Students wash hands at school in Phalombe, Malawi, Oct. 13, 2020. The number of confirmed COVID-19 cases in the African continent has surpassed 2 million, the Africa Centers for Disease Control and Prevention (Africa CDC) said on Thursday. The latest figures from the continental disease control and prevention agency showed that a total of 2,013,388 cases were reported across the continent with the death toll related to the pandemic standing at 48,408 as of Thursday morning. (Photo by Joseph Mizere/Xinhua)

Recognizing the importance of handwashing in preventing the spread of COVID-19 in Africa, concerns have arisen about the condition of millions of Africans who lack access to hygiene facilities and clean water services.

Inequalities in the health sector have existed for many decades and have led to unjust consequences in morbidity and mortality in the continent. These have become even more apparent during the COVID-19 pandemic with individuals from black and minority ethnic groups, poorer socioeconomic backgrounds, urban and rurally deprived locations, and vulnerable groups of society suffering the full force of its effects.

Homeless people are among individuals who experience health consequences in the current COVID-19 pandemic. Their living arrangements whether formal (shelters or halfway houses) or informal (encampments or abandoned buildings) make them susceptible to worse health outcomes.

Various governments have developed policies to address health inequality and its social determinants. Academics and practitioners have given considerable attention to efforts aimed at improving overall population health and reducing the burden of diseases as well as eliminating health disparities based on socioeconomic status, race, geography, gender, and ethnicity. Despite significant efforts to address the socioeconomic issues that aggravate health inequalities, striking disparities in “health status still exists within and among countries”.

We cannot ignore the importance of making hygiene services accessible to vulnerable populations in sub-Saharan Africa. As the WHO-UNICEF data reveals, about 370 million Africans have no basic handwashing facility. In the Democratic Republic of Congo, over 68 million people, more than three-quarters of the country’s population, have no handwashing facilities.

The situation in Nigeria, an oil-rich country where nearly 50 million people have no handwashing facilities, is unspeakable. Health disparities in Nigeria affect the distribution of water and hygiene services among poor populations, which can lead to a disproportionate impact on public health outcomes during a pandemic outbreak such as COVID-19. Ethiopia is another country where the health disparity is appalling, as 43 million people have no handwashing facility.

Health systems strengthening should be everybody’s business. This cannot be left to the government alone. I would love to thank WHO for their continued support in providing policy, evidence, and guidelines during this pandemic.

The private sector needs to come on board in partnerships that can strengthen the health systems in the continent. Provision of handwashing stations, public education on COVID-19 awareness and prevention, training, and empowering community health workers to reduce the burden of the disease at the health facilities, keeping safe and social distancing, provision of accurate data to inform policy and action could go a long way.

The writer, Dr. Abdiqani Sheikh Omar is a Senior WASH Strategic Policy Advisor at the Ministry of Energy and Water in Somalia and Former Director General at Ministry of Health and Human Service, FGs.

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