A Comparative Policy for the COVID-19 Emergency Management of Frontline Health Workers in Selected African Countries
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Abstract
Health workers are often exposed to health risks and danger in the discharge of their duties. This is especially distressing during the COVID-19 pandemic. This study employs a multiple case study design to investigate the COVID-19 emergency management of frontline workers in South Africa, Kenya, Ghana, and Nigeria. The findings from the study reveal that governments in the selected countries prioritize the response phase of the emergency management theory over the mitigation and preparedness phases. The response phase was meted with inevitable consequences. Health workers feared risking their lives, and the majority threatened to abandon their jobs due to insufficient personal protective equipment (PPE) and welfare support. The study concludes that the government should prioritize all the phases of emergency management instead of focusing on the response phase, which involves the use of both human and financial resources on an overwhelming pandemic. They should have prepared the frontline workers adequately and equipped their health systems in preparation for any impending epidemic.
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S. MANGAI, Mary; MASIYA, Tyanai; DEREK DAVIDS, Yul.
A Comparative Policy for the COVID-19 Emergency Management of Frontline Health Workers in Selected African Countries.
Policy & Governance Review, [S.l.], v. 6, n. 1, p. 90-106, feb. 2022.
ISSN 2580-4820.
Available at: <https://journal.iapa.or.id/pgr/article/view/466>. Date accessed: 02 nov. 2025.
doi: https://doi.org/10.30589/pgr.v6i1.466.
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Articles
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
References
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Welcome, M. O. (2011). The Nigerian health care system: Need for integrating adequate medical intelligence and surveillance systems. Journal of Pharmacy & Bioallied Sciences, 3(4), 470â€"478.
World Bank. (2017). Ghana national health insurance schemeâ€"Improving financial sustainability based on expenditure review. World Bank.
World Health Organization (WHO). (2000). The world health report 2000. Health systems: Improving performance. World Health Organization.
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Adejoro, L. (2020, June 15). Compared to Ghana, others, Nigerian doctors fighting COVID-19 earn peanuts as hazard allowances. Punch News Nigeria, 1â€"5.
Adeyi, O. (2016). Health System in Nigeria: From Underperformance to Measured Optimism. Health Systems & Reform, 2(4), 285â€"289.
Adua, F. (2017). Emerging issues in public health: A perspective on Ghana’s healthcare expenditure, policies and outcomes. EPMA Journal, 8, 197â€"206.
Akwash, F. B. A. (2016). Healthcare transformation: Issues, challenges and the way forward. World Wide Journal of Multidisciplinary Research and Development, 2(5), 27â€"30.
Anderson, C. A., Leahy, M. J., DelValle, R., Sherman, S., & Tansey, T. N. (2014). Methodological application of multiple case study design using modified consensual qualitative research (CQR) analysis to identify best practices and organizational factors in the public rehabilitation program. Journal of Vocational Rehabilitation, 41, 87â€"98.
Begg, K., Andrews, G., Mambo, P., Engelbrecht, J., Dudley, L., & Lebese, L. (2018). Development of a national strategic framework for a high- quality health system in South Africa. In L. Rispel & A. Padarath (Eds.), South African health review (pp. 92â€"99). Health Systems Trust.
Catton, H. (2020). ICN calls for data on healthcare worker infect ion rates and deat hs. In The Global Voice of Nurses (pp.1â€"2). https://www.icn.ch/news/icn-calls-data- healthcare-worker-infection-rates-and- deaths
Centers for Disease Control and Prevention. (2020). The public health system & the 10 essential public health services. https://www.cdc.gov/publichealthgateway/publichealthservices/originalessentialhealthservices.html
Chassin, M. R., & Loeb, J. M. (2013). High-reliability health care: Getting there from here. The Milbank Quarterly, 91, 459â€"490. https:// doi.org/10.1111/1468- 0009.12023
Drager, S., Dal Poz, M. R., & Evans, D. B. (2006). Health workers wages: An overview from selected countries. In WHO Report (pp. 1â€"8). https://www.who.int/hrh/documents/ health_workers_wages.pdf ?ua=1
Engelbrect, N. (2020, September 12). Health workers sound alarm bells as virus spirals. News24. https://www.news24. com/news24/southafrica/news/health- wor kers-sound-alarm-bells-as-virus-spirals-20200618
Erasmus, E. (2010). Street-level bureaucracy. Guidance Note, 5, 1â€"5. Hasnain, Z. (2020, October 20). How to increase compensation for health workers during COVID-19. World Bank Report, 1â€"7.
Hupe, P. (2013). Dimensions of discretion: Specifying the object of street-level bureaucracy research. Der moderne staatâ€"dms. Zeitschrift Für Public Policy, Recht Und Management, 6(2), 425â€"440.
Institute for Health Metrics and Evaluation. (2015). Health Service Provision in Ghana: Assessing Facility Capacity and Costs of Care. IHME.
James Lind Institute. (2018, October 4). Emerging Public Health Issues in Ghana. https:// www.jliedu.com/blog/emerging-public- health-issues-ghana/#:~:text=The%20 ch alle nge s % 2 0 f ace d % 2 0 b y % 2 0 Gha na ,ca n%20a mel iora te%20t he%20 challenges%20faced
Kauzya, J.-M. (2020). COVID-19: Reaffirming state-people governance relationships. UNDESA Policy Briefs, 75, 1â€"4. https://doi. org/10.18356/c221362c-en
Lipsky, M. (2010). Street-level bureaucrac y, 30th ann. Ed.: Dilemmas of the individual in public service. Russell Sage Foundation. http://www.jstor.or g/ stable/10.7758/9781610446631
Malakoane, B., Heunis, J. C., Chikobvu, P., Kigozi, N. G., & Kruger, W. H. (2020). Public health system challenges in the Free State, South Africa: A situation appraisal to inform health system strengthening. BMC Health Serv Res, 20, 58.
