Health services in sharp focus

Radical transformation of care system needed after Covid-19 pandemic is over

AFRICA Day this year should be commemorated within the context of challenges brought by the Covid-19 pandemic.

Exponential growth of this outbreak in Africa is of grave concern considering that the public health ecosystem of many of the affected countries is characterised by fragile health systems and a high prevalence of HIV, malnutrition and other comorbidities which can increase the severity of Covid-19 and represent an additional strain on the health system.

It is essential that African governments continue to promote strict adherence to proven public health measures such as social distancing, good personal hygiene practices and cough etiquette.

Health information management and data sharing needs to be strengthened in all affected countries.

One of the challenges facing Africa is the ability to bail out manufacturers in the ways contemplated by governments in high-income states. The impact of the virus will be felt disproportionately by the poor, especially in low-income countries.

If the disproportionate impact on the poor is like prior pandemics and crises, it is not at all clear how the world-economy will emerge out of it.

Responding to the collapse of stock markets, governments are pumping money into the economy but when people are expected to stay home, the circulation of money slows down as well.

The potential social, economic, and security devastation Covid19 could cause in Africa should be enough of an incentive for African governments to invest immediately in preparedness for the worst-case scenario.

Commitment and release of financial resources from partners and donors before a crisis hits Africa will help anticipate demand and address supply chain management, mapping, and stockpiling of Covid-19 response needs. Supplies of these items will be limited in Africa because of reduced manufacturing capacity.

Majority of front-line workers are women, and this demonstrates the pandemic has a disproportionate impact on women.

Although the private sector has been advised not to retrench workers during Covid-19 situation women workers are generally the first ones to be told not to come to work unless called. In many cases, their due wages are pending with the employer.

Since the majority of women workers in Africa are engaged in casual or other forms of informal work, their absence from the workforce will remain an invisible phenomenon.

This pandemic has brought countries’ health services into sharp focus. While governments move to contain the spread of the virus and deliver care, health workers, especially women, are on the front lines, who are expected to provide that care mitigate the epidemic and that makes them particularly vulnerable to the dreaded affliction. Globally, women make up 70% of those employed in the health sector and, based on data available for close to 100 countries, 72% of skilled health occupations.

They are therefore on the front lines in the world’s struggle to treat infected patients. Thus, even in high income countries, women through their roles as caregivers become particularly vulnerable to the dreaded virus.

Other than health-care workers, women form the majority in many other low paid jobs such as tellers in banks, grocery store helpers, receptionists, etc. In any given society, the lowest paid jobs are done by the most vulnerable sections in the population of whom women form a large section.

Many of these women are part of the essential services. Many of them are aware that if they stay out of work, they will find it impossible to put food on the table.

There is another risk and that is women’s dominance in the service fields can expose them to the disease at higher rates than men.

These are the front-line public health workers who are now being celebrated, but who are not given the basic protections of fair labour practice, job security, and adequate wages.

National public health capabilities and infrastructures remain at the core of global health security because they are the first line of defence in infectious disease emergencies. Crisis management plans should be ready in each African country; involvement of the international community should enhance such preparedness. China has illustrated that the Covid-19 pandemic can be limited when public health outbreak response strategies and tactics are implemented early.

When the pandemic is over, it will be necessary to think of radically transforming the health-care system, which must be organised around a solid and competent public service, well-provisioned with material and human resources. Without such essential pre-emptive measures, built around a strong system of public health, the consequence of a new pandemic could be even more catastrophic than the one we are currently experiencing.