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Rebuilding Health Systems in Africa

Welcome to CENFACS’ Online Diary!

29 April 2020


Post No. 141



The Week’s Contents


• Message to Africa-based Sister Organisations: Re-building Bonds, Re-building Bridges in the era of Coronavirus Pandemic

• Rebuilding Health Systems in Africa by shadowing the “epi-curves” of the Coronavirus Pandemic

• African Children’s Climate and Sustainable Development Goals (Generation Global Goals: 3G Project): Reduction of Data Poverty for Children in relation to Covid-19 Impacts


…and much more!




Key Messages


~ Message to Africa-based Sister Organisations:

Re-building Bonds, Re-building Bridges in the era of Coronavirus Pandemic


Covid-19 is a global health and economic threat for everybody as it threatens and destroys lives, both healthily and economically speaking.  Sometimes new threats can bring new opportunities and spaces for poverty reduction and sustainable development.

Covid-19 has led to transport and travel restrictions as measures.  But, it cannot break the unbreakable bridges we built together for ages.  It has tested the level of our development partnership, but it cannot destroy the legacy of our bonds.

In the face of a newly emerged common health and economic threat of this decade, this is a time for renewed opportunity for all us to re-cement the bases of our working-together model of protection and poverty relief.  It is as well an occasion to extend the positive of our human fabric and solidarity to those working on similar goals to reduce and hopefully end poverty and hardships in Africa. 

It is possible to win together the poverty relief battle against Covid-19 not only by avoiding it to reach its peak in any “epi-curves” in Africa, but also to make sure it does not spread further poverty and hardships amongst people and communities.

We can only do it if we remake ourselves, regroup our munitions and fight together as an army of poverty relievers and economic protectors.  It means each support,  however small it may be, counts in the Covid-19 battle.

It is in CENFACS determination to re-engage with you in this new era of the pandemic landscape so that our poverty relief work can find its tone, power and dynamism it needs to win this battle of the 21st Century.  This could mean we need to build again our relationships while developing our new links.

In doing so, we can work together with poor and vulnerable people while providing them with the hopes, spaces and freedoms they need to use their full potentials and achieve the results of their dreams.  It is in this way they can claim the place they deserve in the 2020s and beyond.

For any query or enquiry about the contents of this message, please contact CENFACS.




~ Rebuilding Health Systems in Africa by shadowing the “epi-curves” of the Coronavirus Pandemic


Our advocacy work about “Rebuilding Africa” by shadowing the “epi-curves” of the coronavirus pandemic is still in progress.  We are taking stock of the health systems in Africa and making the health-enhancing case of rebuilding while keeping an upper hand on the battle against Covid-19 to save lives.

Under the Main Development section of this post, you will find further elements about this key message.



~ African Children’s Climate and Sustainable Development Goals (Generation Global Goals: 3G Project): Reduction of Data Poverty for Children in relation to Covid-19 Impacts


The 2020 theme of our 3G project about the reduction of data poverty for African children continues this week.

We are researching on data about children in places of lockdown in Africa and in relation to Covid-19.  Our research is about analysing the impacts of Covid-19 on African children’s realisation of climate and sustainable development goals.  It is indeed about getting the extent to which children are trying to meet the United Nations Sustainable Development and climate Goals within these exceptional conditions of lockdown together with the other anti-coronavirus measures (such as self-isolation, physical distancing, hygiene, disinfection, etc.) to control the spread and speed of the coronavirus pandemic.

As it is known so far, under the special conditions of lockdown in Africa, many children from poor family backgrounds would find that meeting the basic life-sustaining needs (like food, health, security, protection, energy, education, etc.) could be challenging under the life-disrupting and endangering impacts of the coronavirus pandemic. 

Covid-19 has exposed the vulnerability of children from poor family backgrounds; vulnerability that can be exploited if care and protection are not taking seriously.  This could mean that the prospects for meeting the climate and sustainable development goals by these children could be highly reduced, if not nullified.  

