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COVID-19 and resilience of healthcare systems in ten countries.


ABSTRACT: Declines in health service use during the Coronavirus Disease 2019 (COVID-19) pandemic could have important effects on population health. In this study, we used an interrupted time series design to assess the immediate effect of the pandemic on 31 health services in two low-income (Ethiopia and Haiti), six middle-income (Ghana, Lao People's Democratic Republic, Mexico, Nepal, South Africa and Thailand) and high-income (Chile and South Korea) countries. Despite efforts to maintain health services, disruptions of varying magnitude and duration were found in every country, with no clear patterns by country income group or pandemic intensity. Disruptions in health services often preceded COVID-19 waves. Cancer screenings, TB screening and detection and HIV testing were most affected (26-96% declines). Total outpatient visits declined by 9-40% at national levels and remained lower than predicted by the end of 2020. Maternal health services were disrupted in approximately half of the countries, with declines ranging from 5% to 33%. Child vaccinations were disrupted for shorter periods, but we estimate that catch-up campaigns might not have reached all children missed. By contrast, provision of antiretrovirals for HIV was not affected. By the end of 2020, substantial disruptions remained in half of the countries. Preliminary data for 2021 indicate that disruptions likely persisted. Although a portion of the declines observed might result from decreased needs during lockdowns (from fewer infectious illnesses or injuries), a larger share likely reflects a shortfall of health system resilience. Countries must plan to compensate for missed healthcare during the current pandemic and invest in strategies for better health system resilience for future emergencies.

SUBMITTER: Arsenault C 

PROVIDER: S-EPMC9205770 | biostudies-literature | 2022 Jun

REPOSITORIES: biostudies-literature

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COVID-19 and resilience of healthcare systems in ten countries.

Arsenault Catherine C   Gage Anna A   Kim Min Kyung MK   Kapoor Neena R NR   Akweongo Patricia P   Amponsah Freddie F   Aryal Amit A   Asai Daisuke D   Awoonor-Williams John Koku JK   Ayele Wondimu W   Bedregal Paula P   Doubova Svetlana V SV   Dulal Mahesh M   Gadeka Dominic Dormenyo DD   Gordon-Strachan Georgiana G   Mariam Damen Haile DH   Hensman Dilipkumar D   Joseph Jean Paul JP   Kaewkamjornchai Phanuwich P   Eshetu Munir Kassa MK   Gelaw Solomon Kassahun SK   Kubota Shogo S   Leerapan Borwornsom B   Margozzini Paula P   Mebratie Anagaw Derseh AD   Mehata Suresh S   Moshabela Mosa M   Mthethwa Londiwe L   Nega Adiam A   Oh Juhwan J   Park Sookyung S   Passi-Solar Álvaro Á   Pérez-Cuevas Ricardo R   Phengsavanh Alongkhone A   Reddy Tarylee T   Rittiphairoj Thanitsara T   Sapag Jaime C JC   Thermidor Roody R   Tlou Boikhutso B   Valenzuela Guiñez Francisco F   Bauhoff Sebastian S   Kruk Margaret E ME  

Nature medicine 20220314 6


Declines in health service use during the Coronavirus Disease 2019 (COVID-19) pandemic could have important effects on population health. In this study, we used an interrupted time series design to assess the immediate effect of the pandemic on 31 health services in two low-income (Ethiopia and Haiti), six middle-income (Ghana, Lao People's Democratic Republic, Mexico, Nepal, South Africa and Thailand) and high-income (Chile and South Korea) countries. Despite efforts to maintain health service  ...[more]

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