. This highlights the dilemma of grandfathers as ageing men who find themselves in roles not traditionally associated with hegemonic notions of masculinity in their communities.

Embracing e-health systems in managing the COVID 19 pandemic in Sub-Saharan Africa

The COVID-19 pandemic and the policy responses adopted to curtail it have drastically altered how health services are delivered around the globe. To enable the public to continue accessing health care, e-health innovations have become the most viable tool to provide convenient, timely, effective and safe care, while reducing the spread of the virus. This paper utilized data from existing literature to explore the benefits and challenges of implementing e-health technologies in Sub Saharan Africa (SSA) amid this pandemic. Evidence suggests that these technologies have the potential to strengthen public health systems in SSA as they have in First World countries. However, there are a number of challenges that need to be addressed first in order to realize the full promises of e-health on the continent. The paper proposes that African governments should come together and implement similar e-health policies, share software, expertise and other critical ICT infrastructure as it can result in the successful implementation of e-health innovations, while reducing the financial burden associated with their set up.

Cancer service delivery and the impact of the COVID-19 pandemic in sub-Saharan Africa: a scoping review.

The impact of the Coronavirus Disease 2019 (COVID-19) pandemic on health systems is widely reported worldwide. However, what remains unclear is the relative extent of the pandemic's effects on cancer management in sub-Saharan Africa (SSA). This review provides an up-to-date synthesis of the literature to inform post-pandemic policy and practice efforts in the region. Sources searched for published research include MEDLINE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, African Index Medicus, African Wide Information and Web of Science. Using predefined criteria, the retrieved citations were screened for primary research describing the direct and indirect impacts of the COVID-19 pandemic on the cancer care and service delivery landscape in SSA since March 2020. Evidence was summarised using narrative synthesis. Fourteen studies reporting findings from 19 SSA countries were included in this review. Studies were conducted mostly in the first wave of the pandemic (between March and July 2020) (10/14). The most commonly reported impact on cancer treatment (including surgery) were cancellations, delays and modifications (11/14). Half (7/14) of the studies reported on the impact of the pandemic on cancer care resource availability and service restructuring. Other notable impacts included temporary suspension, total cancellations or alterations in cancer screening (3/14) and diagnostic (3/14) services or programmes. Disruptions in cancer research and outreach activities were also reported (3/14). The availability and maintenance of cancer healthcare depended on multiple factors like availability of clinical supplies, existing oncology workforce, adequate supply of personal protective equipment and local pandemic mitigation measures. Notably, no studies reported on the impact of the pandemic on psychosocial support programmes, physiotherapy and other rehabilitation care for cancer patients. Changes in cancer care and service delivery due to the COVID-19 pandemic varied considerably across countries in SSA. This review underscores the need for urgent actions to mitigate current setbacks while recommending evidence-based and contextualised approaches to revitalising cancer care in the post-pandemic era.

Unpacking the Land and Socio-Economic Effects of the COVID-19 Pandemic in Rural Kenya

Following its outbreak in late 2019, the Coronavirus disease (COVID-19) has been reported to have had devastating human health, health systems, and socioeconomic impacts across the globe. Countries in the Global South are known to have been hit harder given the low level of resilience to crises amid high levels of poverty and limited social protection programmes. This includes countries in sub-Saharan Africa (SSA). Most of the existing studies on the COVID-19 pandemic in SSA, however, have focused on the puzzling nature of the considerably low rate at which the virus spread over the continent, the low level of hospitalisation, and the corresponding low morbidity rate. As such, little focus has been given to the social and economic effects of the pandemic in the local communities. Carried out in two rural communities in Kenya—Kilifi and Murang’a—the present study adopts a case study approach for an in-depth, real-life context and explores the socioeconomic (including land-related) effects of the COVID-19 pandemic on the vulnerable rural population and the social group of smallholder farmers. Outcomes of the study show that the local effects of the pandemic are context specific. The findings demonstrate that the pandemic has had far-reaching impact on access to and control over land for some households in the rural communities. It was also accompanied with other negative social and economic effects, including a notable rise in teenage pregnancy, intra-household conflicts, job losses, and businesses closures. Positively, it is also claimed to have contributed to food and nutrition security in some rural regions, following increased availability of nutritious food that could have, otherwise, been sold.

