Postnatal care services availability and utilization during the COVID-19 era in sub-Saharan Africa: A rapid review.

BACKGROUND: Considerable progress has been made globally in improving maternal and newborn babies' health. The COVID-19 pandemic has posed considerable challenges for countries to maintain the provision of high-quality, essential maternal and newborn healthcare services. METHODS: A rapid review was carried out on 20 March 2022 on postnatal care (PNC) services availability and utilization during the COVID-19 era in sub-Saharan Africa. PubMed, Google Scholar, and Africa Journals Online (AJOL) databases were searched for relevant studies. Studies included in the review utilized both primary data and secondary data. FINDINGS: Nineteen studies met the inclusion criteria. The review revealed that there were significant declines in the availability and utilization of PNC services during and after the COVID-19 lockdown. Several reasons were found to contribute to the decline. DISCUSSION: New, innovative strategies are therefore required to ensure that mothers and their newborn babies receive essential PNC to reduce maternal and neonatal morbidity and mortality in sub-Saharan Africa. Some of the strategies that can be used include home-based PNC visits, the use of telemedicine, phone-based referral networks, social media, and community radios.

Commercial sexual exploitation of children in Zimbabwe: A threat to human and social development

Commercial sexual exploitation of children (CSEC) in child sex work is reportedly rising in Zimbabwe. While children of both sexes are affected, more females than males are forced to engage in sexual acts in exchange for money, food, access to shelter, education or some other gains from adults who control these means of survival and commodities. Drivers of CSEC include socioeconomic factors, negative peer pressure, childhood abuse, the influence of uncensored social media, and, more recently, the economic impact of COVID‐19. Involvement in underage sex work exposes children to severe adversities, such as psychosocial and mental health disorders, physical and biological injuries, venereal diseases and HIV. CSEC is a growing concern for resource‐limited countries, disenfranchises children and robs particularly the girl child of a better future. The worsening socioeconomic landscape in Zimbabwe and the COVID‐19 pandemic have exacerbated the problem. Solving the problem of CSEC requires a multipronged approach that involves stakeholders from several sectors, including public health, education, social services, security and the legal fraternity. There is a need to empower communities, empower civil society and development partners, enhance legal frameworks, provide messaging, education and vocational training, as well as rehabilitative services for affected children and their families. CSEC is a violation of the child's rights and a public health concern that needs to be addressed as a matter of urgency to preserve the next generation's human capital necessary for the sustainable development of Zimbabwe.

Commercial sexual exploitation of children in zimbabwe: A threat to human and social development

Commercial sexual exploitation of children (CSEC) in child sex work is reportedly rising in Zimbabwe. While children of both sexes are affected, more females than males are forced to engage in sexual acts in exchange for money, food, access to shelter, education or some other gains from adults who control these means of survival and commodities. Drivers of CSEC include socioeconomic factors, negative peer pressure, childhood abuse, the influence of uncensored social media, and, more recently, the economic impact of COVID-19. Involvement in underage sex work exposes children to severe adversities, such as psychosocial and mental health disorders, physical and biological injuries, venereal diseases and HIV. CSEC is a growing concern for resource-limited countries, disenfranchises children and robs particularly the girl child of a better future. The worsening socioeconomic landscape in Zimbabwe and the COVID-19 pandemic have exacerbated the problem. Solving the problem of CSEC requires a multipronged approach that involves stakeholders from several sectors, including public health, education, social services, security and the legal fraternity. There is a need to empower communities, empower civil society and development partners, enhance legal frameworks, provide messaging, education and vocational training, as well as rehabilitative services for affected children and their families. CSEC is a violation of the child's rights and a public health concern that needs to be addressed as a matter of urgency to preserve the next generation's human capital necessary for the sustainable development of Zimbabwe. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Accessibility and utilization of antenatal care services in sub-Saharan Africa during the COVID-19 pandemic: A rapid review.

Control measures for the COVID-19 pandemic brought unprecedented challenges to health care delivery. Some countries in sub-Saharan Africa (SSA) stopped the provision of essential health care except for those services that were deemed emergencies or life-threatening. A rapid review was conducted on March 18, 2022, on the accessibility and utilization of antenatal care services in sub-Saharan Africa during the COVID-19 pandemic. PubMed, Google Scholar, SCOPUS, and the World Health Organization library databases were searched for relevant studies. A modified Population, Intervention, Control, and Outcomes (PICO) framework informed the development of the search strategy. The review included studies conducted within Africa that described the availability, access, and utilization of antenatal services during the COVID-19 pandemic. Eighteen studies met the inclusion criteria. This review revealed a reduction in access to ANC services, an increase in the number of home deliveries, and a reduction in the number of women attending ANC visits during the COVID-19 pandemic. A decrease in ANC service utilization was reported in some studies in the review. Barriers to ANC access and utilization during the COVID-19 pandemic included movement restrictions, limited transport access, fear of contracting COVID-19 at the health facilities, and facility barriers. The use of telemedicine needs to be improved in African countries to allow for the continued provision of health services during pandemics. In addition, there should strengthening of community involvement in the provision of maternal health services post-COVID-19 so that services may be able to better withstand future public health emergencies.

