Resilience of primary healthcare system across low- and middle-income countries during COVID-19 pandemic: a scoping review

Health Research Policy and Systems, Journal Year: 2023, Volume and Issue: 21(1)

Published: Sept. 18, 2023

Abstract Introduction Globally, the coronavirus disease 2019 (COVID-19) pandemic tested resilience of health system and its shock-absorbing capacity to continue offering healthcare services. The available evidences does not provide comprehensive insight into primary care (PHC) functioning across low- middle- income countries (LMICs) during pandemic. Therefore, objective this scoping review was generate evidence on PHC systems in LMICs COVID-19 Methods A carried out utilizing an iterative search strategy using National Library Medicine (NLM) WHO electronic databases. Data from identified studies were charted Preferred Reporting Items for Systematic Reviews Meta-Analyses extension Scoping (PRISMA-ScR) checklist first step. analysis framework adapted modified developed by Sagan et al., Blanchet position paper ‘Building universal coverage security beyond’. total 26 documents included basis predefined eligibility criteria our analysis. Results Our explored data 44 that implemented strategies at level Most national guidelines sexual, reproductive, maternal, newborn, child, adolescent (SRMNCAH). also transformed reoriented service delivery introducing digital services essential Task shifting, task sharing, redeployment retired staff some frequently adopted workforce most countries. Only a few demonstrated availability necessary monetary resources respond Conclusions functionality variety six building blocks system. To strengthen resilience, we recommend strengthening community-based PHC, cross-sectoral collaboration, establishing surveillance systems, financial risk planning, investing

Language: Английский

---

Changes in emergency department visits and mortality during the COVID-19 pandemic: a retrospective analysis of 956 hospitals

Archives of Public Health, Journal Year: 2024, Volume and Issue: 82(1)

Published: Jan. 12, 2024

Abstract Background During the COVID-19 pandemic, many non-COVID-19 emergency department (ED) visits were indirectly affected. ED and mortality assessed during different pandemic time periods compared with pre-pandemic. Methods The study used data from 41 million Iran Health Insurance Organization members. outcomes associated in 956 hospitals. An analysis of was conducted both for all-cause cause-specific conditions: cardiovascular diseases (CVD), mental substance use disorders, unintentional injuries, self-harm. In addition, total in-hospital analyzed. A negative binomial regression a Poisson log link to estimate incidence rate ratio (IRR) relative risk (RR). Results 1,789,831 12,377 deaths reported study. Pre-pandemic (Sep 2019 Feb 2020), there 2,767 per person-month, which decreased 1,884 first wave national lockdown 20 Apr 19, 2020 (IRR 0.68, [0.56–0.84]). 8.17 1,000 visit-month pre-pandemic period, rising 12.80 (RR 1.57, [1.49–165]). Non-COVID-19 visit rates year Sep 2021 0.73, [0.63–0.86]), but increased after vaccination two years later 2022 1.11, [0.96–0.17]). significantly higher outbreak 1.66, [1.59–1.72]) second 1.27, [1.22–1.32]) pandemic. health disorders declined 8.18 person-month 4.57 0.53, [0.32 0.90]) wave. year, injury 1.63, [1.30–2.03]). As before no significant change CVD self-harm Cardiac arrest leading cause death hospitals’ EDs. Conclusion hospital increased. Despite since outbreak, remains high.

Language: Английский

---

Unintended Consequences of COVID-19 Non-Pharmaceutical Interventions (NPIs) for Population Health and Health Inequalities

International Journal of Environmental Research and Public Health, Journal Year: 2023, Volume and Issue: 20(7), P. 5223 - 5223