Recent malaria does not substantially impact COVID-19 antibody response or rates of symptomatic illness in communities with high malaria and COVID-19 transmission in Mali, West Africa.

Malaria has been hypothesized as a factor that may have reduced the severity of the COVID-19 pandemic in sub-Saharan Africa. To evaluate the effect of recent malaria on COVID-19 we assessed a subgroup of individuals participating in a longitudinal cohort COVID-19 serosurvey that were also undergoing intensive malaria monitoring as part of antimalarial vaccine trials during the 2020 transmission season in Mali. These communities experienced a high incidence of primarily asymptomatic or mild COVID-19 during 2020 and 2021. In 1314 individuals, 711 were parasitemic during the 2020 malaria transmission season; 442 were symptomatic with clinical malaria and 269 had asymptomatic infection. Presence of parasitemia was not associated with new COVID-19 seroconversion (29.7% (211/711) vs. 30.0% (181/603), p=0.9038) or with rates of reported symptomatic seroconversion during the malaria transmission season. In the subsequent dry season, prior parasitemia was not associated with new COVID-19 seroconversion (30.2% (133/441) vs. 31.2% (108/346), p=0.7499), with symptomatic seroconversion, or with reversion from seropositive to seronegative (prior parasitemia: 36.2% (64/177) vs. no parasitemia: 30.1% (37/119), p=0.3842). After excluding participants with asymptomatic infection, clinical malaria was also not associated with COVID-19 serostatus or symptomatic seroconversion when compared to participants with no parasitemia during the monitoring period. In communities with intense seasonal malaria and a high incidence of asymptomatic or mild COVID-19, we did not demonstrate a relationship between recent malaria and subsequent response to COVID-19. Lifetime exposure, rather than recent infection, may be responsible for any effect of malaria on COVID-19 severity.

Unmet contraceptive needs and unintended pregnancies among adolescent girls amid COVID-19 in sub-Saharan Africa and the importance of accurate, reliable and real-time data

COVID-19 in sub-Saharan Africa (SSA) has had a significant negative impact on issues such as the reproductive health of young girls. One of the consequences of the pandemic is a shortage of contraceptives and devices due to supply chain disruptions. The concern is that due to a lack of data, it is unclear how much these restrictions have impacted contraceptive use among youth from sub-Saharan Africa during COVID-19. Thousands of Kenyan schoolgirls have become pregnant due to the lockdown. It was recently reported from Gauteng, one of the South African provinces, that between April 2020 and March 2021 there were over 23,000 teenage pregnancies, with 934 girls aged 10 to 14 giving birth. This opinion piece aims to stimulate discussion on these issues while also addressing the issue of the importance of data for studying contraceptive use and teenage pregnancy in the face of hard-hit pandemics such as the COVID-19 pandemic in SSA.

Does Decentralization Deliver Health Services to Vulnerable Groups in Kenya? A Case Study of Busia and Kakamega Counties -Kenya

Background: Decentralization has become an increasingly important concept in development theory and practice in the world since the 1970s. Decentralization is generally understood to be referring to policies and processes that shift the locus of decision-making and management to the local level, Hellington [1]. According to Elamon, decentralization is particularly attractive because some forms of it promise direct accountability of public institutions; improved management of resources; more reliable information for planning and a more effective interagency collaboration and coordination [2]. Furthermore, it is argued that local officials and community leaders have better knowledge and information about the local context and are therefore more aware of what can work best within the resource constraints while contributing to the achievement of the broader social, economic and development goals of central government. In the health sector, the impetus for decentralization has its roots in the Alma-Ata declaration of Primary Health Care, WHO [3]. This was enhanced by the World Health Organization’s advocacy for strengthening the health system at district level as the most appropriate level for planning and providing health services. Bankausaikaite argues that decentralization therefore appeals to the health sector largely because it is seen as a means to achieving the Primary Health Care (PHC) goals and for its potential to achieve multiple objectives [4]. Furthermore, decentralization continues to be a subject of intense discussions in the health sector reform processes and is seen as a key strategy for achieving poverty reduction objectives and for attaining the global Millennium Development Goals (MDGs). Klouda argues that in the context of Sub-Saharan Africa, a region that has the majority of poor countries in the world, poor health indices and high burden of preventable diseases including a devastating impact of HIV/AIDS, decentralization is perceived as offering a key development strategy in addressing these complex problems [5]. In the specific case of HIV/AIDS, decentralization is perceived as suited to stimulate far-reaching changes that can respond to the complex factors that lead to its transmission and the multiple services necessary to adequately support affected communities through multisectoral actions. Furthermore, Ribot has said that development is often argued as a motive for decentralization [6]. It is argued that decentralization facilitates integrated local development, a necessary factor in the control of HIV/AIDS. The United Nations Development Program, UNDP has actively promoted decentralization in local government and points out that one of the earliest efforts in using decentralization to address the HIV/AIDS pandemic in sub-Saharan Africa has been through the Alliance of Mayors and Municipal Leaders on HIV/AIDS in Africa [7]. These efforts have been supported by donor agencies such as USAID, UNDP, World Bank and Private Foundations. According to Schneider the Ford Foundation in Southern Africa (South Africa, Zimbabwe, Namibia, and Mozambique) for example, focused its grant making on strengthening local government and civic responses to HIV/AIDS at district and community levels [8].

