Relationship between the perceived strength of countries’ primary care system and COVID-19 mortality: an international survey study

Goodyear‐Smith, Felicity; Kinder, Karen; Mannie, Cristina; Strydom, Stefan; Bazemore, Andrew; Phillips, Robert L.

doi:10.3399/bjgpopen20x101129

Cited by 34 publications

(33 citation statements)

References 17 publications

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“…10 It is also known that countries' primary care systems strength, does not in uence the pandemic mortality rate, which is more dependant of perceived stringent border control, movement restriction, and testing regimes. 11 Behaviour change promoted by the government on preventive activities, targeting community health workers, TBAs, traditional leaders and healers with trainings, 12 and general population with a media campaign through television and radio, launched in May 2020, has attained most population, concerning Covid-19, but reduced users and HP' MCH preventive attitudes and behaviours, within the public health system, in primary and secondary health care services.…”

Section: Discussionmentioning

confidence: 99%

Covid-19 Pandemic Impact on Maternal and Child Health Services Access in Nampula, Mozambique: A Mixed Methods Research.

Pires

Macaringue

Abdirazak

et al. 2020

Preprint

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BackgroundThe Covid-19 pandemic limited access to health services in most countries, impacting negatively global health. Last March 2020 in Mozambique, a public state of emergency restrained people’s movements, reduced public services, and launched a national information campaign. The Alert Community for a Prepared Hospital implementation research, has been promoting access to maternal and child health care, at Marrere General Hospital and Marrere Health Centre, in Natikiri, Nampula, the city with the third highest incidence of Covid-19 in Mozambique. Our research aimed to assess the impact of Covid-19 on access to maternal and children health services in Nampula and estimate Alert Community for a Prepared Hospital project sustainability.MethodsMixed-methods research, descriptive, cross-sectional, and retrospective, using review of patient visits documentation, comparing March to May 2019 to same months in 2020, and interviews with health professionals, traditional birth attendants and patients. We involved two health centres and two hospitals. The two Marrere centres were Alert Community for a Prepared Hospital intervention centres, and the other two were control centres, compared using KrushKall Wallis, One-way Anova, mean and standard deviation tests.ResultsComparing 2019 maternal health services indicators with those from 2020, the intervention area had decreases of 28% in family planning visits, 26% in women in first ante-natal visits in the first trimester, and a 74% increase in home deliveries, all without statistical significance. The decrease in hospital maternity deliveries (4%) was statistically significant (p=0.046). The non-intervention area showed a decrease in women in first ante-natal visits in the first trimester (12%). Concerning child health, the intervention area had a 20% reduction in children presenting for vaccination and an 18% in children completely vaccinated, comparable to a reduction of 16% in the non-intervention area. Interviews revealed that most health professionals, traditional birth attendants and patients, have adequate knowledge about Covid-19. ConclusionOur results demonstrate negative collateral effects of Covid-19 on maternal and child health access and a deficient health information system in Mozambique. The Government’s media campaign promoting access to preventive health services, is not achieving its aim. The Alert Community project will need further research, to assess lasting effect on reducing the negative effects of Covid-19 on sexual and reproductive health.Trial registrationThis study was not registered in any data base.

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Section: Discussionmentioning

confidence: 99%

Covid-19 Pandemic Impact on Maternal and Child Health Services Access in Nampula, Mozambique: A Mixed Methods Research.

Pires

Macaringue

Abdirazak

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…Patients are usually encouraged to request advice and speak first to a primary care physician by telephone or a video call to avoid in-person appointments and going to primary care settings. Countries recognized to have strong primary care systems, such as Spain, Belgium, and the United Kingdom, have experienced high COVID-19 mortality rates [23,24]. A recent study analyzing the prognostic factors of patients with COVID-19 in primary care was also conducted in Catalonia, including 322 consecutive patients with COVID-19.…”

Section: Introductionmentioning

confidence: 99%

Clinical Characterization of Patients With COVID-19 in Primary Care in Catalonia: Retrospective Observational Study

