Health-Care Access during the Ebola Virus Epidemic in Liberia

Abstract

The Ebola virus disease (EVD) epidemic, which began in West Africa in December 2013, claimed more than 11,000 lives, with more than 4,800 of these deaths occurring in Liberia. The epidemic had an additional effect of paralyzing the health-care systems in affected countries, which led to even greater mortality and morbidity. Little is known about the impact that the epidemic had on the provision of basic health care. During the period from March to May 2015, we undertook a nationwide, community-based survey to learn more about health-care access during the EVD epidemic in Liberia. A cluster sampling strategy was used to administer a structured in-person survey to heads of households located within the catchment areas surrounding all 21 government hospitals in Liberia. A total of 543 heads of household from all 15 counties in Liberia participated in the study; more than half (67%) of urban respondents and 46% of rural respondents stated that it was very difficult or impossible to access health care during the epidemic. In urban areas, only 20-30% of patients seeking care during the epidemic received care, and in rural areas, only 70-80% of those seeking care were able to access it. Patients requiring prenatal and obstetric care and emergency services had the most difficulty accessing care. The results of this survey support the observation that basic health care was extremely difficult to access during the EVD epidemic in Liberia. Our results underscore the critical need to support essential health-care services during humanitarian crises to minimize preventable morbidity and mortality.

Impact of COVID-19 pandemic on patients with ST-segment elevation myocardial infarction: Insights from a British cardiac center

“…A similar pattern of delay in seeking medical care due to fear of contracting infection within the hospitals was seen in the Ebola epidemic in West Africa in 2013 as evident by a post epidemic survey. 10 Noteworthy, various other causes for patient-related delay in STEMI have been previously described in literature. 11 , 12 However, considering that these causes remained largely unchanged between 2019 and 2020, as well as the fairly similar baseline characteristics of both groups, the COVID-19 pandemic comes out as the major new variable that could possibly explain this substantial difference in patient-related delay.…”

The role of gender inclusive leadership during the COVID-19 pandemic to support vulnerable populations in conflict settings

“…During a pandemic, resources for and access to adequate health services can be further complicated by armed conflict. 12 13 Of particular concern, resources to deal with the pandemic, as evidenced during Ebola and Zika, are often diverted from essential health services for women and girls, namely sexual and reproductive health, with lasting effects for themselves, their children, their families and their economies. 14 Previous public health emergencies have shown that the impact of an epidemic on sexual and reproductive health often goes unrecognised, because the effects are often not the direct result of the infection but instead the indirect consequences of strained healthcare systems, disruptions in care and redirected resources.…”

Economic shocks and child wasting

“…While many features of the current COVID-19 social and economic crisis are unique, it is critical to understand whether the economic shocks currently being experienced in LMICs are likely to significantly increase risks of wasting and wasting-related mortality in addition to the serious impacts of health system disruptions caused by pandemics. [16][17][18] To do so we use an extensive set of 177 Demographic Health Surveys (DHS) 19 that collected information on 1.256 million children in 52 countries over three decades . We link these child and household level data to national level macroeconomic estimates of short-and medium-term changes in Gross National Income per capita (hereafter GNI).…”