The role of social work in the healthcare settings during the COVID-19 pandemic in Africa

Abstract

Globally, the social work profession seeks to empower and support vulnerable groups during the COVID-19 pandemic. These roles and responsibilities seem to be lagging in Africa as the potentials of social workers are underutilized in many areas of practice including the hospital setting. Given the contributions of medical social work, this article highlights the roles of social workers in healthcare delivery amid the COVID-19 pandemic. In addition, it emphasizes the challenges of medical social work. Since healthcare delivery requires collaboration, suggestions are made regarding ways to incorporate medical social work in healthcare settings for optimal healthcare delivery.

Introduction

The outbreak of the COVID-19 has impacted the lives of many people in developed and developing countries (Okafor, 2021). It has negatively affected the psychological, emotional, and social wellbeing of vulnerable groups, particularly older adults, children, people with disabilities, and the poor (Amadasun, 2020a). When social or health disasters pose a risk to many people or communities, interventions from different professionals are required (Cifuentes-Faura, 2020). Social work as a profession provides adequate and appropriate services in the outbreak of pandemics and other emergencies (Brinkerhoff, 2014). The profession seeks to support and empower vulnerable people, including the elderly, children, and people with chronic diseases (Dako-Gyeke et al., 2018). As a profession, social work contributes immensely to the area of care, protection of rights, and support for at-risk populations (Bess and Collins, 2014).

While the pandemic has intensified the need for addressing the health and social needs of people, social workers have contributed to all areas including the healthcare settings (Agwu and Okoye, 2021). Social workers in health settings are referred to as medical or hospital social workers and they provide psychosocial interventions for patients and families to address health-related conditions (Dako-Gyeke et al., 2018; Hassan, 2016). During the COVID-19 pandemic, social workers offer professional skills, competencies, and knowledge in the social determinants of health to help individuals, families, and communities (National Association of Social Workers, 2020). Whereas the pandemic has affected the social life and health of many people, it is essential to ensure that social workers are equipped with the needed resources to respond to the psychosocial challenges of clients (Ashcroft et al., 2021; Bern-Klug and Beaulieu, 2020).

Unfortunately, in Africa, many health practitioners do not recognize the important roles social workers could perform or play within health institutions (Dako-Gyeke et al., 2018). Even in health institutions where professionals recognize the roles of medical social workers, there are limited collaborations to maximize their potentials to address the issues of patients (Dako-Gyeke et al., 2018). Even though the COVID-19 pandemic has threatened the achievement of the sustainable development goals (SDGs) in some African countries (United Nations, 2020), ignoring the roles of social workers in the COVID-19 program and policy response in healthcare settings could impact the attainment of these goals by 2030. This article aims to highlight the roles and challenges of medical social work during the COVID-19 pandemic in Africa. This is crucial because in many countries, hospital social workers and other frontline workers have been active in addressing social and psychological issues including depression, anxiety, and other health issues during the pandemic (Peretz et al., 2020).

The role of medical social workers during the COVID-19 pandemic

Recent literature demonstrates how important the contribution of social work is in addressing the COVID-19 pandemic (Walter-McCabe, 2020). Medical social workers practice at the micro, meso, and macro levels and have been involved in policy decisions and social aspects of health related to the pandemic (Miller and Lee, 2020; Truell, 2020). They possess skills and competencies such as crisis management, advanced care planning, case management, problem solving, and policy development relevant to addressing the COVID-19 pandemic (Bern-Klug and Beaulieu, 2020; Walter-McCabe, 2020). Medical social workers have used these skills and competencies to help in the development of hospitals, mental health facilities, nursing homes, and clinics during the pandemic.

Medical social workers have been involved in the development and monitoring of policies regarding the care and treatment strategies of clients in mental health facilities. Whereas mental health issues have intensified during the pandemic (Usher et al., 2020), medical social workers identify community and environmental factors that impede the mental health of individuals amid. They develop interventions and provide education to deal with societal perceptions of the causes and treatment of mental health issues amid the COVID-19 pandemic. This is crucial given that many people perceive the causes of mental illness as supernatural factors, thus people suffering from this illness seek support from traditional or religious healers (Edwards, 2014; Mfoafo-M’Carthy and Sossou, 2017).

Furthermore, because many people are living in poverty in some parts of Africa, they have difficulties paying their medical bills when hospitalized (Beegle et al., 2016; Chitereka, 2010). While the COVID-19 pandemic has adversely affected the various sources of healthcare financing, including government and donor supports, it has impacted the general delivery of healthcare in some countries (Abor and Abor, 2020). Medical social workers amid the pandemic provide psychosocial analyses of the needs of patients and offer opportunities to waive the medical bills of vulnerable patients. In addition, they have been involved in the investigation and addressing of issues related to the abuse of children and domestic violence which usually cause health problems during the pandemic.

Moreover, counseling is an important role of social workers in healthcare settings during the COVID-19 pandemic. Hough (2010) argues that the major component of counseling encompasses a relationship that is based on support, principles of empowerment of the client, confidentiality, and identification of resources. Since medical social workers have skills and competencies in providing counseling (Dako-Gyeke et al., 2018), they have used these skills with other allied healthcare teams to deal with the emotional and social consequences of the pandemic. Medical social workers have been engaged in developing a therapeutic relationship in counseling with individuals or families (a) to help them recover from illness and post-discharge care and (b) address the issues of addiction related to the pandemic.

