Individual and community-level factors associated with repeat induced abortion among women in Ghana: a multivariable complex sample logistic regression analysis of 2017 Ghana maternal health survey.

BACKGROUND: Repeat induced abortion is a serious public health issue that has been linked to adverse maternal health outcomes. However, knowledge about repeat induced abortion and its associated factors among reproductive age women in Ghana is very scarce. The objective of this study is to examine individual and community factors associated with repeat induced abortion in Ghana which would be helpful to design appropriate programmes and policies targeted at improving the sexual and reproductive health of women. METHODS: We used secondary cross-sectional data from the 2017 Ghana Maternal Health Survey. The study included a weighted sample of 4917 women aged 15-49 years with a history of induced abortion. A multivariable complex sample logistic regression analysis was used to investigate individual and community factors associated with repeat induced abortion among women in Ghana. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) was used to measure the association of variables. RESULTS: Of the 4917 reproductive women with a history of abortion, 34.7% have repeat induced abortion. We find that, compared to women who experience single induced abortion, women who experience repeat abortion are age 25-34 years (AOR:2.16;95%CI = 1.66-2.79) or 35-49 years (AOR:2.95;95%CI:2.18-3.99), have Middle/JHS education (AOR:1.69;95%CI = 1.25-12.27), use contraceptive at the time of conception (AOR:1.48: 95%CI = 1.03-2.14), had sexual debut before 18 years (AOR:1.57; 95%CI: 1.33-1.85) and reside in urban areas (AOR:1.29;95%CI = 1.07-1.57). On the other hand, women who reside in Central (AOR:0.68;95%CI: 0.49-0.93), Northern (AOR:0.46;95%CI:0.24-0.88), Upper West (AOR:0.24; 95%CI: 0.12-0.50) and Upper East (AOR:0.49; 95%CI = 0.24-0.99) regions were less likely to have repeat induced abortion. CONCLUSION: The study showed that both individual and community level determinants were significantly associated with repeat induced abortion. Based on the findings, it is recommended to promote sexual and reproductive health education and more emphasis should be given to adult, those with early sexual debut, those with Middle/JHS education and those who live in urban centers.

Malaria Prevalence and Macroeconomic Output in Ghana, 1990 to 2019.

In Ghana, malaria remains the number 1 reason for outpatient department visits, making it a major public health problem. Thus, there could be significant lost productivity days as a result of malaria morbidity and mortality, which could negatively affect economic output at the macrolevel. Nonetheless, there is a dearth of empirical evidence of the effect of malaria on macroeconomic output in Ghana. This study therefore aims to provide the foremost empirical evidence regarding the effect of malaria prevalence on macroeconomic output in Ghana using a time series design with data spanning the period 1990 to 2019. Gross Domestic Product (GDP), serving as a proxy for macroeconomic output, is the dependent variable, while the prevalence of malaria (overall, among only males and among only females) serves as the main independent variable. The Ordinary Least Square (OLS) regression is used as the baseline estimation technique and the Instrumental Variable Two-Stage Least Square (IV2SLS) regression is employed as the robustness check estimator due to its ability to deal with endogeneity. The IV2SLS regression results show that a percentage increase in the overall prevalence of malaria is associated with a 1.16% decrease in macroeconomic output at 1% significance level. We also find that the effect of malaria in males on macroeconomic output is slightly higher relative to females. The findings from the OLS regression are not qualitatively different from the IV2SLS regression estimates. There is therefore the need to strengthen efforts such as quality case management, larval source management, mass distribution of long-lasting insecticide-treated bed nets, social behavior change, surveillance (both epidemiological and entomological), intermittent preventive treatment of malaria in pregnancy, research among others, which are important toward eliminating malaria.

Adolescent perception of sexual and reproductive health rights and access to reproductive health information and services in Adaklu district of the Volta Region, Ghana.

