The role of health service delivery networks in achieving universal health coverage in Africa

Most countries in Africa are faced with health system problems that vary from one to the next. Countries with a low Human Development Index (HDI) seem to be more prone to challenges in health service delivery. To mark its 70th anniversary on World Health Day, the World Health Organization (WHO) selected the theme “Universal Health Coverage (UHC): Everyone, Everywhere” and the slogan “Health for All. ”UHC refers to ensuring that all people have access to needed health services (including prevention, promotion, treatment, rehabilitation, and palliation) of sufficient quality to be effective while also ensuring that the use of these services does not expose the user to financial hardship. UHC is a WHO’s priority objective. Most governments have made it their major goal. This paper provides a perspective on the challenges of achieving UHC in Sub-Saharan Africa (SSA). It also endeavors to spotlight the successful models of Health Service Delivery Networks (HSDNs) that make significant strides in making progress towards achieving UHC. HSDNs propose models that facilitate the attainment of affordability and accessibility while maintaining quality in delivering health services. Additionally, it brings up to speed the challenges associated with setting up HSDNs in health systems in SSA. It then makes propositions of what measures and strategic approaches should be implemented to strengthen HSDNs in SSA. This paper further argues that UHC is not only technically feasible but it is also attainable if countries embrace HSDNs in SSA

The role of health service delivery networks in achieving universal health coverage in Africa

Most countries in Africa are faced with health system problems that vary from one to the next. Countries with a low Human Development Index (HDI) seem to be more prone to challenges in health service delivery. To mark its 70th anniversary on World Health Day, the World Health Organization (WHO) selected the theme “Universal Health Coverage (UHC): Everyone, Everywhere” and the slogan “Health for All. ”UHC refers to ensuring that all people have access to needed health services (including prevention, promotion, treatment, rehabilitation, and palliation) of sufficient quality to be effective while also ensuring that the use of these services does not expose the user to financial hardship. UHC is a WHO’s priority objective. Most governments have made it their major goal. This paper provides a perspective on the challenges of achieving UHC in Sub-Saharan Africa (SSA). It also endeavors to spotlight the successful models of Health Service Delivery Networks (HSDNs) that make significant strides in making progress towards achieving UHC. HSDNs propose models that facilitate the attainment of affordability and accessibility while maintaining quality in delivering health services. Additionally, it brings up to speed the challenges associated with setting up HSDNs in health systems in SSA. It then makes propositions of what measures and strategic approaches should be implemented to strengthen HSDNs in SSA. This paper further argues that UHC is not only technically feasible but it is also attainable if countries embrace HSDNs in SSA

Psychosocial Factors of Stigma and Relationship to Healthcare Service among Adolescents Living With HIV/AIDS in Kano State, Nigeria

Background Stigma associated with HIV shapes all aspect of prevention and treatment, yet there are limited data on how HIV-infected adolescents are affected by stigma. Stigma increases risk of psychological problems among HIV-infected individuals which can affect access to treatment and social support services. This study is aimed at identifying psychosocial factors of stigma and relationship to healthcare services among adolescents on antiretroviral therapy (ART) in Gwale Local Government Area (LGA) of Kano state, Nigeria. Methods A facility based cross-sectional survey was carried out from January 26 to February 28, 2020 across six health facilities providing ART service in Gwale local government. A structured interviewer-administered questionnaire was used to collect the data. ART clients attending clinics were interviewed following an informed verbal consent. Descriptive statistics was used to summarize the data and results are presented using simple frequency tables and percentages. Upon completion of univariate analysis, the data was analyzed at the bivariate level using chi-square test to determine associations between different variables. Results One hundred and eight (108) clients voluntarily participated in the study of which 54 (50%) are male respondents and 54 (50%) are female respondents. Under the internalized stigma item, 67% of HIV-infected adolescents who have lost father or mother to AIDS reported feeling less valuable than other children who are not infected with HIV. Under the perceived stigma items, 86% of participants who have lost father or mother to AIDS reported to have excluded themselves from health services and social activities in the last twelve months due to fear of being insulted. Under the experienced stigma items, 62% of participants who have lost father or mother to AIDS reported to have been avoided by friends and colleagues in the last twelve months. Conclusion The study revealed that loss of intimate relation (father or mother) to AIDS and equal treatment with other HIV negative siblings were found to be significantly associated with the three forms of stigma (internalized stigma, perceived stigma and experienced stigma) including access to healthcare services. There is need for social and psychological support programs among HIV-infected adolescents

Psychosocial factors of stigma and relationship to healthcare services among adolescents living with HIV/AIDS in Kano state, Nigeria.

