Factors associated with COVID-19 infections and mortality in Africa: A cross-sectional study using publicly available data

Introduction The current COVID-19 pandemic is a global threat. This
elicits questions on the level of preparedness and capacity of health
systems to respond to emergencies. Relative to other parts of the world,
Africa has poorly developed health systems with limited capacity to
respond to health crises. Africa is particularly disadvantaged. Methods
This cross-sectional study uses publicly available core health data for 53
African countries, to determine risk factors for cumulative COVID-19
deaths and cases per million in all countries in the continent.
Descriptive statistics were determined for the indicators and a negative
binomial regression was used for modelling the risk factors. Results In
Sub-Saharan Africa, an increase in the number of nursing and midwifery
personnel decreased the risk of COVID-19 deaths (p=0.0178) while a unit
increase in UHC index of service coverage and prevalence of insufficient
physical activity among adults increased the risk of COVID-19 deaths
(p=0.0432 and p=0.0127). An increase in the proportion of infants
initiating breastfeeding reduced the number of cases per million
(p<0.0001) while an increase in higher healthy life expectancy at
birth increased the number of cases per million (p=0.0340). Conclusion
Despite its limited resources, Africa’s preparedness and response to the
COVID-19 pandemic can be improved by identifying and addressing specific
gaps in the funding of health services delivery. These gaps impact
negatively on service delivery but appear to have received limited funding
and policy priority.