A World Bank study has found that the pandemic put a strain on healthcare workers, which affected the health system. (Paul Botes)
KwaZulu-Natal lost $544.64 million during the first year of the Covid-19 pandemic, and the Western Cape $337.91 million, according to a study by the World Bank and Resolve to Save Lives, a global public health initiative.
The study, published this week, looked at the economic burden of Covid-19 on healthcare workers and shone a light on the major systems failures caused by the pandemic in South Africa, Kenya, Colombia and eSwatini, which had a loss of $16.19 million.
The cost per healthcare worker infection was more than $30 000 in eSwatini, Kenya, Western Cape and KwaZulu-Natal, while that in Colombia was $10 105, the lowest number.
The study noted that high rates of healthcare worker infection and death exacerbates the effect of epidemics and pandemics.
Infected healthcare workers can be vectors of disease transmission to patients and colleagues, amplifying or seeding broader outbreaks. Second, healthcare worker absenteeism because Covid-19 illness, isolation or death, and fear of being infected disrupts essential health service delivery.
The economic burden was highest in the sites with the lowest healthcare worker density; the regions that could least afford to lose healthcare workers had the least protections.
Speaking at the presentation of the study, Nonhle Ngcongo, a registered midwife, said during the first year of the pandemic healthcare workers experienced a delay in the provision of personal protective equipment (PPE). As a result, they re-used disposable PPEs because it was the only measure to try to defend against infections.
“During the pandemic that was [the only time] when the department of health had the urgency of providing us with resources that are basic and needed. It’s only when there [were] eyes on us as a country the resources [were] fast-tracked and the turnaround time was fast,” Ngcongo said.
According to the report, health systems were overwhelmed by surging Covid-19 cases, which meant that patients with other life-threatening emergencies or longitudinal health care needs were compromised.
Essential health care services — including maternity care, immunisation, chronic disease management, emergency services and surgery — were severely disrupted, particularly in low- and middle-income countries where human resources for health were already in short supply.
The detrimental effect of Covid-19 on maternal and child healthcare globally have been documented: fewer immunisations were given, fewer women received the full scope of antenatal care and fewer babies were delivered in health care facilities. Studies show stark differences in maternal and child health service provision, including routine child immunisation.
Ngcongo said the pandemic also affected healthcare workers in a psychological way; they feared attending to clients optimally, were demotivated and had a sense of helplessness, which caused a substandard provision of nursing care.
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