Public willingness to adhere to COVID-19 precautionary measures in Sudan: an application of the Health Belief Model

INTRODUCTION: coronavirus disease (COVID-19) is a highly infectious disease caused by the novel coronavirus (SARS-CoV-2). Several public health and social protective measures that may prevent or slow down the transmission of COVID-19 were introduced. However, these measures are unfortunately being neglected or deliberately ignored by some individuals. METHODS: a cross sectional online based survey was conducted to identify possible factors influencing public willingness to adhere to precautionary measures and preventive guidelines against COVID-19 during the lockdown periods in Sudan. The questionnaire was used to collect socio-demographic data of study participants, their health beliefs and willingness regarding adherence to precautionary measures against COVID-19 based on the constructs of the Health Belief Model. RESULTS: a total of 680 respondents completed and returned the online questionnaire. Significant predictors of the willingness to adhere to the precautionary measures against COVID-19 were gender (β= 3.34, P<0.001), self-efficacy (β= 0.476, P<0.001), perceived benefits (β= 0.349, P<0.001) and perceived severity (β= 0.113, P=0.005). These factors explained 43% of the variance in respondents' willingness to adhere to COVID-19 precautionary measures. Participants who were female, confident in their ability to adhere to the protective measures when available, believing in the benefits of the protective measures against COVID-19 and perceiving that the disease could have serious consequences were more likely to be willing to adhere to the protective measures. CONCLUSION: female respondents and respondents having higher self-efficacy, higher perceived benefits and higher perceived severity were more likely to be willing to adhere to the protective measures against COVID-19 in Sudan

Exploring Challenges to COVID-19 Vaccination in the Darfur Region of Sudan.

The current COVID-19 pandemic has affected the ability of health systems to provide essential services globally. The Darfur region, located in the western part of Sudan, has been largely devastated by the war that began in 2003 and has been drawing considerable attention from the international community. The war, which erupted as a result of environmental, political, and economic factors, has led to tragic outcomes. Collapsing health-care infrastructures, health workforce shortages, lack of storage facilities for medicines and medical products, and inadequate access to health services are some of the effects of the war. After Sudan received the AstraZeneca COVID-19 vaccine through the COVID-19 Vaccines Global Access facility, significant challenges have been implicated in the delivery, storage, and use of the vaccine in the Darfur region. Lack of vaccine storage and transportation facilities, vaccination hesitancy, inequity in the distribution to health facilities, and shortage of health-care professionals resulting from insecurity and instability have added an extra layer of burden on local authorities and their ability to manage COVID-19 vaccinations in the region adequately. Addressing the impact of COVID-19 requires an effectively managed vaccination program. In the face of current challenges in Darfur, ensuring a fully vaccinated population might remain far-fetched and improbable if meaningful efforts are not put in place by all stakeholders and actors to address some of the challenges identified

National health systems strengthening as the primary strategy to achieve Universal Health Coverage in African countries

Africa is the second largest continent and has its socioeconomic and health peculiarities. Countries are faced with varying challenges towards its Universal Health Coverage (UHC) achievement and hence the region requires health system reforms to drive equitable and balanced medical services to its populace. The main objectives of the paper were to explore the complexities of the African health systems, subsequently highlighting major challenges to UHC and to provide a framework for strategic approaches to health system strengthening to ensure realization of UHC. Information presented in this paper was collected from published literature and reports on Rwanda, Kenya, Nigeria, Tanzania, Ghana, Tunisia, Democratic Republic of Congo, Zambia, Egypt and South Africa, amidst other African countries. The published literature points to the presence of a somewhat slow progress towards UHC or at least an existent knowledge of it. However, common challenges faced can be grouped into 1) Financial constraints which include low levels of government expenditure on health and increased out-of-pocket percentages, (2) Lack of coverage of key services which includes majorly immunization rates and existence of health insurance for citizens, (3) Input constraints ranging from drug availability to skilled healthcare workforce, information and research and (4) Lack of political support and commitment&nbsp;towards universal health coverage. To overcome the above-stated constraints, two broad groups of interventions were identified; General interventions largely focusing on reprioritization of health budget, quality and improved services, equipped facilities and efficient social protection systems; and Specific interventions which emphasizes the importance of eliminating shortage of health workers, ensuring availability of essential medicines/ products, embracing decentralization at supply chain management, validating data/ information system and advocacy for impactful health education/promotion. Although there will be strength and weakness for whatever reforms adopted, implementation is totally contextual and contingent upon countries' specific health system bottlenecks. Sources of Funding None Conflicts of Interest The authors declare no conflict of interest Acknowledgement We would like to thank Dr. AugustinoTing Mayai for assistance and mentorshi

National health systems strengthening as the primary strategy to achieve Universal Health Coverage in African countries