Mayer¹,

Vidal-Alaball²,

Puigdellı́vol-Sánchez³

et al. 2021

JMIR Public Health Surveill

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Background The country of Spain has one of the highest incidences of COVID-19, with more than 1,000,000 cases as of the end of October 2020. Patients with a history of chronic conditions, obesity, and cancer are at greater risk from COVID-19; moreover, concerns surrounding the use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin type II receptor blockers (ARBs) and its relationship to COVID-19 susceptibility have increased since the beginning of the pandemic. Objective The objectives of this study were to compare the characteristics of patients diagnosed with COVID-19 to those of patients without COVID-19 in primary care; to determine the risk factors associated with the outcome of mortality; and to determine the potential influence of certain medications, such as ACEIs and ARBs, on the mortality of patients with COVID-19. Methods An observational retrospective study of patients diagnosed with COVID-19 in the Catalan Central Region of Spain between March 1 and August 17, 2020, was conducted. The data were obtained from the Primary Care Services Information Technologies System of the Catalan Institute of Health in Barcelona, Spain. Results The study population included 348,596 patients (aged >15 years) registered in the Primary Care Services Information Technologies System of the Catalan Central Region. The mean age of the patients was 49.53 years (SD 19.42), and 31.17% of the patients were aged ≥60 years. 175,484/348,596 patients (50.34%) were women. A total of 23,844/348,596 patients (6.84%) in the population studied were diagnosed with COVID-19 during the study period, and the most common clinical conditions of these patients were hypertension (5267 patients, 22.1%) and obesity (5181 patients, 21.7%). Overall, 2680/348,596 patients in the study population (0.77%) died during the study period. The number of deaths among patients without COVID-19 was 1825/324,752 (0.56%; mean age 80.6 years, SD 13.3), while among patients diagnosed with COVID-19, the number of deaths was 855/23,844 (3.58%; mean age 83.0 years, SD 10.80) with an OR of 6.58 (95% CI 6.06-7.15). Conclusions We observed that women were more likely to contract COVID-19 than men. In addition, our study did not show that hypertension, obesity, or being treated with ACEIs or ARBs was linked to an increase in mortality in patients with COVID-19. Age is the main factor associated with mortality in patients infected with SARS-CoV-2.

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“…These analyses were conducted as part of a broader international project which solicited primary care experts' perceptions of their respective countries' primary care strength, pandemic plan implementation, border control measures, movement restriction and testing correlated against COVID-19 mortality rates. Full methodological details are published elsewhere (Goodyear-Smith et al, 2020). This mixed-method paper provides analysis of respondents' perceptions on their country's pandemic plan and political decision-making correlated with their country's current mortality rate.…”

Section: Methodsmentioning

confidence: 99%

“…Belgium (Molenberghs et al, 2020). Because the pandemic reached countries at different times, our earlier paper used a country's maximum death rate on a 7-day moving average basis to quantify the severity of the pandemic in a country at its worst point, to compensate for these differing trajectories (Goodyear-Smith et al, 2020). However, COVID-19 has now spread to nearly every country, with rising case numbers, and in some cases second waves of infection, hence cumulative death rates were used in this current analysis to allow for more realistic comparisons.…”

Section: Response Variablementioning

confidence: 99%

Primary care perspectives on pandemic politics

Goodyear‐Smith

Kinder

Eden

et al. 2021

Global Public Health

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While the COVID-19 pandemic now affects the entire world, countries have had diverse responses. Some responded faster than others, with considerable variations in strategy. After securing border control, primary health care approaches (public health and primary care) attempt to mitigate spread through public education to reduce personto-person contact (hygiene and physical distancing measures, lockdown procedures), triaging of cases by severity, COVID-19 testing, and contact-tracing. An international survey of primary care experts' perspectives about their country's national responseswas conducted April to early May 2020. This mixed method paper reports on whether they perceived that their country's decision-making and pandemic response was primarily driven by medical facts, economic models, or political ideals; initially intended to develop herd immunity or flatten the curve, and the level of decision-making authority (federal, state, regional). Correlations with country-level death rates and implications of political forces and processes in shaping a country's pandemic response are presented and discussed, informed by our data and by the literature. The intersection of political decision-making, public health/ primary care policies and economic strategies is analysed to explore implications of COVID-19's impact on countries with different levels of social and economic development.

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Relationship between the perceived strength of countries’ primary care system and COVID-19 mortality: an international survey study

Cited by 34 publications

References 17 publications

Covid-19 Pandemic Impact on Maternal and Child Health Services Access in Nampula, Mozambique: A Mixed Methods Research.

Covid-19 Pandemic Impact on Maternal and Child Health Services Access in Nampula, Mozambique: A Mixed Methods Research.

Clinical Characterization of Patients With COVID-19 in Primary Care in Catalonia: Retrospective Observational Study

Primary care perspectives on pandemic politics

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