Strengthening health systems in Africa: The COVID-19 pandemic fallout

Abstract

This narrative review aims to highlight the shift in the paradigm of strengthening health systems in the African setting since the onset of the coronavirus disease-19 (COVID-19) pandemic. Strengthening health systems involves upgrading a country’s health-care system through increased funding for health infrastructure, health policy improvement, and universal health coverage (UHC). Inadequate funding for health infrastructure, erratic health policy, and the inability to meet UHC targets have contributed to high mortality rates among the continent’s vulnerable groups. The COVID-19 pandemic has further exposed the weak health systems in many African countries, especially in sub-Saharan Africa. Before the pandemic in Africa, the African health context’s challenges essentially comprised weak health systems, weak governance and accountability, high rates of out-of-pocket expenditures, adverse social determinants of health, and non-harmonization of health aid and health service delivery. During the pandemic, a significant shift in the paradigm of strengthening health systems has occurred, with emphasis on increased funding for health infrastructure, which targets the following: Improvement of health infrastructure, the motivation of the health workforce, and improvement in laboratory facilities. It is hoped that the fallout from strengthening health systems in Africa after the pandemic can be sustained by a continental peer-review mechanism to monitor compliance with increased funding for the health sector among member nations. In the post-pandemic period, further gains in strengthening the health systems can be achieved by improving UHC (through increased funding for health insurance), constant capacity training for health care workers in critical care medicine, and institutionalization of hand hygiene.