Social workers are engaged in case management to promote healthcare amid the pandemic. Case management is defined as a client-centered, assessment-based interdisciplinary approach to integrating healthcare and social support services by assessing individuals’ needs and preferences, developing a comprehensive care plan, managing services, monitoring, and reassessing services as needed by the identified case manager following evidence-based standards of care (Green, 2017: 10). Given that the COVID-19 pandemic has increased pressure on healthcare facilities (Abor and Abor, 2020), hospital social workers make referrals of patients to appropriate institutions for further care. Medical social workers are well trained to improve and develop support services including creating resource opportunities and providing social support to advance the psychosocial wellbeing of individuals, families, and communities to deal with the pandemic.

An important mandate of the social work profession is to empower and liberate people through social change development, draw on the tenets of human rights and social justice to advocate for the sanctity of life (Amadasun, 2020b). With these responsibilities, medical social workers are better positioned to undertake frontline roles to empower individuals and communities affected by COVID-19. They deliver optimal healthcare, link individuals with services and resources in nursing homes and clinics. Other responsibilities include providing education to help restrict the spread of the COVID-19 virus, making sure vulnerable groups are included in planning and social service systems as well as linking communities to necessities of life including food and clean water (International Federation of Social Works [IFSW], 2020). While different myths are associated with the causes and cure of the COVID-19 pandemic among many people (Tabong and Segtub, 2021), medical social workers create awareness on stigma, discrimination, and myths associated with the pandemic.

Challenges to education and practice of medical social work

Social work education in many African countries is a product of foreign methodologies rather than progressive societal transformation (Mwansa, 2011). Thus, many of the skills and competencies acquired by social workers through education have limited capacity to deal with the social needs and problems in developing countries (Rwomire, 2012). With a limited focus on medical social work in educational curriculums, many students could have difficulties understanding and applying social work theories to solve real-life situations in healthcare settings. In view of that, social work education should focus on developing new theories and practices that will impact health policies and practice at both national and international levels. As argued by Brinkerhoff (2014), with increased education of social work students in the areas of trauma and stress management they will be prepared to respond to pandemics and disasters when they occur.

Although social workers are instrumental in the provision of healthcare, they may encounter challenges in the delivery of their services due to limited professional recognition. Many governments do not prioritize social workers’ roles in the hospital settings, and this is apparent as several health facilities have limited or no social workers among professional teams (Chitereka, 2010). In many cases, medical social workers’ services are not recognized by core health professionals in hospital settings (Dako-Gyeke et al., 2018). Consequently, many healthcare facilities may be deficient in providing psychosocial support to patients amid the COVID-19 pandemic. Because social work is an important profession in the health setting, more effort are warranted to improve and sustain the unique roles of social workers in healthcare settings.

Furthermore, medical social work practice in Africa is constrained by inadequate financial and material support (Umoren, 2016). This is because of the belief that investment in social welfare programs does not contribute directly to economic growth and the social work profession is not understood by many people (Kreitzer et al., 2009; Rwomire and Raditlhokwa, 1996). In many African countries, resources may be truly inaccessible to promote effective and efficient activities that need to be carried out to deal with patients’ issues in the healthcare settings (Dako-Gyeke and Kofie, 2017). As a result, medical social workers may lack both material and financial resources (Umoren, 2016) to assess patients’ psychosocial needs, follow up on case management issues and address the social consequences of chronic illnesses amid the pandemic.

Conclusions and implications

The article highlights the contribution of medical social workers in the health settings during the COVID-19 pandemic. Unfortunately, social workers may have difficulties working with other core health professionals in addressing the psychosocial needs of patients due to inadequate recognition and resources. While the COVID-19 pandemic has impacted the psychological, emotional, and social needs of people, interventions to support people require the competencies and skills of medical social workers in healthcare facilities.

Since social work practice in many African countries lacks a statutory body to regulate the profession (Spitzer, 2019; Twikirize et al., 2014), social workers could advocate for policies that support the practice of social work. This will help enhance social work inclusion in the healthcare settings during and after the COVID-19 pandemic. While many practitioners in other fields have migrated to a blend of in-person and online support services during the pandemic, social work education must focus on strengthening the technical skills of students in the healthcare systems, particularly on social media, telemedicine, and video conferencing.

In addition, there is a need to establish effective collaboration between practitioners and academics to assess organizational needs and opportunities for social workers within healthcare institutions. This calls for analyzing country specific policies and trends on resource allocations that consider the unsatisfied needs of social workers. Besides, health authorities and departments responsible for social welfare need to reconsider the unique roles of social workers in healthcare, policy formulation, and implementation in health facilities. This is important as countries that have utilized the skills and competencies of social workers have achieved positive results in dealing with the pandemic (Samuel, 2020). Thus, the importance of social workers in combating the COVID-19 pandemic in hospital settings is inevitable, and their skills must be utilized during and after the pandemic in many African countries.