Table 1

Effect of COVID-19 on medical education in Africa

Medical education component/stakeholderEffect of COVID-19Selected country examples
Students and health workers in training
  • Closure of universities and health worker training institutions.

  • Delays and cancellation of examinations.

  • Delays in graduation.

  • Increased mental health stress.

  • The President of Republic of Uganda announced the temporary closure of all educational institutions in the country including the medical schools beginning on the 20 March 2020.

  • The Federal Government of Nigeria announced the closure of all tertiary institutions including the medical schools on the 19 March 2020.26

  • The Ethiopian Government announced the closure of all schools in the country by March 2020.

  • In the second wave of COVID-19, several universities in Sudan announced the suspension of classes.27

  • The West African College of Physicians postponed the April/May 2020 postgraduate medical examinations.28

  • Final year medical students in Egypt requested for the postponement of their examinations for fear of being infected with COVID-19.29

  • Since the closure of universities in Nigeria on 19 March 2020, there has been no academic activities in all public medical schools in Nigeria till the end of 2020 hence no medical graduates from any of the schools.

  • In a survey of young people (including students) round the globe, 83% of respondents reported that the pandemic worsened pre-existing mental health conditions.7

Medical educators—teaching and research faculty
  • Decreased access to research funds from internal and external sources.

  • Budget cuts leading to delayed salaries, and job losses.

  • Increased brain drain as African health workers move to high income countries.

  • Budget cuts in South Africa have compromised the ability of higher education and research systems to meet postgraduate funding targets.30

  • In Nigeria, a State government requested of university teachers including medical educators to sacrifice 20% of their salaries as a result of COVID-19.31

  • Another State in Nigeria did not pay its university teachers including medical educators for the first 6 months into the pandemic.32

  • In Rwanda, some private sector universities suspended academic and administrative staff and reduced the salaries of others.33

  • In Zimbabwe, medical doctors and other health workers held a protest over the decision by the government to reduce their wages in response to COVID-19.34

  • Fifty-eight medical doctors from Nigeria emigrated as a group to the United Kingdom at the peak of the pandemic.11

Schools of medicine, nursing and allied health services
  • Shortage of personal protective equipment (PPEs).

  • Decreased funding to medical schools.

  • Reduced number of patients seeking care from teaching hospitals

  • Decreased revenue from patient care.

  • Reduced research opportunities, collaborations and partnerships.

  • Decrease in research outputs, for example, publications, seminars.

  • Ethiopia, Gambia, Mauritania and Kenya faced severe shortages of PPE supplies and so received supplies from the WHO.35

  • In the revised 2020 budget, Nigeria announced budgetary cuts for education and health as a result of COVID-19 pandemic.36

  • In South Africa, the National Research Foundation got a 19% reduction in government allocation for research grants as a result of the COVID-19 pandemic.30

  • In Nigeria, several public and private health facilities turned away patients during the COVID-19 pandemic.

  • In Zimbabwe, clinics turned away patients with malaria for fear they could be infected with COVID-19.37

  • Authors from developing countries were involved in only 11% of early articles published on COVID-19 as against 15% participation before the pandemic.14

  • The United States Bureau of Educational and Cultural Affairs suspended all exchange programmes that involve travelling to and from the USA because of COVID-19 pandemic.38

Society
  • Medical students may drop out of school due to COVID-19 delays.

  • Students in training and drop outs may practice as quacks in the community.

  • Migration of healthcare professionals to developed economies.

  • Abuse of health work force

  • Health workers being infected with COVID-19

  • Death of health workers from COVID-19

  • Arab News Network reported on 16 May 2020 that a total of 8600 medical doctors from Egypt have been accepted in the USA based on a call for application from medical professionals especially those working on COVID-19.39

  • Health workers in Malawi complained of insults, stigma and discrimination because of their involvement in the fight against COVID-19.40

  • On 23 July 2020, the WHO announced that more than 10 000 health workers in 40 African countries have been infected with COVID-19.41

  • The Nigerian Medical Association announced on 26 December 2020 that 20 medical doctors in Nigeria died from COVID-19 infection in 1 week.42