In order to help those children, there is a need to gather data about them around the topic of coronavirus.  The kinds of data that we are interested in are both textual and numerical ones.  They can be structured or unstructured or even both. 

Information extracted from this data can help to find out not only how these children are specifically coping with the conditions of health and care at this critical time of the coronavirus pandemic, but also how they are meeting the spectrum of sustainable development goals in general.

The above key areas are CENFACS’ research on new data related to the meeting of climate and sustainable development goals under the constraint of Covid-19 measures and restrictions.

For further details about this piece of research related to CENFACS’ 3G Project, please contact CENFACS.      



Extra Messages


~ Coming in May 2020: Volunteering Stories from Places of Health and Sanitary Crisis


The 2020s Volunteering Stories will focus on healthcare since Covid-19 has seriously disrupted and endangered lives in many respects and aspects.  These stories, which will be of course of change makers and enablers, will be of life savers and rebuilders, health protectors and key poverty relievers.

For further details including the agenda for this year’s May Stories, please contact CENFACS.




~ The Essentials of CENFACS Protection Key Notes held from 01 to 29 April 2020


CENFACS’ Month of Protection, which climaxed to a Virtual Reflection Day, is ending tomorrow.  What can we retain from the four selected protection key notes that made this month?


# Essential Messages from Protection Notes


The essential messages from these notes are as follows.

Note 1: Protection of sanitation

It is absolutely vital to protect sanitation so that lives can be saved and sustained while protecting basic healthcare systems and infrastructures. 

Note 2: Protection against Coronavirus-induced Poverty and Vulnerability

CENFACS’ Coronavirus Spring Project and Virtual Support against the Coronavirus Pandemic are set up to respectively protect poor and vulnerable people who might be affected by the life-threatening and –destroying impacts of the coronavirus pandemic.  They are people-centred protection initiatives that are designed to directly benefit people, the coronavirus-hit ones. 

Note 3: Protection of Poor, near Poor and Lower-middle Incomes

CENFACS and Africa-based organisations are trying to help the poor, near poor and lower-middle incomes affected by the Covid-19 storm.  CENFACS is doing it via Advisory Support for Coronavirus Rescue Income, which is part of CENFACS’ Cube of Protection.

Many of our ASOs have developed activities and services related to the incomes issue to deal with circumstances created by the coronavirus pandemic.

Note 4: Protection of Basic Health Infrastructures

It is imperative to protect and enhance basic healthcare infrastructures while extending or rebuilding specific coronavirus-related infrastructures as the need is urgent and pressing to save lives. 

The above are the essentials of the Month Protection.  However, we cannot conclude these notes without thanking those who made our first Virtual Protection Day.


# A Thank-You Message


It is a great pleasure and gesture to spend only ONE DAY OUT OF THREE HUNDRED AND SIXTY-FIVE DAYS (1 out of 365 days) in a year to think of poor and vulnerable people and families, and among them are particularly but not exclusively the elderly women and young children for this year of Covid-19 pandemic. 

It was fruitful to reflect on the conditions and protection of women and children in times of health and sanitation crisis like of Covid-19 disaster.  None underestimates the immense pain and sufferings that all the people are experiencing during this time of the coronavirus pandemic, without forgetting the fatalities and economic damage it has created.

However, because of the nature and terms of reference of our Reflection Day, we focussed on two types of the victims (that is elderly women and young children) of this health and sanitation crisis. 

Taking times and making some thoughts for their defence against harm, danger and loss; is worthwhile.  Many thanks to all our Virtual Reflection Day supporters!

For those who want to go beyond these essential messages, they can let CENFACS know.



~ Covid-19 and Africa’s Informal and Gig In-working Poor


The Covid-19 conflict has uncovered some of the segments making African economies.  Amongst these segments are the informal and gig economies.  What are these types of economy?