Cervical cancer in sub-Saharan Africa: an urgent call for improving accessibility and use of preventive services.

Sub-Saharan Africa has the highest rates of cervical cancer in the world, largely attributed to low cervical cancer screening coverage. Cervical cancer is the most common cause of death among women in 21 of the 48 countries in sub-Saharan Africa. Close to 100% of all cases of cervical cancer are attributable to Human papillomavirus (HPV). HPV types 16 and 18 cause at least 70% of all cervical cancers globally, while types 31, 33, 45, 52, and 58 cause a further 20% of the cases. Women living with HIV are six times more likely to develop cervical cancer than those without HIV. Considering that sub-Saharan Africa carries the greatest burden of cervical cancer, ways to increase accessibility and use of preventive services are urgently required. With this review, we discuss the preventive measures required to reduce the burden of cervical cancer in sub-Saharan Africa, the challenges to improving accessibility and use of the preventive services, and the recommendations to address these challenges.

Commercial sexual exploitation of children in Zimbabwe: A threat to human and social development

Commercial sexual exploitation of children (CSEC) in child sex work is reportedly rising in Zimbabwe. While children of both sexes are affected, more females than males are forced to engage in sexual acts in exchange for money, food, access to shelter, education or some other gains from adults who control these means of survival and commodities. Drivers of CSEC include socioeconomic factors, negative peer pressure, childhood abuse, the influence of uncensored social media, and, more recently, the economic impact of COVID‐19. Involvement in underage sex work exposes children to severe adversities, such as psychosocial and mental health disorders, physical and biological injuries, venereal diseases and HIV. CSEC is a growing concern for resource‐limited countries, disenfranchises children and robs particularly the girl child of a better future. The worsening socioeconomic landscape in Zimbabwe and the COVID‐19 pandemic have exacerbated the problem. Solving the problem of CSEC requires a multipronged approach that involves stakeholders from several sectors, including public health, education, social services, security and the legal fraternity. There is a need to empower communities, empower civil society and development partners, enhance legal frameworks, provide messaging, education and vocational training, as well as rehabilitative services for affected children and their families. CSEC is a violation of the child's rights and a public health concern that needs to be addressed as a matter of urgency to preserve the next generation's human capital necessary for the sustainable development of Zimbabwe. [ FROM AUTHOR]

The HIV epidemic and the COVID-19 pandemic: A double tragedy for sub-Saharan African women.

After four decades of the HIV epidemic, women from sub-Saharan Africa remain at a differentially high risk of acquisition. The Joint United Nations Programme on HIV and AIDS (UNAIDS) statistics show that the majority of HIV infections occur in this population and region. Evidence from previous humanitarian crises demonstrated adverse maternal consequences as a result of neglect for the provision of essential maternal, sexual and reproductive health services. The ongoing COVID-19 pandemic has had a similar effect, including an additional risk of HIV acquisition amongst women in sub-Saharan Africa. The COVID-19 pandemic has aggravated the risk of sub-Saharan Africa women to HIV infection because of a multitude of factors including child marriages, teenage pregnancies, dropping out of school, increase in incidence of sexual and gender-based violence and reduced access to preventive and treatment services for HIV and sexually transmitted infections. These include provision of care for rape and sexual and gender-based violence victims and provision of pre-exposure and postexposure prophylaxis for HIV and other STIs. Failure to urgently restore and maintain robust HIV prevention and treatment during the ongoing COVID-19 pandemic poses a risk of reversing the gains made over the years in reducing the incidence and morbidity from HIV amongst the population of sub-Saharan Africa women. There is need for an urgent and robust discourse to formulate effective interventions for protecting women and girls living in sub-Saharan Africa from an aggravated risk of HIV infection during the ongoing COVID-19 pandemic and other future humanitarian crises.

The role of social media during the COVID-19 pandemic: Salvaging its 'power' for positive social behaviour change in Africa.