Leading in a time of crisis: exploring early experiences of health facility leaders during the COVID-19 pandemic in Nigeria’s epicentre

PurposeThe COVID-19 pandemic has had a disruptive effect on the health system. Health facility leaders were at the forefront of maintaining service delivery and were exposed to varied stressors in the early phase of the pandemic. This study aims to explore the leadership experiences of health facility leaders during the early phase of the COVID-19 pandemic in Nigeria’s epicentre.Design/methodology/approachThis study conducted an exploratory descriptive qualitative study. To achieve this, 33 health facility leaders of different cadres across primary, secondary, and tertiary levels of the public health care system in Lagos, Nigeria, were remotely interviewed. The key informant interviews were transcribed verbatim and were analysed by using thematic analysis.FindingsThe health facility leaders experienced heightened levels of fear, anxiety and stressors during the early phase of the pandemic. They also had genuine concerns about exposing their family members to the virus and had to manage some health-care workers who were afraid for their lives and reluctant. Coping mechanisms included psychological and social support, innovative hygiene measures at health facility and at home, training and staff welfare in more ways than usual. They were motivated to continue rendering services during the crisis because of their passion, their calling, the Hippocratic oath and support from the State government.Originality/valueThe experiences of health facility leaders from different parts of the world have been documented. However, to the best of the authors’ knowledge, this is one of the first studies that specifically report multi-layer leadership experiences of health facility leaders during the early phase of the COVID-19 pandemic in sub-Saharan Africa.

Health service utilisation during the COVID-19 pandemic in sub-Saharan Africa in 2020: a multicountry empirical assessment with a focus on maternal, newborn and child health services

IntroductionThere are concerns about the impact of the COVID-19 pandemic on the continuation of essential health services in sub-Saharan Africa. Through the Countdown to 2030 for Women’s, Children’s and Adolescents’...

Assessing the Efficiency of Public Health and Medical Care Services in Curbing the COVID-19 Pandemic in Sub-Saharan Africa: A Retrospective Study

In the late of December 2019, a new coronavirus (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV 2) emerged from the city of Wuhan, China and was subsequently declared a pandemic by the World Health Organization (WHO) on March 11, 2020 after it had spread to many countries across the globe. On February 28, 2020, the Sub-Saharan Africa (SSA) reported its first case in Nigeria, and it has since spread to all countries in SSA. Several public health and medical care measures were rolled out by many countries to stem the tide of the spread at the height of the pandemic, between February 28, 2020 and February 28, 2021, period covered by this study. This paper evaluates the levels of health system efficiency of the COVID-19 public health measures and medical care services and their determinants across Sub-Saharan African (SSA) countries using country-level data for those countries. The data was analyzed using bootstrap data envelopment analysis (DEA) and other advanced econometric analyses that produce robust estimations of the relationship between health systems efficiency and their determinants. The general finding of the study suggests that there is more room for health systems in SSA to improve their technical efficiency in fighting the COVID-19 pandemic. The most important determinants of health system efficiency in the fight against the spread of the virus were GDP per capita, population density, temperature levels, and quality of governance. Adequate health system preparedness and human resource strategies geared towards recruiting and/or retaining well-qualified and experienced healthcare workers to provide professional services would prove critical in containing pandemics of this nature.