Published: March 23, 2023

Since the start of COVID-19 pandemic in early 2020, governments around world have adopted an array measures intended to control transmission SARS-CoV-2 virus, using both pharmaceutical and non-pharmaceutical interventions (NPIs). NPIs are public health that do not rely on vaccines or medicines include policies such as lockdowns, stay-at-home orders, school closures, travel restrictions. Although intention was slow viral transmission, emerging research indicates these also had unintended consequences for other aspects health. Hence, we conducted a narrative review studies investigating NPIs, with particular emphasis mental lifestyle risk factors non-communicable diseases (NCD): physical activity (PA), overweight obesity, alcohol consumption, tobacco smoking. We reviewed scientific literature combinations search terms ‘COVID-19′, ‘pandemic’, ‘lockdowns’, ‘mental health’, ‘physical activity’, ‘obesity’. were found considerable adverse health, activity, obesity. The impacts consumption varied greatly within between studies. variability different groups implies increased inequalities by age, sex/gender, socioeconomic status, pre-existing lifestyle, place residence. In conclusion, proper assessment use attempts spread should be weighed against potential Our findings relevance future preparedness response teams.

Language: Английский

---

The effect of Covid-19 pandemic on the primary health care utilization and cost: an interrupted time series analysis

Cost Effectiveness and Resource Allocation, Journal Year: 2025, Volume and Issue: 23(1)

Published: Feb. 12, 2025

Changes in the demand behavior for primary care during covid-19 pandemic may translate into changes overall public health situation Iran with increase prevalence of non-communicable diseases. The present study aimed to investigate impact Covid-19 on utilization and cost Fars province Iran. Monthly was extracted from data base branch Health Insurance Organization (IHIO) interrupted time series analysis (ITSA) used short-term long-term effects care. mean difference test showed that monthly after has decreased significantly (64307 11581 US dollars cost). ITSA estimates number visits by 53,003 short term 2,330 long term. Moreover, shows a significant decrease $24,722 $3,822 per month term, respectively. It found reduction Considering role controlling burden chronic diseases, planning active follow-up patients conditions should be agenda.

Language: Английский

---

Estimating the effects of COVID-19 on essential health services utilization in Uganda and Bangladesh using data from routine health information systems

Frontiers in Public Health, Journal Year: 2023, Volume and Issue: 11

Published: Sept. 27, 2023

Since March 2020, the coronavirus disease 2019 (COVID-19) pandemic has been a major shock to health systems across world. We examined national usage patterns for selected basic, essential services, before and during COVID-19 in Uganda Bangladesh, determine whether affected reporting of service utilization use services each country.

Language: Английский

---

Impact of COVID-19 Pandemic on Utilization of Healthcare Services and Spending Patterns in Dubai, United Arab Emirates: A Cross-Sectional Study

Healthcare, Journal Year: 2024, Volume and Issue: 12(4), P. 473 - 473

Published: Feb. 14, 2024

Background: The COVID-19 pandemic affected the utilization of healthcare services in many parts world. response to burden imposed by was associated with ensuring provision optimum services. This study aimed estimate effect on health and spending patterns Dubai, UAE. Methods: cross-sectional used secondary data compare between 2019 2020. extracted from insurance claims eClaimLink platform. Descriptive inferential statistics were calculate percent change service percentages total each encounter type across major diagnostic categories (MDCs). Results: In 2020, there an overall reduction outpatient visits inpatient admissions 27% 21%, respectively, compared 2019. Outpatient prescriptions decreased all MDCs except mental behavioral disorders, which showed increase 8% 29% prescriptions. facilities also reduced significantly various MDCs, ranging 10% 44%. Similarly, a downward trend seen diagnostics for different MDCs. An expenditure drugs neoplasm reported, despite corresponding decrease same. Conclusion: A significant spending, resulting decline volume at levels (hospitals, clinics, speciality centres), reported during pandemic. impact this study, as it upward spending. For neoplasms, although declined, increased significantly.

Language: Английский

---

The impact of Covid-19 on harm reduction policies in Iran: an interrupted time series analysis

Harm Reduction Journal, Journal Year: 2025, Volume and Issue: 22(1)

Published: Jan. 7, 2025

Language: Английский

---

The Trend of Prehospital Emergency Medical Care Services after the COVID-19 Pandemic: A Time Series Analysis

The Open Public Health Journal, Journal Year: 2025, Volume and Issue: 18(1)