The ongoing coronavirus disease 2019 (COVID-19) pandemic remains a significant global public health crisis. The unique evolution of the COVID-19 pandemic has seen social media emerging and growing into an important vehicle for rapid information dissemination. This has in turn given rise to multiple sources of information, leading to what has come to be known as 'infodemic', associated with the plethora of misinformation and conspiracy theories. In this perspective, we explore the growth of the social media industry and the impact it has had during the ongoing COVID-19 crisis. We argue that while the multiple information pieces circulating on social media cause misinformation and panic, this might not necessarily and in all the cases influence sustained behaviours in the target population groups. We offer suggestions on how the power of social media can be harnessed and integrated into social and public health for a better digital balance for communication for development.

COVID-19 Response in Zimbabwe: The Need for a Paradigm Shift?

Zimbabwe reported its first case of coronavirus disease 2019 (COVID-19) on 20 March 2020 and the country's response has largely adhered to international protocols. From the outset of the pandemic, most control measures were premised upon knowledge of breaking infectious diseases' chains of transmission gained from previous experiences with comparable pathogens. As relatively little was known about the novel virus, and the prospects of effective vaccines were not on the horizon, these tough control measures were deemed appropriate. Two years into the pandemic, a massive evolution of knowledge has transpired, and safe and effective vaccines against the virus are now available, are administered to billions of people, and can significantly reduce new infections, severe disease, hospitalisation, and death from the disease. Based on the understanding of the pandemic and the need to restore socio-economic activities, in this review we propose a paradigm shift in addressing the challenges of the COVID-19 pandemic. The COVID-19 response should take into consideration the local context and tailor-make a response that addresses local challenges.

Prevention and Control of Infectious Diseases: Lessons from COVID-19 Pandemic Response in Zimbabwe

The coronavirus disease (COVID-19) has exposed the unpreparedness of governments in their capacities to prevent, detect, and respond to emerging infectious diseases. Many healthcare systems have been overburdened and the coordinated efforts in different countries have focused on containment and mitigation, with varying degrees of success. A delay in the detection of and response to infectious diseases can lead to the overburdening of already challenged health systems. Containment strategies, such as social distancing, contact tracing, quarantining of exposed individuals and lockdowns, can help control the spread of the infection in communities. Still, long-term solutions should be sought to counter future outbreaks. In this paper, we focus on Zimbabwe to identify and discuss public health strategies that can result in an effective response to future infectious disease outbreaks. We consider potential solutions to facilitate early detection, control, and mitigation of any similar emerging infectious disease. We argue that sustained financial support in public health infrastructure, both locally and nationally, integrated surveillance response systems, and improved communication and research within and across public and private sectors can be instrumental in limiting the damage caused by future outbreaks.

Risk of mortality in HIV-infected COVID-19 patients: A systematic review and meta-analysis.

BACKGROUND: The relationship between HIV infection and COVID-19 clinical outcomes remains a significant public health research problem. We aimed to determine the association of HIV comorbidity with COVID-19 mortality. METHODS: We searched PubMed, Google Scholar and World Health Organization library databases for relevant studies. All searches were conducted from 1st to 7th December 2021. Title, abstract and full text screening was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The relative risk of mortality in HIV-infected COVID-19 patients was computed using a random-effects model. All analyses were performed using Meta and Metasens statistical packages available in R version 4.2.1 software package. The quality of included studies was assessed using the GRADE approach, Egger's test was employed to determine the risk of bias. RESULTS: A total of 16 studies were included in this review. Among the COVID-19 patients with HIV infection, the mortality rate due to COVID-19 was 7.97% (4 287/53,801), and among the COVID-19 patients without HIV infection, the mortality rate due to COVID-19 was 0.69% (127, 961/18, 513, 747). In the random effects model, we found no statistically significant relative risk of mortality in HIV-infected COVID-19 patients (RR 1.07, 95% CI 0.86-1.32). The between-studies heterogeneity was substantial (I2 = 91%, P < 0.01), while the risk of publication bias was not significant. CONCLUSION: Findings did not link HIV infection with an increased risk of COVID-19 mortality. Our results add to the conflicting data on the relationship between COVID-19 and HIV infection.

Risk Factors for COVID-19 Infection Among Healthcare Workers. A First Report From a Living Systematic Review and meta-Analysis.

