The psychological impact of the COVID-19 pandemic on healthcare workers in sub-Saharan Africa. A narrative review of existing literature.
Authors: Kitara David Lagoro , Oyat Freddy Wathum Drinkwater , Oloya Johnson Nyeko , Atim Pamela , Aloyo Judith , Ikoona Eric Nzirakaindi 
Published: August 2022

Abstract
Background: The ongoing Coronavirus disease 2019 (COVID-19) pandemic has significantly impacted the physical and mental health of the general population worldwide, with healthcare workers (HCWs) at particular risk. The pandemic's effect on healthcare workers' mental well-being has been severe and characterized by depression, anxiety, work-related Stress, sleep disturbances, and post-traumatic stress disorders (PTSD). Therefore, protecting the mental well-being of HCWs is a significant priority. This review is to determine identifiable risk factors for adverse mental health outcomes and any protective or coping measures to mitigate the adverse effects of the COVID-19 crisis among HCWs in sub-Saharan Africa.Methods: We performed a literature search using PubMed, Google Scholar, Cochrane Library, and Embase for relevant materials. We obtained all articles published between March 2020 and April 2022 relevant to the review subject and met pre-defined eligibility criteria. We selected twenty-three articles for the initial screening, and we included twelve papers for the final review.Result: A total of 5,323 participants in twelve studies predominantly from Ethiopia (08 studies), one from Uganda, Cameroon, Mali, and Togo fulfilled the eligibility criteria. Investigators found that 16.3–71.9% of HCWs with depressive symptoms, 21.9-73.5% with anxiety symptoms, 15.5-63.7% experienced work-related stress symptoms, 12.4-77% experienced sleep disturbances, and 51.6-56.8% reported PTSD symptoms. Healthcare workers, especially those working in emergency, intensive care units, infectious disease wards, pharmacies, and laboratories, were at higher risk of developing adverse mental health impacts. HCWs had profound fear, were very anxious and stressed with the high transmission rate of the virus and high death rates among their patients and lived in constant fear of infecting their families and themselves. Other sources of fear and work-related Stress were the lack of standardized PPEs and available treatment and vaccines to protect themselves against the virus. HCWs faced stigma, abuse, financial problems, and lack of support.Conclusion: The prevalence of depression, anxiety, insomnia, and PTSD in HCWs in sub-Saharan Africa during the COVID-19 pandemic has been high. Several organizational, community, and work-related challenges and interventions were identified, including improvement of workplace infrastructures, adoption of correct and shared infection control measures, provision of standardized personal protective equipment (PPE), social support, and the implementation of resilience training programs. Setting up permanent multidisciplinary mental health teams at regional and national levels to deal with mental health issues and providing psychological support to patients and HCWs, supported with long-term surveillance and sufficient budgetary allocation, is recommended.