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INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and outcomes in Mexico, describe observed and predicte
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d trends in services over 24 months, and to estimate the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
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RESULTS: Between 76 and 97% of the PHCS offered RMCAH services before the lockdown. Except in antenatal, delivery and adolescent care, there was a decline of between 2 and 6% in all the services during the lockdown and up to 10% decline after the lockdown with variation across and within States. Dur
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ing the lockdown. Full-service delivery was reported by 75.2% whereas 24.8% delivered partial services. There was a significant reduction in clients' utilization of the services during the lockdown, and the difference between States before the pandemic, during, and after the lockdown. Reported difficulties during the lockdown included stock-out of drugs (25.7%), stock-out of contraceptives (25.1%), harassment by the law enforcement agents (76.9%), and transportation difficulties (55.8%). Only 2% of the PHCs reported the availability of gowns, 18% had gloves, 90.1% had hand sanitizers, and a temperature checker was available in 94.1%. Slightly above 10% identified clients with symptoms of COVID-19.
CONCLUSIONS: The large proportion of PHCs who provided RMCAH services despite the lockdown demonstrates resilience. Considering the several difficulties reported, and the limited provision of primary protective equipment more effort by the government and non-governmental agencies is recommended to strengthen delivery of sexual and reproductive health in primary health centres in Nigeria during the pandemic.
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ABSTRACT
Objectives: We developed COVID-19 Outbreak Simulator (https://ictr.github.io/covid19-outbreak-simulator/) to quantitatively estimate the effectiveness of preventative and interventive measures to prevent and battle
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COVID-19 outbreaks for specific populations.
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INTRODUCTION: Health service use among the public can decline during outbreaks and had been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the government of the Democratic Republic of the Congo (DRC) sta
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rted implementing public health measures across Kinshasa, including strict lock-down measures in the Gombe health zone.
METHODS: Using monthly time series data from the DRC Health Management Information System (January 2018 to December 2020) and interrupted time series with mixed effects segmented Poisson regression models, we evaluated the impact of the pandemic on the use of essential health services (outpatient visits, maternal health, vaccinations, visits for common infectious diseases and non-communicable diseases) during the first wave of the pandemic in Kinshasa. Analyses were stratified by age, sex, health facility and lockdown policy (i.e, Gombe vs other health zones).
RESULTS: Health service use dropped rapidly following the start of the pandemic and ranged from 16% for visits for hypertension to 39% for visits for diabetes. However, reductions were highly concentrated in Gombe (81% decline in outpatient visits) relative to other health zones. When the lock-down was lifted, total visits and visits for infectious diseases and non-communicable diseases increased approximately twofold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected.
CONCLUSION: The COVID-19 pandemic resulted in important reductions in health service utilizsation in Kinshasa, particularly Gombe. Lifting of lock-down led to a rebound in the level of health service use but it remained lower than pre-pandemic levels.
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A study conducted by the World Health Organisation Regional Office for Africa. The COVID-19 pandemic has had a significant impact on older persons both globally and in the African region. Although overall the region’s population is younger relativ
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e to many other world regions, the WHO AFRO region has a population just over 62 million older people and is ageing rapidly, with the number of older people expected to triple in the next three decades (Aboderin et al., 2020).
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Quick reference guide
Guidelines on Management of COVID-19 in Kenya
recommended
It has been over a year since Kenya identified the first case of COVID-19 in the country. The Government formed the National COVID-19 task force, which supported the country's response through multi
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-sectoral technical working groups on testing, case management, risk communication and community engagement among others. An earlier version of the COVID case management guideline was released in April 2020 and capacity building of health care workers on diagnosis and treatment of COVID-19 was quickly carried out, even as counties prepared themselves by setting up isolation centres and supplies
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The COVID-19 pandemic has disproportionately impacted the informal women workers due to lockdowns, curfews, school closures, and all other containment measures- most of which missed the feminist lens in their formulation, enforcement, and reporting.
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All recovery efforts, therefore, ought to deliberately consider the informal sector.
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Consenso de recomendaciones de cuidados paliativos en la pandemia por SARS-Cov-2/COVID-19 - 2020
T. Fernández Dávil, P. A. Hidalgo Andrade, F. G. Torres Toala et al.
El Gobierno des Todos, Ecuador
(2020)
CC
Consolidated recommendations for palliative care in the SARS pandemic-Cov-2/COVID-19 2020
Recommendations for in-patient management of COVID-19 in adult patients
Version 10, November 2020.
Protocol for the management of specialized centres for the treatment of people with alcohol and other drug abuse problems (CETAD) in the framework of the COVID-19 pandemic. Version 1.
Flow chart for the care of symptomatic-respiratory patients suspected of COVID-19
Protocolo Atención de enfermería a pacientes adultos con COVID-19 sin complicaciones respiratorias
Gavilanez Medina Patricia, Gualoto Lincango Blanca, Chamorro Obando Patricia et al
Ministerio de Salud Pública del Ecuador
(2020)
CC
Nursing Care Protocol for adult patients with COVID-19 without respiratory complications
COVID-19, General Epidemiological Surveillance Guidelines (Version 6)
The Participation of the National Police of Ecuador in the handling and transport of COVID-19 corpses