Health care workers (HCWs) are more than ten times more likely to be infected with coronavirus infectious disease 2019 (COVID-19) than the general population, thus demonstrating the burden of COVID-19 among HCWs. Factors that expose HCWs to a differentially high-risk of COVID-19 acquisition are important to elucidate, enable appropriate public health interventions to mitigate against high risk and reduce adverse outcomes from the infection. We conducted a systematic review and meta-analysis to summarize and critically analyze the existing evidence on SARS-CoV-2 risk factors among HCWs. With no geographical limitation, we included studies, in any country, that reported (i) the PCR laboratory diagnosis of COVID-19 as an independent variable (ii) one or more COVID-19 risk factors among HCWs with risk estimates (relative risk, odds ratio, or hazard ratio) (iii) original, quantitative study design, and published in English or Mandarian. Our initial search resulted in 470 articles overall, however, only 10 studies met the inclusion criteria for this review. Out of the 10 studies included in the review, inadequate/lack of protective personal equipment, performing tracheal intubation, and gender were the most common risk factors of COVID-19. Based on the random effects adjusted pooled relative risk, HCWs who reported the use of protective personal equipment were 29% (95% CI: 16% to 41%) less likely to test positive for COVID-19. The study also revealed that HCWs who performed tracheal intubations were 34% (95% CI: 14% to 57%) more likely to test positive for COVID-19. Interestingly, this study showed that female HCWs are at 11% higher risk (RR 1.11 95% CI 1.01-1.21) of COVID-19 than their male counterparts. This article presents initial findings from a living systematic review and meta-analysis, therefore, did not yield many studies; however, it revealed a significant insight into better understanding COVID-19 risk factors among HCWs; insights important for devising preventive strategies that protect them from this infection. PROSPERO registration number: CRD42020193508 available for public comments via the link below https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020193508).

The COVID-19 Pandemic: Public Health Responses in Sub-Saharan Africa.

The World Health Organisation declared the ongoing COVID-19 global health challenge a pandemic in March 2020. Since then, countries across the globe have implemented different public health control strategies-including global vaccination programs-in attempts to mitigate the further transmission of severe acute respiratory syndrome coronavirus 2. However, to date, the virus has continued to spread rapidly despite these interventions. Countries across sub-Saharan Africa have implemented variable control strategies to combat the pandemic; however, despite the continent being among the least affected in terms of direct case burden, morbidity, and mortality, it has experienced marked socioeconomic disruption. Therefore, economic resuscitation is an urgent priority. The continent is vastly underrepresented in the body of scientific evidence due to limited research resources, testing capacity and genomic surveillance leading to empirical responses or responses guided by evidence from elsewhere. To inform the ongoing pandemic, and to prepare for the future, this Special Issue calls for manuscripts on global COVID-19 responses, and encourages researchers and stakeholders from resource-limited settings, particularly from sub-Saharan Africa, to share their COVID-19 public health responses. Areas to be covered include, but are not limited to, surveillance, case management, infection prevention and control, risk communication and community engagement, logistics, laboratory, ports of entry, and co-ordination. Manuscripts including primary research, viewpoints/perspectives, and comprehensive literature reviews are all welcome.

Emerging SARS-CoV-2 Variants, Inequitable Vaccine Distribution, and Implications for COVID-19 Control in Sub-Saharan Africa

Since the onset of the COVID-19 pandemic, four SARS-CoV-2 variants of concern have emerged, which have shifted the clinical and epidemiological characteristics of the disease. Of concern is the impact of the emerging variants on COVID-19 vaccination programmes, with vaccination perceived as a key global pandemic control strategy. Variants of concern can reduce the effectiveness of the currently available vaccines, shift herd immunity thresholds, and promote wider vaccine inequities as richer countries hoard vaccines for booster shots for their populations without accounting for the needs of the underdeveloped countries of sub-Saharan Africa. Currently, Africa lags far behind the rest of the world, with most sub-Saharan Africa countries still to reach 50% vaccination of their eligible populations against global herd immunity thresholds of 70–90%. As long as the vaccination gap between sub-Saharan Africa and the rest of the world persists, SARS-CoV-2 will most likely persist as a significant global health threat, with continued emergence of variants of concern. Therefore, strategies to ensure wider reach of different types of vaccines on the African continent are urgently required alongside fighting vaccine hesitancy and logistical barriers to access for the marginalized populations. Sub-Saharan Africa must look for opportunities to manufacture vaccines on the continent and enhance genomic sequencing capacity as key pandemic-control strategies.

Maternal, Sexual and Reproductive Health in Marginalised Areas: Renewing Community Involvement Strategies beyond the Worst of the COVID-19 Pandemic.

The COVID-19 pandemic and resultant lockdowns have brought unprecedented challenges for Maternal, Sexual and Reproductive Health (MSRH) services. Components of MSRH services adversely affected include antenatal, postnatal, and newborn care; provision of family planning and post-abortion care services; sexual and gender-based violence care and prevention; and care and treatment for sexually transmitted infections including HIV. Resuscitating, remodeling or inventing interventions to restore or maintain these essential services at the community level, as a gateway to higher care, is critical to mitigating short and long-term effects of the COVID-19 pandemic on essential MSRH. We propose a possible framework for community involvement and propose integrating key information, education, and communication of MSRH messages within COVID-19 messages.

Facilitating sexual and reproductive health services for adolescent girls in the COVID-19 era: An urgent public health priority.

No abstract available.