BACKGROUND: One of the key targets of Ghana's Adolescent Health Service Policy and Strategy is to ensure that 90% of adolescents and young people have knowledge of sexual and reproductive health services and rights. This phenomenon has led to the establishment of adolescent-friendly health facilities to increase access to health information and services among adolescents. Despite these efforts, access to health information and service utilisation remains low among adolescents. Our study seeks to examine adolescents' perception of sexual and reproductive health rights (SRHR) and access to reproductive health information and services in the Adaklu district of the Volta region of Ghana. METHODS: A baseline cross-sectional household survey of 221 adolescents aged 10-19 years in 30 randomly selected communities was used. A structured questionnaire was developed and administered to the respondents. A binary logistic regression analysis was used to examine the association between adolescents' perception of adolescent sexual and reproductive health rights (ASRHR) and access to reproductive health information and services. RESULTS: Adolescents' perception of SRHR was poor, and this poor perception may have been reflected in a few proportions (10%) of adolescents accessing SRH information and services. Majority (91.9%) of adolescents do not use sexual and reproductive health (SRH) services in the Adaklu district. Adolescents who attained primary education (aOR = 5.99, CI: 1.16-30.95), those who never had sexual communication with their father (aOR = 8.89, CI: 1.99-39.60) and adolescents who never experienced any form of sexual coercion (aOR = 11.73, CI: 1.61-85.68) had a higher likelihood of not utilising SRH services in Adaklu district. Regarding access to SRH information, adolescents who ever discussed sexual matters with their fathers, those who ever used contraceptives and adolescents who ever experienced sexual coercion had lower odds of accessing information on contraception, sexually transmitted infections, and teenage pregnancy. CONCLUSIONS: Access to and use of sexual and reproductive information and health services among adolescents in Adaklu district remain very low, which has implications for adolescents' knowledge and perception of their SRHR. Considering the factors predicting this phenomenon, it is recommended that interventions can be tailored to address the unique challenges faced by adolescent in accessing comprehensive SRH support.

Multinomial logistic regression analysis of the determinants of anaemia severity among children aged 6-59 months in Ghana: new evidence from the 2019 Malaria Indicator Survey.

BACKGROUND: Anaemia among children under age five is a major public health issue. Although anaemia prevalence is declining in Ghana, the severity among anaemic children is worsening. This study aims to investigate the determinants of anaemia severity among children aged 6 to 59 months in Ghana. METHOD: The study utilized a weighted sample of 1,258 children with anaemia with data obtained from the 2019 Ghana Malaria Indicator Survey. The predictor variables included maternal, household child and health system characteristics. SPSS version. At the multivariate level, three different multinomial logistic models were run with selected predictor variables. All tests were conducted at the 95% confidence level. RESULTS: The overall anaemia prevalence among children under age five was 43.5%. Of these, 2.6% were severely anaemic, 48.5% were moderately anaemic, and 48.9% had mild anaemia. The multinomial analysis showed that maternal, household, child and health system factors significantly predicted anaemia levels among anaemic children. The results indicate that a lower likelihood of anaemia severity is likely to be found among children whose mothers belong to Pentecostal/Charismatic faith (AOR = 0.18-model I; AOR = 0.15-model III) and children who tested negative for malaria (AOR = 0.28-model II and III). Again, a higher probability of anaemia severity was found among anaemic children whose mothers were not aware of NHIS coverage of malaria (AOR = 2.41-model II, AOR = 2.60-model III). With regard to moderate anaemia level, children who belong to the poorest, poorer and middle household wealth index had a higher likelihood of being moderately anaemic compared to those in rich households. Similarly, anaemic children who were less than 12 months old (AOR = 2.21-model II, AOR = 2.29-model III) and those between the ages of 1-2 years (AOR = 1.84-model II, AOR = 1.83-model III) were more likely to have moderate anaemia levels. CONCLUSION: The study findings show the importance of understanding the interrelation among different factors that influence anaemia severity among children under age five as critical in developing strategies and programmes aimed at addressing childhood anaemia.

Sex of household head and other household determinants of childhood anaemia among households in Ghana: regression analysis of the 2019 Malaria Indicator Survey.