BACKGROUND: Stigma associated with HIV shapes all aspect of prevention and treatment, yet there are limited data on how HIV-infected adolescents are affected by stigma. Stigma increases risk of psychological problems among HIV-infected individuals which can affect access to treatment and social support services. This study aimed at identifying psychosocial factors of stigma and relationship to healthcare services among adolescents on antiretroviral therapy (ART) in Gwale Local Government Area (LGA) of Kano state, Nigeria. METHODS: A facility-based cross-sectional survey was carried out from January 26 to February 28, 2020 across six health facilities providing ART service in Gwale local government. A structured interviewer-administered questionnaire was used to collect the data. ART clients attending clinics were interviewed following an informed consent. Descriptive statistics was used to summarize the data and results are presented using simple frequency tables and percentages. Upon completion of univariate analysis, the data was analyzed at the bivariate level using chi-square test to determine associations between different variables. RESULTS: One hundred and eight (108) clients voluntarily participated in the study of which 54 (50%) are male respondents and 54 (50%) are female respondents. Under the internalized stigma item, 67% of HIV-infected adolescents who have lost their father or mother to AIDS reported feeling less valuable than other children who are not infected with HIV. Under the perceived stigma items, 86% of participants who have lost their father or mother to AIDS reported to have excluded themselves from health services and social activities in the last twelve months due to fear of being insulted. Under the experienced stigma items, 62% of participants who have lost their father or mother to AIDS reported to have been avoided by friends and colleagues in the last twelve months. CONCLUSION: The study revealed that loss of intimate relation (father or mother) to AIDS and equal treatment with other HIV negative siblings were found to be significantly associated with the three forms of stigma (internalized stigma, perceived stigma, and experienced stigma) including access to healthcare services. There is a need for social and psychological support programs among HIV-infected adolescents

COVID-19 and antimicrobial resistance: a review

As the world continues to respond to the coronavirus pandemic (COVID-19), there is a larger hidden threat of antimicrobial resistance (AMR) lurking behind. AMR remains worrisome in that the pathogens causing resistant infections to thrive in hospitals and medical facilities, putting all patients at risk, irrespective of the severity of their medical conditions, further compounding the management of COVID-19. This study aims to provide overview of early findings on COVID-19 and AMR as well as to provide recommendations and lesson learned toward improving antimicrobial stewardship. We conducted a rapid narrative review of published articles by searching PubMed and Google Scholar on COVID-19 and Antimicrobial Resistance with predetermined keywords. Secondary bacterial infections play crucial roles in mortality and morbidity associated with COVID-19. Research has shown that a minority of COVID-19 patients need antibiotics to treat secondary bacterial infections. Current evidence reiterates the need not to give antibiotic therapy or prophylaxis to patients with mild COVID-19 or to patients with suspected or confirmed moderate COVID-19 illness unless it is indicated. The pandemic has also brought to the fore the deficiencies in health systems around the world. This comes with a lot of lessons, one of which is that despite the advances in medicine; we remain incredibly vulnerable to infections with limited or no standard therapies. This is worth thinking in the context of AMR, as the resistant pathogens are evolving and leading us to the era of untreatable infections. There is a necessity for continuous research into understanding and controlling infectious agents, as well as the development of newer functional antimicrobials and the need to strengthen the antimicrobial stewardship programs

