{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T16:03:00Z","timestamp":1784131380909,"version":"3.55.0"},"reference-count":29,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2020,11,11]],"date-time":"2020-11-11T00:00:00Z","timestamp":1605052800000},"content-version":"unspecified","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,10,12]]},"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The current COVID-19 pandemic is a global threat. This elicits questions on the level of preparedness and capacity of health systems to respond to emergencies relative to other parts of the world.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study uses publicly available core health data for 53 African countries to determine risk factors for cumulative COVID-19 deaths and cases per million in all countries in the continent. Descriptive statistics were determined for the indicators, and a negative binomial regression was used for modelling the risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In sub-Saharan Africa, an increase in the number of nursing and midwifery personnel decreased the risk of COVID-19 deaths (p=0.0178), while a unit increase in universal healthcare (UHC) index of service coverage and prevalence of insufficient physical activity among adults increased the risk of COVID-19 deaths (p=0.0432 and p=0.0127). An increase in the proportion of infants initiating breast feeding reduced the number of cases per million (p&lt;0.0001), while an increase in higher healthy life expectancy at birth increased the number of cases per million (p=0.0340).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite its limited resources, Africa\u2019s preparedness and response to the COVID-19 pandemic can be improved by identifying and addressing specific gaps in the funding of health services delivery. These gaps impact negatively on service delivery in Africa, which requires more nursing personnel and increased UHC coverage to mitigate the effects of COVID-19.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-042750","type":"journal-article","created":{"date-parts":[[2020,11,11]],"date-time":"2020-11-11T16:34:05Z","timestamp":1605112445000},"page":"e042750","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":32,"title":["Factors associated with COVID-19 infections and mortality in Africa: a cross-sectional study using publicly available data"],"prefix":"10.1136","volume":"10","author":[{"given":"Charles","family":"Okeahalam","sequence":"first","affiliation":[{"name":"School of Economics and Finance, Faculty of Commerce, University of the Witwatersrand, Johannesburg, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Williams","sequence":"additional","affiliation":[{"name":"School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7433-4383","authenticated-orcid":false,"given":"Kennedy","family":"Otwombe","sequence":"additional","affiliation":[{"name":"School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa"},{"name":"Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,11,11]]},"reference":[{"key":"2025121602144409000_10.11.e042750.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30119-5"},{"key":"2025121602144409000_10.11.e042750.2","unstructured":"World Health Organisation . 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