BACKGROUND: Childhood anaemia is still a major public health concern. Although the prevalence of anaemia among children under age five is reducing in Ghana, the severity level is still worsening. This study sought to examine and compare household factors affecting the anaemia status of children under age five living in male- and female-headed households in Ghana. METHODS: The study used a weighted sample of 5,799 household heads from the 2019 Ghana Malaria Indicator Survey (GMIS). A binary logistic regression analysis was used to examine the effect of sex of household heads and other household factors on the anaemia status of children under the age of five in male- and female-headed households in Ghana. All analyses were conducted at the 95% confidence level. RESULTS: The results showed that a higher proportion (83.0%) of children under age five are not anaemic in households in Ghana. However, the probability of a child being anaemic is higher in male-headed households (aOR = 1.28; C.I:1.08-1.51), in the poorest (aOR = 2.41; CI: 1.59-3.65), poorer (aOR = 2.04; C.I:1.41-2.94) and middle (aOR = 1.78; C.I:1.29-2.46) household wealth category. Higher likelihood of anaemia was found among children in households that used charcoal (aOR = 1.51; C.I:1.15-1.99) and fuelwood (aOR = 1.44; C.I:1.02-2.02) for cooking. Similarly, there is a high probability of childhood anaemia in households with 5-10 members (aOR = 4.49; C.I: 3.78-5.34), 11 or more members (aOR = 7.21; C.I: 4.60-11.31) and household residing in northern part of Ghana (aOR = 1.40; C.I:1.07-1.83). The lower odds of being anaemic were recorded among children whose household heads were aged 40 years and older, household using other cooking fuels (aOR = 0.49; C.I: 0.21-0.78) and household with no bednets (aOR = 0.57; C.I: 0.44-0.74). CONCLUSIONS: The GMIS data suggest that anaemia and its severity are higher among children living in MHH than among those living in FHH. The results indicate that poverty, a higher number of household members, relatively younger male household heads and the type of cooking fuel used were factors accounting for the differences in childhood anaemia in MHH and FHH. Equal attention should be given to MHH and FHH in terms of programmes and interventions aimed towards preventing and reducing childhood anaemia in Ghana.

Utilization of abortion services from an unsafe provider and associated factors among women with history of induced abortion in Ghana.

BACKGROUND: In sub-Saharan Africa (SSA), numerous studies have examined women's choice of abortion methods and services using hospital-based data, community-based surveys and nationally representative data. Little research focuses on the factors influencing a woman's choice of abortion provider. This study sought to identify factors that are associated with why a woman seeks abortion care services from an unsafe provider in Ghana. METHODS: We used nationally representative data of women from the 2017 Ghana Maternal Health Survey (GMHS). Data analysis was restricted to women aged 15-49 with a recent history of induced abortion. Analyses focused on a weighted sample of 1,880. Descriptive analysis and the chi-square test were used to examine the proportion of women utilizing abortion services from unsafe providers. Factors hypothesized to affect the utilization of abortion services from unsafe providers were examined using both bivariable and multivariable logistic regression analyses. RESULTS: The proportion of survey respondents who reported that they utilize abortion service from unsafe providers were 57.5%. After adjusting for confounders, those who have knowledge of abortion legality [aOR: 0.381 (0.271-0.541)] and those who have attained secondary or higher education [aOR: 0.613 (0.411-0.914)] were less likely to use abortion services from unsafe providers. On the other hand, women belonging to the Ewe ethnic group [aOR: 0.696 (0.508-0.953)], those residing in the middle belt zone [aOR: 1.743 (1.113-2.728)], younger women aged 15-29 years [aOR: 2.037 (1.234-3.362)] were more likely to use abortion services from unsafe abortion providers. CONCLUSIONS: This research suggests that increasing the knowledge of women on the legal status of abortion through public education and encouraging more women to pursue secondary or higher education can contribute to reducing the use of abortion services from unsafe providers. These interventions should be targeted among younger women and those who reside in the middle belt zones of Ghana.

Motivators and demotivators to accessing malaria in pregnancy interventions in sub-Saharan Africa: a meta-ethnographic review.

BACKGROUND: Despite the introduction of efficacious interventions for malaria control, sub-Saharan Africa continues to bear the highest burden of malaria and its associated effects on vulnerable populations, such as pregnant women and children. This meta-ethnographic review contributes to literature on malaria in pregnancy interventions in sub-Saharan Africa by offering insights into the multiple factors that motivate or demotivate women from accessing MiP interventions. METHODS: A meta-ethnographic approach was used for the synthesis. Original qualitative research articles published from 2010 to November 2021 in English in sub-Saharan Africa were searched for. Articles focusing on WHO's recommended interventions such as intermittent preventive treatment with sulfadoxine-pyrimethamine, long-lasting insecticidal nets and testing and treatment of Malaria in Pregnancy (MiP) were included. Selected articles were uploaded into Nvivo 11 for thematic coding and synthesis. RESULTS: Twenty-seven original qualitative research articles were included in the analysis. Main factors motivating uptake of MiP interventions were: (1) well organized ANC, positive attitudes of health workers and availability of MiP services; (2) Women's knowledge of the effects of malaria in pregnancy, previous experience of accessing responsive ANC; (3) financial resources and encouragement from partners, relatives and friends and (4) favourable weather condition and nearness to a health facility. Factors that demotivated women from using MiP services were: (1) stock-outs, ANC charges and health providers failure to provide women with ample education on the need for MiP care; (2) perception of not being at risk and the culture of self-medication; (3) fear of being bewitched if pregnancy was noticed early, women's lack of decision-making power and dependence on traditional remedies and (4) warm weather, long distances to health facilities and the style of construction of houses making it difficult to hang LLINs. CONCLUSIONS: Health system gaps need to be strengthened in order to ensure that MiP interventions become accessible to women. Additionally, health managers need to involve communities in planning, designing and implementing malaria interventions for pregnant women. It is important that the health system engage extensively with communities to facilitate pregnant women and communities understanding of MiP interventions and the need to support pregnant women to access them.