Basic understanding of informal and gig economies

Within the employment and economic literature, informal economy is defined as activities that are not captured by national accounts and official statistics.  Informal workers can include: street vendors, domestic workers, construction workers, etc.

A gif economy is all sorts of ways of making ends meet that are temporary and made of individual pieces paid separately without working for a specified employer.  Amongst the gig workers, one can mention the following ones: street cleaners, zero-hour contract workers, food delivery bikers, etc.

Both informal sector and gig economy can be found in many parts of Africa. For example, the International Labour Organisation (1) argues that

“In Africa, 89.7 per cent of employed women are in informal employment in contrast to 82.7 per cent of men” (p. 20 & 21)

The same organisation states that

“Informal employment is the main source of employment in Africa, accounting for 85.8 per cent of all employment, or 71.9 per cent, excluding agriculture” (p.29)

Although these figures are for 2018, they nevertheless give us some indication about informal economy in Africa.

However, what is thought here is not only the size of the informal sector and gig economy in Africa.  What we are trying to ponder about is how Covid-19 has impacted poor people who are trying to make a living in those economies, especially those precarious workers whose life depends on informality and temporality.


Uneven distribution of the Covid-19 Impacts

Like in our previous thoughts, we are not trying to argue against the anti-coronavirus measures.  We are simply striving to consider the ways in which the impacts of these measures have been unevenly distributed between the informal and gig in-working poor on one hand and the non poor on the other hand. 

In this respect, any anti-coronavirus measures taken should help to minimise the social and economic impacts of the coronavirus pandemic on the in-working poor of the informal sector and gig economy, while addressing the precariousness of these people and this model of life survival.

As we are trying to present our thoughts, we are at the same supporting the Africa-based Sister Organisations that are tirelessly working with these kinds poor people and poverty.  We are encouraging them to keep up with their work in raising awareness of the Covid-19 amongst the in-working poor communities, in demystifying some of the African myths surrounding diseases and illnesses, in helping them with basic sanitary equipment, etc. 

This is the purpose of this extra message.  The thoughts on Covid-19 continue…

(1) International Labour Organisation (2018), Women and Men in the Informal Economy: A Statistical Picture (3rd Edition), Geneva





Main Development


Rebuilding Health Systems in Africa by shadowing the “epi-curves” of the Coronavirus Pandemic


In our post no. 138, we made a case for conducting our “Rebuilding Africa” advocacy work by shadowing the epidemiological curve (“epi-curve”) of the coronavirus pandemic in Africa.  Our rebuilding model depends on the state of advancement of Covid-19, although African countries are at different stages of the Covid-19 pandemic.  As the number of confirmed infected cases by the Covid-19 keeps on growing in many places in Africa, this suggests that we are in the ascending trend of the “epi-curves” in some of these countries.

From the above information, we can step up our “Rebuilding Africa” advocacy work.  We are doing it by focussing on the health systems so that they can be rebuilt to match or cope with this upwards trend of the Covid-19 in Africa.  This rebuilding is needed since Africa is under-resourced and under-equipped in terms of health infrastructures; infrastructures which include health buildings, systems, capacities and services.

Africa can try to rebuild or upgrade its health systems during this ascending phase of the “epi-curve” to stop the spread and ripple effect of Covid-19.  This will increase the badly needed resources and support the health systems need in Africa.  It could also add value to other anti-coronavirus measures (such as lockdown, physical and social distancing, personal protective equipment, travel restrictions, economic protection, etc.).  However, this rebuilding task can only happen if it is done with and by Africans for Africans in Africa.


• • Rebuilding Health Systems in Africa with Africans


Like any rebuilding work, this one requires support for every one involves in it at multiple levels.    In the context of this post, we are going to limit to the following three levels: multilateral, CENFACS and Africa-based Sister Organisation levels.


