5 Ways to Strengthen African Healthcare Systems During COVID-19

As most African countries enter month six of dealing with the Corona virus, the continent is nearing the one million mark in number of cases and WHO is warning that the world is in for a deep, long crisis.

What preliminary conclusions can Africa draw and how can we manage COVID-19 better going forward? Every crisis is also opportunity, is Africa seizing the opportunities that COVID-19 offers? 

Let us examine some of Africa’s key systems, analyze, learn and seize the opportunity going forward.

The Health System

Much has been written about the inadequacies of Africa’s health systems.  Some of the key elements characterizing them are:

  • Insufficient and inadequately trained personnel. According to WHO, Africa needs to increase health personnel by 63% to ensure adequate health coverage to citizens. In addition, the health sector suffers from a severe brain drain as doctors and nurses trained in Africa head to Europe, the U.S. and other countries where they can earn decent salaries and work in minimally acceptable conditions.
  • Insufficient and poor-quality health infrastructure. Accessing healthcare is challenging for all Africans, but particularly so for the 60% who live in rural areas.  Not only are there not enough health centers, those that do exist lack equipment, personnel and basic supplies.
  • Lack of health information and data. While Africa continues to appear to be less impacted by COVID-19 than other continents, the truth is no one really knows.  Nigeria which is among the top 10 African countries carrying out the most testing is averaging 1.3 tests per 1000 people.  South Africa which has carried out the highest number of tests on the continent is at 48 tests per 1000 people. In comparison, the UK is testing 134 people per thousand and the US, 162.  In both countries the testing level is considered to be insufficient. 

In addition, many African countries lack the data on deaths from previous years to be able to make comparisons on comorbidities or abnormally high death rates.

  • Lack of research and development capacity to test innovations. Ordinary Africans have reacted to the COVID-19 crisis as they should, by innovating. From herbal remedies to ventilators and tests, Africans young and old have put their know-how and creativity to work to find solutions for coronavirus.  Is there a miracle cure or a savvy tech application that can reduce testing time and cost somewhere on the continent? Hard to tell.  The continent lacks the research and development facilities to test, improve and scale these innovations.

In the midst of all the crisis activity that goes into fighting a pandemic what are some of the systemic solutions African countries should be implementing to ensure that African health systems come out of this crisis stronger and more resilient than ever? There are many. Here are just five suggestions:

1 – A percentage of aid, debt forgiveness and/or new debt should be used to invest in structural solutions for health infrastructure and training of personnel.

COVID-19 and Africa’s estimated needs of over $200 billion to respond to COVID-19 have triggered a variety of initiatives for debt cancellation, debt suspension and debt standstill.

The G20, OECD, the African Development Bank, the African Union and others are all mobilizing funds to enable Africa to respond to COVID-19.  While this must be handled with flexibility and adapted to each country’s situation, it is imperative that access to these resources be conditioned by a percentage being used for structural investments in African healthcare systems such as:

  • Upgrading training institutions in an aim to improve short-term training for healthcare workers facing the crisis as well as increasing the quantity and quality of healthcare workers in African countries in the medium term. The African Union should consider setting a minimum quota of increase in healthcare workers which will condition funding.
  • Making use of green technology to ensure that energy supplies to healthcare facilities are sustainable and independent of dysfunctional national grids. This will also generate green jobs for the healthcare and other sectors.
  • Making efficient use of technology for:
    • Distance learning for healthcare workers
    • Telemedecine to increase access to healthcare and specialized health services for citizens
    • Providing information and education for preventive health measures

This will also require investment in internet infrastructure to improve connectivity which has been discovered to be highly insufficient in Africa during this crisis.

2 – Decentralize, decentralize, decentralize (see STRATEGIES! upcoming article on the Municipal Approach to fighting COVID-19)

While many countries have zoned their national territory into health districts, generally these districts remain extremely weak in decision-making power and resources.  While it is important to maintain norms and quality standards at national level, COVID-19 like most health challenges requires proximity healthcare management.  Empowering local health districts to work with decentralized branches of the health ministry and local elected officials will enable African countries to improve access to healthcare by bringing services much closer to the population. It will also greatly improve the ability to collect health information from the population.

3 – Build a national health information system

Weak information systems and the lack of data are compromising understanding of the virus and decision-making in African countries.  It is extremely important that COVID-19 is used as an opportunity to make a quantum leap in health information systems. 

The crisis has created a focus on health systems for governments and for citizens.  It is the opportunity to set up an information system to collect data at all levels, from individual clinics and hospitals to districts and up to national level.

Almost all African countries have vibrant tech communities full of young entrepreneurs who could be instrumental in devising and running these information systems.  It is therefore an opportunity to digitalize health systems, create jobs and vastly improve data collection and analysis in the health system which will improve evidence-based decision-making.

4 – Partner with the Diaspora to obtain high-level skills

Tens of thousands of African medical professionals trained on the continent, work in other parts of the world. This is mainly due to poor working conditions: salary, professional growth, equipment, etc. in many African countries.  At the emergence of COVID-19, many of these doctors and nurses put their knowledge at the disposal of their home countries, demonstrating the attachment they have to Africa no matter where they are in the world.