Determinants of communication on sexual issues between adolescents and their parents in the Adaklu district of the Volta region, Ghana: a multinomial logistic regression analysis.

BACKGROUND: Poor communication on sexual issues between adolescents and their parents results in high rates of negative sexual practices such as teenage pregnancy. Contributing factors to this poor communication on sexual issues between adolescents and their parents in a high teenage pregnancy setting have not been adequately explored. We sought to fill this gap by examining the factors that predict communication on sexual issues between adolescents and their parents in the Adaklu district of the Volta region of Ghana. METHODS: A baseline cross-sectional household survey of 221 adolescents aged 10-19 years in 30 randomly selected communities was used. A well-structured questionnaire was developed. A multinomial logistic regression analysis was used to examine factors that significantly influenced communication between adolescents and their parents regarding sex. RESULTS: Only 11.3% of adolescents had discussions on sexual issues with both parents while 27.6% of communicated sexual issues with only one parent in Adaklu district. Adolescent males (AOR = 0.21, CI = 0.06-0.75), those aged 10-14 years (AOR = 0.41, CI = 0.04-0.57), non-members of adolescent health clubs (AOR = 0.46, CI = 0.21-1.00), and those living with only a father (AOR = 0.19, CI = 0.06-0.61) had lower odds of communicating with their parents on sexual issues. CONCLUSIONS: Adolescent-parental communication on sexual issues in Adaklu district is very low. This situation requires more empowerment of adolescents to enable them to discuss sexual issues with their parents through increased engagement with adolescent health club activities and capacity building capacity of parents with the right information on sexual and reproductive health by health staff within the district. Additionally, parents need to be equipped with communication skills to enable them to communicate effectively with their children.

Parent-adolescent and older sibling adolescent communication on issues about sex is considered an important aspect of adolescent development and well-being, as it ensures informed decision making and good behavior and a protective factor for adolescent sexual health. However, poor communication on sexual issues between adolescents and their parents results in high rates of negative sexual practices such as teenage pregnancy. Contributing factors to this poor communication on sexual issues between adolescents and their parents in a high teenage pregnancy setting have not been adequately explored. This paper, therefore, examines the factors that predict communication on sexual issues between adolescents and their parents in the Adaklu district of the Volta region of Ghana. It highlights individual, household, societal and sexual-related factors that predict communication on sexual issues between adolescents and their parents in an area with a high rate of teenage pregnancy among adolescent girls.The data on adolescent sexual and reproductive health in Adaklu district show poor communication on sexual issues between adolescents (aged 10­19 years) and their parents. Improving communication on sexual issues between adolescents and their parents in rural settings requires capacity building of parents (especially mothers) with the right information and communication skills for discussing sexual and reproductive health issues with their children.

Mixed effect analysis of factors influencing the use of insecticides treated bed nets among pregnant women in Ghana: evidence from the 2019 Malaria Indicator Survey.