Towards 90-90-90 Target: COVID-19 and HIV Response in Africa

As cases of the novel coronavirus disease (COVID-19) continue to rise, so are the concerns of the effects this pandemic could have on people living with HIV. In response to the pandemic, measures have been put in place by African governments to limit the spread of the virus. We examine the impact of these measures on ensuring progress towards the HIV advocacy of "90-90-90" by 2020, i.e., 90% of all people living with HIV will know their status, 90% of people diagnosed will receive sustained antiretroviral therapy (ART), and 90% of people receiving ART will have viral suppression all by the end of 2020. COVID-19 arrival on the continent and measures implemented have a significant effect on the control of HIV epidemic and the achievement of the 90-90-90 goals. It is therefore essential that African health stakeholders continue to advance efforts to ensure access to HIV care services is sustained during this COVID-19 pandemic

Towards a post‐COVID world: Challenges and progress of recovery in Kazakhstan

Abstract Kazakhstan announced the first cases of COVID‐19 in March 2020. Within a span of a few months, the pandemic ravaged all regions affecting vulnerable populations due to limited access to healthcare services and co‐morbidities. To minimize the spread of the pandemic, the government announced the implementation of containment measures such as quarantine, movement restrictions, and lockdowns among others. The collateral effect of the pandemic has disrupted economic and learning activities pushing several people below the poverty line. The pandemic revealed the weakness of healthcare including the acute shortage of essential medicines and lack of hospital beds. This calls for stringent measures to revive the economy and mitigate the reeling effect of the pandemic. As a result, Kazakhstan commenced COVID‐19 vaccination efforts in February 2021. To date, about 47.8% are fully vaccinated pushing Kazakhstan closer to achieving herd immunity at the 60% threshold. However, the country faces challenges such as vaccine hesitancy and uncertainty surrounding vaccine effectiveness against new variants of SARS‐CoV2, among others. This paper aims to explore the health and socioeconomic challenges caused by COVID‐19 in Kazakhstan, control strategies, vaccination campaigns and progress towards herd immunity

Road to achieving COVID‐19 herd immunity in Niger Republic: Challenges and recommendations

Abstract COVID‐19 pandemic has had tremendous impact on countries across the world and Niger Republic is not left out of the ravaging impact of the virus. The rapid dissemination of the virus across the globe has led to the development of safe and efficacious vaccines at an unprecedented level. While Niger Republic has prioritized COVID‐19 vaccination in line with the global plan to attain herd immunity by vaccinating 70% of world's population, the country has continued to struggle to expand coverage of its population. Niger Republic is faced with challenges such as conflict, COVID‐19 vaccine hesitancy, poor COVID‐19 vaccine demand and inefficient information system, consequently leading to low COVID‐19 vaccine demand and uptake. These challenges coupled with the different wave of the pandemic, the latest largely driven by the Omicron variant has slowed down progress towards achieving herd immunity in Niger Republic. There is need for the Nigerien government to scale up vaccination drive as well as implement refined approaches towards achieving the country's herd immunity target. This paper aimed to discuss the current state of COVID‐19 vaccination including efforts and challenges towards achieving herd immunity in Niger Republic, thus informing strategies to ramp up COVID‐19 vaccination in the country

COVID-19 in a shattered health system: Case of Libya

No abstract available

COVID‐19 and progress towards achieving universal health coverage in Africa: a case of Nigeria

Universal Health Coverage (UHC) 2030 is a global health target, and countries are making efforts to convert plans into tangible results. Nigeria, the most populated country in Africa, has made commitments towards UHC2030 target but is underperforming across many building blocks of health and progress has been slow. The arrival of COVID-19 poses additional pressure on the already feeble health system causing the government to direct focus towards containing the pandemic. However, existing gaps in health workforce density, weak primary health care infrastructure and inadequate budgetary allocation have resulted in inequitable access to basic healthcare services. This situation weighs most heavily on the poor who are mostly part of the informal economy thereby pushing people further into poverty. On the other hand, COVID-19 has provided valuable insights into Nigeria's current health system status which hopefully can be helpful in strengthening efforts towards building resilient health system and preparing the country towards future pandemic. The pandemic has highlighted the importance of essential health services and the need to strengthen primary healthcare system. It is, therefore, important that stakeholders in Nigeria and other African countries carry out situation analysis of the current health systems towards achieving UHC2030