Published: Jan. 16, 2025

Introduction The COVID-19 epidemic in 2019 directly or indirectly had an impact on the healthcare system of hospitals. Iran was among countries whose hospitals and especially emergency were affected by outbreak Coronavirus. main objective this study is to compare number services, including heart respiratory diseases, accidents, drowning, CO poisoning, after coronavirus pandemic Chaharmahal Bakhtiari provinces. Methods In study, obtaining necessary permissions, attempt made analyze data most common Emergency Medical Services (EMS) extracted monthly city from ASAYAR during 2020-2023 using time series Auto-regressive Integrated Moving Average (ARIMA) model. Results services related accidents upward trend based seasonal changes. Examination effects shows that occurred months June through September; disease relatively constant. addition, diseases constant average despite many fluctuations observations. During pandemic, interventions calls increased. Conclusion Therefore, should increase their response capacity these cases modifying programs approaches, increasing staff, providing appropriate training.

Language: Английский

---

Access and use of general and mental health services before and during the COVID-19 pandemic: a systematic review and meta-analysis

BMJ Open, Journal Year: 2025, Volume and Issue: 15(3), P. e091342 - e091342

Published: March 1, 2025

Objectives To quantify access to health services during the COVID-19 pandemic and measure change in use between prepandemic periods a population with assessment of psychological distress or diagnosis mental disorders. Data sources We developed piloted search syntax adapted it enter following databases from 1 January 2020 31 March 2023: PubMed/MEDLINE, PsycINFO, Web Science, Epistemonikos WHO International Clinical Trials Registry Platform. reran searches end original 3 December 2024. Design systematically screened titles, abstracts full texts retrieved records. Eligibility criteria included observational studies on any populations regions, covering such as doctor visits, hospital admissions, diagnostic examinations, pharmaceutical therapies (MH) services. Only using validated scales assess disorders defined Diagnostic Statistical Manual Mental Disorders were included. extraction synthesis extracted data purposefully designed form evaluated studies’ quality Newcastle-Ottawa Scale. measured incidence rate (IR) IR ratio (IRR) periods. calculated contacts days catchment areas different used random effects DerSimonian-Laird inverse-variance model heterogeneity statistics I² τ². computed pooled IRR tested hypothesis no variation (IRR=1). Results 10 014 records examined text 580 articles. 136 primary which 44 meta-analysed. The was 2.59 contact months per 000 inhabitants (IR=2.592; 95% CI: 1.301 5.164). observed reduction 28.5% negligible differences by age group type (IRR=0.715; 0.651 0.785). significant effect sizes across (τ 2 =5.44; p<0.001 τ =0.090; p<0.001). Conclusion By considering MH, our study provides consolidated evidence quantifies pandemic. PROSPERO registration number CRD42023403778.

Language: Английский

---

Effect of the COVID-19 pandemic on utilization of essential health services in Iran evidence from an interrupted time series analysis

BMC Public Health, Journal Year: 2024, Volume and Issue: 24(1)

Published: April 11, 2024

Abstract Background The COVID-19 disrupted the provision of essential health services in numerous countries, potentially leading to outbreaks deadly diseases. This study aims investigate effect pandemic on utilization Iran. Methods An analytical cross-sectional was conducted using interrupted time series (ITS) analysis. Data about five indicators, including 'childhood vaccination, infant care, hypertension screening, diabetes and breast cancer screening,' were obtained from electronic record System two-time intervals: 15 months before (November 2018 January 2020) after (January 2020 May 2021) onset pandemic. data analyzed by utilizing ITS. In addition, a Poisson model employed due usage count data. Durbin-Watson (DW) test used identify presence lag-1 autocorrelation All statistical analysis performed R 4.3.1 software, considering 5% significance level. Results ITS showed that significantly affected all ( P < 0.0001 ). screening (RR = 0.51, p 0.001), 0.884, 0.435, childhood vaccination (IRR 0.947, care 1.666, exhibited significant decrease short term following However, long-term trend for service utilization, except 0.952, demonstrated increase. Conclusions It is imperative utilize this evidence develop policies will be translated into targeted planning implementation sustain during public emergencies. also vital raise awareness knowledge regarding consequences interruptions services. it important supply- demand-side factors contributing these disruptions.

Language: Английский

---