• • • Rebuilding Health Systems in Africa via Bilateral and Multilateral Support


It is hoped that African countries have enough innovated to raise revenues from within domestic and international sources to tackle the Covid-19.  Already, some efforts and appeals made by Africa in its high-level engagement with bilateral and multilateral donors and financial backers (such as the International Monetary Fund and the World Bank) have started to produce some results.  This will help not only to save lives, but also to start rebuilding some health systems in Africa.


• • • Rebuilding Health Systems in Medical Centres in Africa via CENFACS


At CENFACS level, we are still appealing for support via our Coronavirus Spring Project (CSP) and Charitable Response to the Coronavirus (CRC)

CSP is designed to directly support the coronavirus–hit people via their local representative organisation on the grounds in Africa, while CRC will help both individuals and organisations.  Both projects are meant to be results-oriented in tackling emergent and urgent threats posed the coronavirus pandemic. 

One can hope any funding raised will help medical centres in Africa to rebuild their health systems and capacities especially in those areas where local people do not have access to healthcare and medical facilities.


• • • Rebuilding Health Systems in Africa via ASOs


At the level of relationship between CENFACS and Africa-based Organisations (ASOs), we are working with local ASOs to support them rebuild or upgrade their health capacity, especially those organisations that own and run medical centres in places where people are at risk and in most need. 

We hope to mobilise the financial resources needed to support ASOs working on the fields since we know by experience that not all the statutory funding and multilateral overseas aid reach some poor and marginalised people and hard-to-reach communities in some of the remote areas of Africa.  This is despite the big headlines in the global media.


• • Rebuilding Health Systems to Meet the Continuing Challenge of Sanitary Poverty Reduction


Since we are in the month of Protection and in Spring Relief season (with in mind our advocacy about Rebuilding Africa), we are seizing this opportunity to re-advocate about the need for Africa to rebuild or redevelop its health care systems and services in order to meet the challenge of poverty reduction, particularly but not exclusively sanitation poverty. 

A time of crisis, like of Covid-19, can be a golden opportunnity to build or rebuild what was not done.  To do that let us make sense of the meaning of words used, here health systems.

We can use the definition of the World Health Organisation (2) which argues that

“A health system consists of all organisations, institutions, resources and people whose primary purpose is to improve health”.

The WHO framework describes health systems in terms of six core components or building blocks, which include:

√ Service delivery

√ Health workforce

√ Health information systems

√ Access to essential medicine

√ Financing

√ Leadership or governance


In terms of our “rebuilding health systems” advocacy, one can focus on the above components in order to make sure that they are capable of meeting the challenge that Covid-19 has posed.  If these components are not resilient to the Covid-19 shock, then this is the right moment to start the work of rebuilding them while continuing to save lives. 

At this critical time of Covid-19, supporting CENFACS and ASOs in this way will help ASOs working in the healthcare issues to help rebuild the following for today and the generations to come:

√ Core health capacities and capabilities of ASOs

√ Health workforce and volunteers locally

√ Mobile equipment to trace the Covid-19 and related diseases

√ Healthcare working conditions

√ Number of people treated by local medical centres

√ Personal protection equipment for healthcare workers and volunteers

√ Quantity and quality of medicine to poor and vulnerable people

√ Data systems about Covid-19 and similar viruses

It is this charitable and voluntary participation of CENFACS and ASOs in the fight against Covid-19 that can add value, however little it may be, to the mega funding relief which sometimes does not always bring the expected outcome and  impact related to its size. 

Furthermore supporting CENFACS and ASOs in this way can open up alternative ways of reducing poverty and hardships in healthcare while re-motivating tired donors from fatigue.        

For further details about and to support the “Rebuilding Africa” advocacy, CENFACS and ASOs, please contact CENFACS.

(2) https://www.who.int/healthinfo/systems/WHO_MBHSS_2010_full_web.pdf (accessed April 2020)


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Thank you for visiting CENFACS website and reading this post.

Thank you as well to those who made or make comments about our weekly posts.

We look forward to receiving your regular visits and continuing support throughout 2020 and beyond.

With many thanks.


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