BACKGROUND: Malaria during pregnancy is a major cause of maternal morbidity globally and leads to poor birth outcomes. The World Health Organization has recommended the use of insecticide treated bed nets (ITN) as one of the effective malaria preventive strategies among pregnant women in malaria endemic areas. This study, therefore, seeks to examine the individual and household factors associated with the use of ITNs among pregnant women in Ghana. METHODS: Data for this study was obtained from the 2019 Ghana Malaria Indicator Survey (GMIS) conducted between September 25 and November 24, 2019. The weighted sample comprised 353 pregnant women aged 15-49 years. Data was analyzed with SPSS version 22 using both descriptive and multilevel logistics regression modelling. Statistically significant level was set at p < 0.05. RESULTS: The study found that 49.2% of pregnant women in Ghana use ITN to prevent malaria. Pregnant women aged 35-49 years (AOR = 3.403, CI: 1.191-9.725), those with no formal education (AOR = 5.585, CI = 1.315-23.716), and those who had secondary education (AOR = 3.509, CI = 1.076-11.440) had higher odds of using ITN. Similarly, higher odds of ITN usage was found among who belonged to the Akan ethnic group (AOR = 7.234, CI = 1.497-34.955), dwell in male-headed households (AOR = 2.232, CI = 1.105-4.508) and those whose household heads are aged 60-69 years (AOR = 4.303, CI = 1.160-15.966). However, pregnant women who resided in urban areas (AOR = 0.355, CI = 0.216-0.582), those whose household heads aged 40-49 years (AOR = 0.175, CI = 0.066-0.467) and those who belonged to richer (AOR =0.184, CI = 0.050-0.679) and richest (AOR = 0.107, CI = 0.021-0.552) households had lower odds of using ITN for malaria prevention. CONCLUSIONS: Individual socio-demographic and household factors such as pregnant women's age, educational level, place of residence, ethnicity, sex and age of household head, and household wealth quintile are associated with the use of ITN for malaria prevention among pregnant women. These factors ought to be considered in strengthening malaria prevention campaigns and develop new interventions to help increase ITN utilization among vulnerable population living in malaria- endemic areas.

Determinants of willingness to accept child vaccination against malaria in Ghana.

BACKGROUND: Malaria is a public health problem in Ghana with children being one of the most vulnerable. Given this, in 2019, Ghana decided to add the first malaria vaccine (RTS, S) as part of routine immunisations for children in the near future. This study, thus, examines the determinants of malaria vaccine awareness and willingness to uptake the vaccine for children in Ghana. METHOD: The study uses data from the 2019 Ghana Malaria Indicator Survey while employing the binary logistic regression as the empirical estimation technique. RESULTS: The study finds that religion, region of residence and awareness of the malaria vaccine, influence the willingness to uptake the vaccine for children. Moreover, younger mothers (15-26 years), households in the richest wealth quintile, male-headed households and the number of children aged five years and below in a household, are found to be associated with less willingness to uptake the vaccine for children. CONCLUSION: Paying attention to awareness creation, region, religion, younger mothers (15-26 years), households in the richest wealth quintile, male-headed households and households with more children aged five years and below, can ensure optimal uptake of the malaria vaccine for children in Ghana.

COVID-19 vaccine hesitancy among the adult population in Ghana: evidence from a pre-vaccination rollout survey.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has already claimed over four million lives globally and over 800 deaths in Ghana. The COVID-19 vaccine is a key intervention towards containing the pandemic. Over three billion doses of the vaccine have already been administered globally and over 800,000 doses administered in Ghana, representing less than 5% vaccination coverage. Fear, uncertainty, conspiracy theories and safety concerns remain important threats to, a successful rollout of the vaccine if not managed well. OBJECTIVE: Ascertain the predictors of citizens' probability of participating in a COVID-19 vaccine trial and subsequently accept the vaccine when given the opportunity. METHODOLOGY: The study was an online nation-wide survey among community members (n = 1556) from 18th September to 23rd October, 2020 in the 16 regions in Ghana. Binary probit regression analysis with marginal effect estimations was employed to ascertain the predictors of community members' willingness to participate in a COVID-19 vaccine trial and uptake the vaccine. RESULTS: Approximately 60% of respondents said they will not participate in a COVID-19 vaccine trial; 65% will take the vaccine, while 69% will recommend it to others. Willingness to voluntarily participate in COVID-19 vaccine trial, uptake the vaccine and advise others to do same was higher among adults aged 18-48 years, the unmarried and males (p < 0.05). Significant predictors of unwillingness to participate in the COVID-19 vaccine trial and uptake of the vaccine are: married persons, females, Muslims, older persons, residents of less urbanised regions and persons with lower or no formal education (p < 0.05). Predominant reasons cited for unwillingness to participate in a COVID-19 vaccine trial and take the vaccine included fear, safety concerns, lack of trust in state institutions, uncertainty, political connotations, spiritual and religious beliefs. CONCLUSION: The probability of accepting COVID-19 vaccine among the adult population in Ghana is high but the country should not get complacent because fear, safety and mistrust are important concerns that have the potential to entrench vaccine hesitancy. COVID-19 vaccine rollout campaigns should be targeted and cognisant of the key predictors of citizens' perceptions of the vaccine. These lessons when considered will promote Ghana's efforts towards vaccinating at least 20 million people to attain herd immunity.