Mangai, M. S., de Vries, M. S., & de Kruijf, J. A. M. (2018). Case-studyâ€"Co-production of secondary health services in Ghana and Nigeria. In Co-production and co-creation: Engaging citizens in public services (pp. 64â€"166). Routledge.
Maphumulo, W. T., & Bhengu, B. R. (2019). Challenges of quality improvement in the healthcare of South Africa post-apartheid: A critical review. Curationis, 42(1), e1â€"e9. https://doi. org/10.4102/curationis.v42i1.1901
McEntire, D. A. (2005). The status of emergency management theory: Issues, barriers, and recommendations for improved scholarship. Journal of Emergency Management, 3(3), 44â€"54.
Ministry of E conomy and Industry. (2020, November 9). Health sector in Ghanaâ€" Review. https://itr ade.go v.il/g hana/ files/2020/05/Health-Sector-in-Ghana- Review.pdf
Mulaki, A., & Muchiri, S. (2019). Kenya health system assessment. Palladium, Health Policy Plus.
Murray, C. J., & Frenk, J. (2000). A framework for assessing the performance of health systems. Bulletin of the World Health Organization, 78(6), 717â€"731.
Nguyen, V. K., & Sama, M. T. (2008). Social context and determinants of HIV transmission: Lessons from Africa. In V. K. Nguyen & M. T. Sama (Eds.), Governing health systems in Africa (pp. 237â€"255). CODESRIA.
Oleribe, O. O., Momoh, J., Uzochukwu, B. S., Mbofana, F., Adebiyi, A., Barbera, T., Williams, R., & Taylor-Robinson, S. D. (2019). Identifying key challenges facing healthcare systems in Africa and potential solutions. International Journal of General Medicine, 12, 395â€"403.
Olufemi, A. (2020, September 23). Coronavirus: Kwara approves N25,000 daily allowance for frontline health workers. Premium Times. https://www.premiumtimesng. com/coronavirus/391578-coronavirus- kwara-approves-n25000-daily-allowance- for-frontline-health-workers.html
Onwujekwe, O., Onoka, C., Uguru, N., Nnenna, T., Uzochukwu, B., Eze, S., Kirigia, J., & Petu, A. (2010). Preferences for benefit packages for community-based health insurance: An exploratory study in Nigeria. BMC Health Services Research, 10, 162. https://doi. org/10.1186/1472-6963-10-162
Roberson, M. R. (2020, November 24). Ghana: Healthcare for a country in transition. Duke. https://globalhealth.duke.edu/news/ ghana-healthcare-country-transition
Rosenthal, U., Charles, M. T., & ’t Hart, P. T. (1989). Coping with crises: The management of disasters, riots, and terrorism. Charles C Thomas Pub Limited.
Schwikowski, M. (2020, November 26). Africa confronts COVID-19 with a poor prognosis. Deutsche Welle. https://www.dw.com/en/ africa-confronts-covid-19-with-a-poor- prognosis/a-53229698
Tshangela, L. (2020, June 20). COVID-19 frontline workers part II: Nurses share their stories. SABC News. https://www.sabcnews.com/ sabcnews/covid-19-frontline-workers- nurses-share-stories/
Uroko, C. (2020, April 9). Ghana insures, pays 50% allowance to frontline health workers. Business Day. Available at https://bus i ne s s d ay.ng/h e alth /ar ti c le /c ov i d -19-ghana-insures-pays-50-allowance-to- frontline-health-workers/
Weible, C. M., Nohrstedt, D., Cairney, P., Carter, D. P., Crow, D. A., Durnová, A. P., Heikkila, T., Ingold, K., McConnell, A., & Stone, D. (2020). COVID-19 and the policy sciences: Initial reactions and perspectives. Policy Sciences,53(2), 225â€"241.
Welcome, M. O. (2011). The Nigerian health care system: Need for integrating adequate medical intelligence and surveillance systems. Journal of Pharmacy & Bioallied Sciences, 3(4), 470â€"478.
World Bank. (2017). Ghana national health insurance schemeâ€"Improving financial sustainability based on expenditure review. World Bank.
World Health Organization (WHO). (2000). The world health report 2000. Health systems: Improving performance. World Health Organization.
World Health Organization (WHO). (2015). Health worker Ebola infections in Guinea, Liberia and Sierra Leone. A preliminary report. World Health Organization.
World Health Organization (WHO). (2020a).Coronavirus disease (COVID-19) outbreak: Rights, roles and responsibilities of health workers, including key considerations for occupational safety and health. World Health Organization.
World Health Organization (WHO). (2020b). COVID-19 Situation update for the WHO African Region. External Situation Report. World Health Organization.
World Health Organization (WHO). (2020c). Strengthening preparedness for COVID-19 in cities and other urban settings: Interim guidance report for local authorities. World Health Organization.
World Health Organization (WHO) Regional Office for Europe. (2020, November 2). Public health services. World Health Organization. https://www.euro.who.int/en/health- topics/Health-systems/public-health- services/public-health-services