Africa is the second largest continent and has its socioeconomic and health peculiarities. Countries are faced with varying challenges towards its Universal Health Coverage (UHC) achievement and hence the region requires health system reforms to drive equitable and balanced medical services to its populace. The main objectives of the paper were to explore the complexities of the African health systems, subsequently highlighting major challenges to UHC and to provide a framework for strategic approaches to health system strengthening to ensure realization of UHC. Information presented in this paper was collected from published literature and reports on Rwanda, Kenya, Nigeria, Tanzania, Ghana, Tunisia, Democratic Republic of Congo, Zambia, Egypt and South Africa, amidst other African countries. The published literature points to the presence of a somewhat slow progress towards UHC or at least an existent knowledge of it. However, common challenges faced can be grouped into 1) Financial constraints which include low levels of government expenditure on health and increased out-of-pocket percentages, (2) Lack of coverage of key services which includes majorly immunization rates and existence of health insurance for citizens, (3) Input constraints ranging from drug availability to skilled healthcare workforce, information and research and (4) Lack of political support and commitment&nbsp;towards universal health coverage. To overcome the above-stated constraints, two broad groups of interventions were identified; General interventions largely focusing on reprioritization of health budget, quality and improved services, equipped facilities and efficient social protection systems; and Specific interventions which emphasizes the importance of eliminating shortage of health workers, ensuring availability of essential medicines/ products, embracing decentralization at supply chain management, validating data/ information system and advocacy for impactful health education/promotion. Although there will be strength and weakness for whatever reforms adopted, implementation is totally contextual and contingent upon countries' specific health system bottlenecks. &nbsp; Sources of Funding None &nbsp; Conflicts of Interest The authors declare no conflict of interest &nbsp; Acknowledgement We would like to thank Dr. AugustinoTing Mayai for assistance and mentorshi

The formidable task of fighting COVID-19 in Sudan

Sudan is facing a formidable task of fighting COVID-19. The country is suddenly challenged by this health issue that will test its path towards peace, stability, and development. The fragile task of handling COVID-19 epidemic in Sudan is brought about by several factors such as the weak healthcare system and political conflicts, that have been intertwined with the recent regime. Even before the COVID-19 pandemic, there was already high unemployment, soaring inflation and lack of social protection and safety nets for its populace. The government has been trying its best to address the pandemic, however, much still needs to be done. Neglecting Sudan by the international community in terms of support towards containment of COVID-19 has grievous implications for transition out of military dictatorship and efforts to curb the pandemic globally. As no country is safe if all is not safe. It is essential that Sudan should leverage on innovations, country-compatible measures, and other tailor-made strategies for effective responses

Addressing language inequities in global health science scholarly publishing

No abstract available

The challenge of dearth of information in Tanzania’s COVID-19 response

No abstract available

Willingness to vaccinate against COVID-19 among healthcare workers: an online survey in 10 countries in the eastern Mediterranean region

BACKGROUND: Willingness of healthcare workers to be vaccinated is an important factor to be considered for a successful COVID-19 vaccination programme. This study aims to understand the willingness of health workers to receive a COVID-19 vaccine and its associated concerns across 10 countries in the Eastern Mediterranean Region (EMR). METHOD: A cross-sectional study was conducted in January 2021 among healthcare workers in EMR using an online survey. Data were analyzed using IBM SPSS software package version 20.0. RESULTS: A total of 2806 health workers (physicians, nurses and pharmacists) completed and returned the informed consent along with the questionnaire electronically. More than half of the respondents (58.0%) were willing to receive a COVID-19 vaccine, even if the vaccination is not mandatory for them. On the other hand, 25.7% of respondents were not willing to take COVID-19 vaccine while 16.3 % were undecided. The top three reasons for not willing to be vaccinated were unreliability of COVID-19 vaccine clinical trials (62.0%), fear of the side effects of the vaccine (45.3%), and that COVID-19 vaccine will not give immunity for a long period of time (23.1%). CONCLUSION: Overall, the study revealed suboptimal acceptance of COVID-19 vaccine among the respondents in the EMR. Significant refusal of COVID-19 vaccine among healthcare professionals can reverse hard-won progress in building public trust in vaccination program. The findings suggest the need to develop tailored strategies to address concerns identified in the study in order to ensure optimal vaccine acceptance among healthcare workers in the EMR

Drug shortage crisis in Sudan in times of COVID-19

Sudan is witnessing severe drugs, medicines, and medical supplies shortages, which present a major impediment to the provision of emergency healthcare services. Drug insecurity in Sudan is as a result of several accumulated factors, primarily due to worsening economic condition, inappropriate pricing policy, privatization of the pharmaceutical sector, poor manufacturing and weak weak weregulatory system. These could threaten patient health through replacement of highly efficacious medicines with less effective alternatives and by impacting the scheduling of urgent medical operations and procedures. Drug and medicine shortages are of catastrophic impact especially amid the current epidemic of COVID-19 where these are salient needs. Efforts should be quickly directed to ensure immediate access to pharmaceutical products and other essential health commodities. Effective policies on drug importation, production, pricing, and distribution should be established to avoid the consequences of an impending crisis

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely