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AbstractThe novel coronavirus disease (COVID-19) has put an additional strain on Afghanistan's weak healthcare system. Prior to the pandemic, the government and its allies had already problems in providing high quality health services for the people in Afghanistan because of inadequate facilities, insecurities, and ongoing conflicts. This year, COVID-19 exacerbated the situation and overwhelmed the healthcare system even further. As predicted, an influx of migrants suspected of having COVID-19 contributed to community transmission and led to an increase of cases across the country. A series of deadly attacks on civilians and healthcare workers in the country poses an additional burden, and severely weakens healthcare structures in times where health services are indispensable. These circumstances make evident that the international community needs to provide more support for Afghanistan's healthcare system and pass the United Nations resolution for a ceasefire in the country.

Most countries in Africa are faced with health system problems that vary from one to the next. Countries with a low Human Development Index (HDI) seem to be more prone to challenges in health service delivery. To mark its 70th anniversary on World Health Day, the World Health Organization (WHO) selected the theme "Universal Health Coverage (UHC): Everyone, Everywhere" and the slogan "Health for All. "UHC refers to ensuring that all people have access to needed health services (including prevention, promotion, treatment, rehabilitation, and palliation) of sufficient quality to be effective while also ensuring that the use of these services does not expose the user to financial hardship. UHC is a WHO's priority objective. Most governments have made it their major goal. This paper provides a perspective on the challenges of achieving UHC in Sub-Saharan Africa (SSA). It also endeavors to spotlight the successful models of Health Service Delivery Networks (HSDNs) that make significant strides in making progress towards achieving UHC. HSDNs propose models that facilitate the attainment of affordability and accessibility while maintaining quality in delivering health services. Additionally, it brings up to speed the challenges associated with setting up HSDNs in health systems in SSA. It then makes propositions of what measures and strategic approaches should be implemented to strengthen HSDNs in SSA. This paper further argues that UHC is not only technically feasible but it is also attainable if countries embrace HSDNs in SSA.

Africa is the second largest continent and has its socioeconomic and health peculiarities. Countries are faced with varying challenges towards its Universal Health Coverage (UHC) achievement and hence the region requires health system reforms to drive equitable and balanced medical services to its populace. The main objectives of the paper were to explore the complexities of the African health systems, subsequently highlighting major challenges to UHC and to provide a framework for strategic approaches to health system strengthening to ensure realization of UHC. Information presented in this paper was collected from published literature and reports on Rwanda, Kenya, Nigeria, Tanzania, Ghana, Tunisia, Democratic Republic of Congo, Zambia, Egypt and South Africa, amidst other African countries. The published literature points to the presence of a somewhat slow progress towards UHC or at least an existent knowledge of it. However, common challenges faced can be grouped into 1) Financial constraints which include low levels of government expenditure on health and increased out-of-pocket percentages, (2) Lack of coverage of key services which includes majorly immunization rates and existence of health insurance for citizens, (3) Input constraints ranging from drug availability to skilled healthcare workforce, information and research and (4) Lack of political support and commitmenttowards universal health coverage. To overcome the above-stated constraints, two broad groups of interventions were identified; General interventions largely focusing on reprioritization of health budget, quality and improved services, equipped facilities and efficient social protection systems; and Specific interventions which emphasizes the importance of eliminating shortage of health workers, ensuring availability of essential medicines/ products, embracing decentralization at supply chain management, validating data/ information system and advocacy for impactful health education/promotion. Although there will be strength and weakness ...

Background: COVID-19 vaccine hesitancy is one of the major concerns in the roll out of vaccines in many countries. The aim of the study was to assess the level of COVID-19 vaccine acceptability among the population in Herat, Afghanistan, the third largest city in the country. Methods: This cross-sectional study was conducted between 15 April 2021 and 20 April 2021 among the general population of Herat City to examine the acceptability rate of COVID-19 vaccine. Sample size was calculated at 555. Different variables were collected using a questionnaire developed. Data were evaluated in IBM SPSS program. Results: Only 10.63% of the participants were willing to receive COVID-19 vaccine without having any concern and reservation. 45% were willing to receive the COVID-19 vaccine. 66.5% were concerned about the vaccine and its side effects and 29% were afraid of being infected by transmission of COVID-19 through the administration of vaccine on them. Conclusion: This research demonstrates that, concerns about the vaccine, myths and misinformation are widespread which will undermine the vaccination process. This study recommends the initiation of more health-related campaigns and awareness programs by the government for general population to enhance and expedite the roll out of COVID-19 vaccine.

Coronavirus disease 2019 (COVID-19) has proved to be a severe global public health threat, causing high infection rates and mortality worldwide. Burundi was not spared the adverse health outcomes of COVID-19. Although Burundi's initial response to the COVID-19 pandemic was criticized, hope arose in June 2020 when the new government instituted a plan to slow virus transmission that included public health campaigns, international travel restrictions, and mass testing, all of which proved effective. Burundi has faced many challenges in containing the virus, the first of which was the lack of initial preparedness and appropriate response to COVID-19. This was exacerbated by factors including shortages of personal protective equipment (PPE), limited numbers of life-saving ventilators (around 12 ventilators as of April 2020), and the presence of only one COVID-19 testing center with less than ten technicians in July 2020. Moreover, as Burundi is amongst the poorest countries in the world, some citizens were unable to access necessities such as water and soap, required for compliance with government recommendations regarding hygiene. Interestingly, Burundi did not implement a nationwide lockdown, allowing mass gatherings and public services to continue as usual due to a firm belief in God's protection. As the daily confirmed cases have tripled since December 2020, Burundi must prepare itself for the threat of a new wave. Establishing precautionary measures to contain the virus and strengthening the health surveillance system in Burundi would significantly positively impact the prevention and management of COVID-19.