COVID-19 is the opportunity for African countries to innovate and create short and medium term programs where African medical professionals in the Diaspora can “give back” by providing highly specialized services and training that African countries have difficulty accessing.

A wide variety of NGOs have already enabled African Diaspora medical personnel to return home for short term medical missions.  African governments should learn from this and envisage programs where Diaspora could return home for 3 to 24 months to teach, mentor and transfer skills. If investment is made in the overall working conditions of medical staff, there is no doubt a certain percentage of them would return definitively.

It is estimated that 1/5 doctors trained on the continent, work outside of it.  It is time for Africa to go on the offensive and stem the brain drain.

5 – Build national, regional and continental systems for research and development

It is the job of citizens who can, to create and innovate.  It is the job of states to channel that innovation, test it, help improve it and scale it so that it can be used to solve the problems of a society. COVID-19 has stimulated a rash of innovation in Africa.  Unfortunately, few countries have put into place systems to harness this innovation and do the work necessary to transform it into solutions for the country, the continent and perhaps the world.

Africa needs to improve on this at all levels.  In this moment of crisis, every country should put into place a system for collecting innovative ideas, technology, systems and concepts.  Of course, a high percentage will be of no use.  This is part of the process.  Research and development centers where these ideas can be tested should be put in place at national level if possible, but certainly at regional and continental levels.  Finding African solutions to African problems begins with harnessing and testing new ideas.  COVID-19 offers a wonderful opportunity for Africa to build systems that do this.

It remains unclear whether Africa has truly lucked out where COVID-19 is concerned and unclear whether it will be comparatively less impacted by the disease.  What is clear, is that this crisis provides opportunity for African countries to make fundamental systemic changes that will improve healthcare on the continent for decades.  There are a myriad of systemic changes to be made.  The above five are just a sample.  In the necessary frenzy of fighting the pandemic in the immediate, this opportunity for tremendous systemic change should not be missed.

N.B. Upcoming articles by STRATEGIES! on “Systemic changes for the African economy during COVID-19” and “The Municipal Approach to fighting COVID-19

Sources

Testing in Africa – https://www.bbc.com/news/world-africa-53181555

Debt forgiveness – https://www.un.org/africarenewal/magazine/july-2020/external-debt-complicates-africas-post-covid-19-recovery-mitigating-efforts

Diaspora – https://www.universityworldnews.com/post.php?story=20200624152928519

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4908684/

10 Days at STRATEGIES! Consulting Firm

Our work at STRATEGIES! is always extremely busy and extremely exciting. The last 10 working days have been a great example of this. 

10 Days Contributing to Solutions in 10 Key Areas Across the Globe

 

1) Fiscal Decentralization and Investment Environment in Benin.

With the GIZ Governance Fund based in Germany we began analysis of how to support ongoing reforms in fiscal decentralization and strengthening the national framework for public and private investment in Benin.  The GIZ team in Benin and experts from Germany will provide technical assistance, STRATEGIES! will facilitate the process. A great kick-off online working session enabled us to begin identifying priority areas for support to Benin institutions. Exciting to see Benin making changes that will strengthen decentralization and improve the business environment.

2) Agriculture in Africa

STRATEGIES! has been working to support Agriculture at the continental level since 2007.  It was bittersweet to attend the session bringing an end to GIZ support to CAADP programs. Bitter, because endings are always a little so. Ever so sweet as CAADP successes were listed and we could identify where STRATEGIES! had contributed.  From anchoring CAADP implementation in national planning and budgeting frameworks to ensuring the voices of farmers and especially women farmers are included in the process. STRATEGIES! played its part.

                                        

3) Mining in West Africa

Since 2012, STRATEGIES! has been working on mining in Africa.  In the last 10 days we have engaged with partners at the KP-Civil Society Coalition and at GIZ in Côte d’Ivoire in healthy discussions on how the mining sector in Africa is adapting to COVID-19.  What is the impact in the short term and the medium term? What are the strategic decisions countries need to take for both large-scale and artisanal mining?  How do we ensure the rights of communities affected by mining are protected in this moment? Very interesting initial study produced by our partner the KP-CSC here: https://www.kpcivilsociety.org/wp-content/uploads/2020/06/The-Impact-of-COVID-19-on-African-communities-affected-by-diamond-mining-KPCSC.pdf

4) Racial Justice in the United States

The United States is in crisis. Citizens are also examining the opportunities to rethink and redesign their society.  As our partners at Humanity United and Vital Voices analyze how to improve racial justice within their institutions, they called on us at STRATEGIES! to help think through solutions and facilitate discussions. Our unique African perspective contributes to globalizing perspectives on racial justice. It is extremely exciting to be part of this discussion.

                                                  

5) Police Reform in Africa

As racial justice is top on the global agenda, so is police reform.  Throughout the world communities, cities and entire countries are discussing the role of the police.  STRATEGIES! was thrilled to be contacted by the GIZ program on Police Reform in Africa to help develop and facilitate their first online discussion session. 

