Regulations by the Minister of Health (the “Minister”) Governing The Control and Abatement of the Spread and Eradication of the Ebola Virus Disease (EVD) in Liberia, hereinafter
PLoSONE 14(9):e0223104.https://doi.org/10.1371/journal.pone.0223104.
The survey centering on reasons behind community resistance was conducted in Butembo in November during a time of Ebola transmission. A researcher from Catholic University of Graben in Butembo and collaborators at the University o...f Alberta in Edmonton published their findings on Sep 26 in PLOS One.
To spark focus group discussions, the researchers used an 18-item questionnaire based on similar ones used during West Africa's outbreak in Guinea, where community resistance and episodes of violence also complicated the outbreak response.
Participants were a convenience sample of 670 adults from the region who were recruited by medical students at Catholic University of Graben. Those surveyed included clinicians, community members, and displaced persons.
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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) started implementing public health measures across Kin...shasa, 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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