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

<p><span><b>Introduction</b></span></p> <p><span>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.</span></p> <p><span><b>Methods</b></span></p> <p><span>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.</span></p> <p><span><b>Results</b></span></p> <p><span>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&lt;0.0001) while an increase in higher healthy life expectancy at birth increased the number of cases per million (p=0.0340).</span></p> <p><span><b>Conclusion</b></span></p> <p><span>Despite its limited resources, Africa's preparedness and response to the COVID-19 pandemic can be improved by identifying and addressing <i>specific</i> 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. </span></p>