Theological education and the COVID-19 pandemic in Sub-Saharan Africa: A Malawian perspective

The coronavirus disease 2019 (COVID-19) pandemic has brought a unique disruptive moment of unprecedented proportions in world history affecting all spheres of life. Theological education in Malawi, Sub-Saharan Africa, has not been spared in experiencing the effects of the COVID-19 pandemic. This study argues that the effectiveness of theological education in Africa contributes towards the future of Christianity on the continent, because it serves as a foundation for a vibrant missional church. Nevertheless, the COVID-19 pandemic has provided opportunities for creativity and innovation which could ensure the survival and sustainability of theological education in Africa. It is therefore crucial to critically reflect on how the provision of theological education in Malawi in particular, and in Sub-Saharan Africa, in general, can be sustained during the uncertain and challenging times when the COVID-19 pandemic is devastating the African continent and the entire world. This article investigated the challenges and opportunities for theological education in Malawi in view of the ongoing COVID-19 pandemic. In view of this, the following five objectives emerged: (1) to evaluate the Malawi government’s response to the COVID-19 pandemic; (2) to discuss the history and importance of theological education in Africa; (3) to examine the challenges of theological education in Malawi in view of the ongoing COVID-19 pandemic; and (4) to assess the prospects of theological education in Malawi in view of the ongoing COVID-19 pandemic. A qualitative research methodology was used, namely a literature review and interviews with members of the faculty of theological institutions in Malawi. Six main findings were established: First, the COVID-19 pandemic has presented both challenges and opportunities for theological education in Africa. Second, the effectiveness of theological education in Africa has contributed towards the future of Christianity on the continent. Third, the COVID-19 pandemic has challenged the dominant models of theological education in Africa. This entails a shift from face-to-face teaching to online teaching and learning. Fourth, the COVID-19 pandemic has provided opportunities for the sustainability of theological education in Africa. Fifth, theological education has encountered misleading theologies regarding the COVID-19 pandemic. Sixth, theological education has the opportunity of constructing life-giving theologies in Africa. This study has two implications: (1) navigating the changing terrain of theological education in Malawi; and (2) theological education’s employment of digital technologies during and post the COVID-19 pandemic.Contribution: This study has contributed to the discourse of theological education in Africa by providing solutions to the challenges posed by the COVID-19 pandemic.

Is social media, as a main source of information on COVID-19, associated with perceived effectiveness of face mask use? Findings from six sub-Saharan African countries.

Background:The use of face masks as a public health approach to limit the spread of coronavirus disease 2019 (COVID-19) has been the subject of debate. One major concern has been the spread of misinformation via social media channels about the implications of the use of face masks. We assessed the association between social media as the main COVID-19 information source and perceived effectiveness of face mask use.Methods:In this survey in six sub-Saharan African countries (Botswana, Kenya, Malawi, Nigeria, Zambia and Zimbabwe), respondents were asked how much they agreed that face masks are effective in limiting COVID-19. Responses were dichotomised as ‘agree’ and ‘does not agree’. Respondents also indicated their main information source including social media, television, newspapers, etc. We assessed perceived effectiveness of face masks, and used multivariable logistic models to estimate the association between social media use and perceived effectiveness of face mask use. Propensity score (PS) matched analysis was used to assess the robustness of the main study findings.ResultsAmong 1988 respondents, 1169 (58.8%) used social media as their main source of information, while 1689 (85.0%) agreed that face masks were effective against COVID-19. In crude analysis, respondents who used social media were more likely to agree that face masks were effective compared with those who did not [odds ratio (OR) 1.29, 95% confidence interval (CI): 1.01–1.65]. This association remained significant when adjusted for age, sex, country, level of education, confidence in government response, attitude towards COVID-19 and alternative main sources of information on COVID-19 (OR 1.33, 95%CI: 1.01–1.77). Findings were also similar in the PS-matched analysis.Conclusion:Social media remains a viable risk communication channel during the COVID-19 pandemic in sub-Saharan Africa. Despite concerns about misinformation, social media may be associated with favourable perception of the effectiveness of face masks.