The impact of the COVID-19 pandemic on the provision & utilisation of primary health care services in Goma, Democratic Republic of the Congo, Kambia district, Sierra Leone & Masaka district, Uganda

Abstract

Introduction This study aimed to determine whether the COVID-19 pandemic had an impact on essential primary healthcare services at public primary healthcare facilities. Methods The number of weekly consultations for antenatal care (ANC), outpatient (OPD), immunisations (EPI), family planning (FP) and HIV services, between January 2018 and December 2020, were collected from 25 facilities in Masaka district, Uganda, 21 in Goma, and 29 in Kambia district, Sierra Leone. Negative binomial regression models accounting for clustering and season were used to analyse changes in activity levels between 2018, 2019 and 2020. Results In Goma, we found no change in OPD, EPI or ANC consultations, FP was 17% lower in March-July 2020 compared to 2019, but this recovered by December 2020. New diagnoses of HIV were 34% lower throughout 2020 compared to 2019. In Sierra Leone, compared to the same periods in 2019, facilities had 18–29% fewer OPD consultations throughout 2020, and 27% fewer DTP3 doses in March-July 2020. There was no evidence of differences in other services. In Uganda there were 20–35% fewer under-5 OPD consultations, 21–66% fewer MCV1 doses, and 48–51% fewer new diagnoses of HIV throughout 2020, compared to 2019. There was no difference in the number of HPV doses delivered. Conclusions The level of disruption varied across the different settings and qualitatively appeared to correlate with the strength of lockdown measures and reported attitudes towards the risk posed by COVID-19. Mitigation strategies such as health communications campaigns and outreach services may be important to limit the impact of lockdowns on primary healthcare services.

Concurrent emergencies: overlapping Salmonella and COVID-19 concerns in public health strategies and preparedness

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“…The prevalence of maternal health service usage was observed to be low in various places, such as Ethiopia 13 and several developed countries, 14 as well as in many African countries like Congo, Sierra Leone, and Uganda. 15 The extent of disruption varied across these diverse settings, and it appeared to be qualitatively associated with the stringency of lockdown measures and the perceived attitudes towards the risks posed by COVID-19.…”

Impact of Coronavirus Disease 2019 on the Diagnosis and Treatment of Pancreatic Cancer: An Observational Cohort Study

“…The coronavirus disease 2019 (COVID-19) outbreak has significantly impacted health-care systems worldwide. 1 - 3 To better allocate resources and reduce the viral transmission risk, many health-care facilities were obliged to postpone or cancel non-urgent procedures, surgeries, and appointments. 4 , 5 Several guidelines recommended individuals to avoid hospital visits and surgeries during the COVID-19 pandemic, unless absolutely necessary.…”