Health-seeking behaviour and cost of fever treatment to households in a malaria-endemic setting of northern Ghana: a cross-sectional study.

OBJECTIVES: To examine the health-seeking behaviour and cost of fever treatment to households in Ghana. DESIGN: Cross-sectional household survey conducted between July and September 2015. SETTING: Kassena-Nankana East and West districts in Upper East region of Ghana. PARTICIPANTS: Individuals with an episode of fever in the 2 weeks preceding a visit during routine health and demographic surveillance system data collection were selected for the study. Sociodemographic characteristics, treatment-seeking behaviours and cost of treatment of fever were obtained from the respondents. RESULTS: Out of 1845 households visited, 21% (393 of 1845) reported an episode of fever. About 50% (195 of 393) of the fever cases had blood sample taken for testing by microscopy or Rapid Diagnostic Test, and 73.3% (143 of 195) were confirmed to have malaria. Of the 393 people with fever, 70% (271 of 393) reported taking an antimalarial and 24.0% (65 of 271) took antimalarial within 24 hours of the onset of illness. About 54% (145 of 271) of the antimalarials were obtained from health facilities.The average cost (direct and indirect) incurred by households per fever treatment was GH¢27.8/US$7.3 (range: GH¢0.2/US$0.1-GH¢200/US$52.6). This cost is 4.6 times the daily minimum wage of unskilled paid jobs of Ghanaians (US$1.6). The average cost incurred by those enrolled into the National Health Insurance Scheme (NHIS) was GH¢24.8/US$6.5, and GH¢50/US$11.6 for those not enrolled. CONCLUSIONS: Prompt treatment within 24 hours of onset of fever was low (24%) compared with the Roll Back Malaria Programme target of at least 80%. Cost of treatment was relatively high when compared with average earnings of households in Ghana and enrolment into the NHIS reduced the cost of fever treatment remarkably. It is important to improve access to malaria diagnosis, antimalarials and enrolment into the NHIS in order to improve the case management of fever/malaria and accelerate universal health coverage in Ghana.

Urban health nexus with coronavirus disease 2019 (COVID-19) preparedness and response in Africa: Rapid scoping review of the early evidence.

INTRODUCTION: Severe acute respiratory syndrome coronavirus 2 also called coronavirus disease 2019 was first reported in the African continent on 14 February 2020 in Egypt. As at 18 December 2020, the continent reported 2,449,754 confirmed cases, 57,817 deaths and 2,073,214 recoveries. Urban cities in Africa have particularly suffered the brunt of coronavirus disease 2019 coupled with criticisms that the response strategies have largely been a 'one-size-fits-all' approach. This article reviewed early evidence on urban health nexus with coronavirus disease 2019 preparedness and response in Africa. METHODS: A rapid scoping review of empirical and grey literature was done using data sources such as ScienceDirect, GoogleScholar, PubMed, HINARI and official websites of World Health Organization and Africa Centres for Disease Control and Prevention. A total of 26 full articles (empirical studies, reviews and commentaries) were synthesised and analysed qualitatively based on predefined inclusion criteria on publication relevance and quality. RESULTS: Over 70% of the 26 articles reported on coronavirus disease 2019 response strategies across Africa; 27% of the articles reported on preparedness towards coronavirus disease 2019, while 38% reported on urbanisation nexus with coronavirus disease 2019; 40% of the publications were full-text empirical studies, while the remaining 60% were either commentaries, reviews or editorials. It was found that urban cities remain epicentres of coronavirus disease 2019 in Africa. Even though some successes have been recorded in Africa regarding coronavirus disease 2019 fight, the continent's response strategies were largely found to be a 'one-size-fits-all' approach. Consequently, adoption of 'Western elitist' mitigating measures for coronavirus disease 2019 containment resulted in excesses and spillover effects on individuals, families and economies in Africa. CONCLUSION: Africa needs to increase commitment to health systems strengthening through context-specific interventions and prioritisation of pandemic preparedness over response. Likewise, improved economic resilience and proper urban planning will help African countries to respond better to future public health emergencies, as coronavirus disease 2019 cases continue to surge on the continent.