            

 

 

6) Macro Trends in the Great Lakes Region

The International Conference of the Great Lakes Region (ICGLR) has been a privileged partner at STRATEGIES! for over 12 years.  STRATEGIES! facilitated the development of the ICGLR mission, vision and strategic framework years ago and we have facilitated planning sessions at various levels over the years. To strengthen evidence-based planning at the ICGLR, STRATEGIES developed a macro-trends tool in 2015 which gives an overview of the key security, economic and humanitarian statistics in the region yearly. 1/3 Africans lives in the Great Lakes Region.  As the region faces COVID-19, it is more important than ever, to analyze the macro-trends.

 

7) Planning with Farmers at the Continental Level

The Pan-African Farmers’ Organization is a long-time partner.  It was great to renew with them this year as STRATEGIES! facilitated the development of the African Agribusiness Youth Strategy for the African Union.  This week PAFO engaged discussions with us about its own strategic planning.  PAFO represents 70-80 million farmers in Africa with farmer’s dozens if organizations at national level, 5 regional levels and the continental level.  We are still in preliminary discussions, but it would be an honor to support the planning process of this essential continental organization.

           

 

8) Engaging Men as Allies for Women’s Political Participation

Gender equality is part of the DNA of STRATEGIES! and we continuously look forward to projects that enable us to work in this domain.  This week we were thrilled to develop a bid for an offer on “Engaging Men as Allies for Women’s Political Participation”.  Will STRATEGIES! win the bid?  Remains to be seen.  However, we have truly enjoyed developing our offer and it has rekindled our commitment to this value. Fingers crossed!

                                    

 

9) Fighting Gender-Based Violence in the Great Lakes Region

The Regional Training Facility of the ICGLR is based in Uganda and trains police, medical and judicial staff from ICGLR’s 12 Member States on how to fight against Sexual and Gender-Based Violence using national institutions and instruments that have been agreed upon at the ICGLR regional level.  It is always a delight to exchange with the results-focused RTF team.  Despite COVID-19, they are carrying out studies and training sessions. We discussed how STRATEGIES! can support them to strengthen their online training sessions.  It will be a pleasure as usual.

      

 

10) Writing the STRATEGIES! Story

It is 2020 and @Strategies is 25 years old!  We are preparing for celebration.  One of the things that will mark this celebration is the writing of our story.  Today began the first session of the collective writing of the book. A session full of laughter, memories and lessons. It’s going to be great!

 

By Kah Walla, CEO of STRATEGIES! Consulting Firm

STRATEGIES ! accompagne STAND UP FOR CAMEROON dans l’élaboration d’un plan de lutte communal Contre COVID-19

Dans le cadre de la lutte contre le COVID-19, STRATEGIES ! a accompagné le mouvement STAND UP FOR CAMEROON dans la conception et l’élaboration d’un plan de lutte communal. 

Ce plan communal est un outil permettant aux communes d’avoir une vue d’ensemble dans la réponse au COVID-19. L’outil comprend une approche globale et une stratégie avec les quatre rubriques clés de: 

  • Coordination
  • Prévention
  • Prise en Charge
  • Sécurité

 A la fin du plan de lutte communale sont des étapes clés sur 10 jours qui permette à une commune de démarrer l’implémentation de sa lutte contre le COVID-19. 

Le cabinet STRATEGIES! a mis son expertise en matière de décentralisation à la disposition de STAND UP FOR CAMEROON  dans le cadre d’un groupe de travail comprenant chercheurs, médecins, économistes et gestionnaires pour développer ce plan communal qui est mis à la disposition du public gracieusement. 

Téléchargez le Plan Communal ici

STRATEGIES ! a plus de 22 ans d’expérience dans la planification communale, la gestion participative au niveau local, le développement économique local, la communication interne et externe d’une commune, etc. .

Face à cette crise mondiale, STRATEGIES! se tient prêt à accompagner les municipalités, gouvernements locaux et leurs partenaires dans la recherche et la mise en œuvre des solutions efficaces pour lutter contre COVID-19 dans les communes. 

STRATEGIES! Supports STAND UP FOR CAMEROON in the development of a municipal plan to fight COVID-19

Communal Approach Cameroon to Fight Against COVID 19

As part of the fight against COVID-19, STRATEGIES! supported the STAND UP FOR CAMEROON movement in the design and development of a municipal plan to fight against the virus. This plan is a tool which gives municipalities the ability to build a complete response to COVID-19. The tool includes a global approach and a strategy with the four key aspects:

  • Coordination
  • Prevention
  • Care
  • Security

The final part of the municipal plan includes key steps which will enable a city council to begin implementation of its fight against COVID-19 within 10 days.

STRATEGIES! made its expertise in decentralization available to STAND UP FOR CAMEROON in the framework of a working group including researchers, doctors, economists and managers to develop this municipal plan which is made available to the public free of charge.  Click here to download the plan

STRATEGIES! has over 22 years of experience in municipal planning, participatory management at local level, local economic development, internal and external communication of a municipality, etc.

In the face of this global crisis, STRATEGIES! stands ready to support municipalities, local governments and their partners in the search and implementation of effective solutions to fight COVID-19 at the local level.