Announcement

Collapse
No announcement yet.

Health Policy Plan . Resilience of front-line facilities during COVID-19: evidence from cross-sectional rapid surveys in eight low- and middle-income countries

Collapse
X
 
  • Filter
  • Time
  • Show
Clear All
new posts

  • Health Policy Plan . Resilience of front-line facilities during COVID-19: evidence from cross-sectional rapid surveys in eight low- and middle-income countries

    Health Policy Plan


    . 2023 May 30;czad032.
    doi: 10.1093/heapol/czad032. Online ahead of print. Resilience of front-line facilities during COVID-19: evidence from cross-sectional rapid surveys in eight low- and middle-income countries

    Michael A Peters 1 , Tashrik Ahmed 1 , Viviane Azais 1 , Pablo Amor Fernandez 1 , Prativa Baral 1 , Salomé Drouard 1 , Rachel Neill 1 , Kante Bachir 2 , Poidinguem Bassounda 3 , Queen Dube 4 , Sabrina Flora 5 , Edwin Montufar 6 , Charles Nzelu 7 , Mahamadi Tassembedo 8 , Chea Sanford Wesseh 9 , Bushra Alam 10 , Jean de Dieu Rusatira 1 , Tawab Hashemi 1 , Alain-Desire Karibwami 1 , Virginia Moscosco 1 , Munirat Ogunlayi 1 , Tania Ortiz de Zunigalo 1 , Julie Ruel-Bergeron 1 , Isidore Sieleunou 1 , Peter M Hansen 1 , Gil Shapira 10



    AffiliationsAbstract

    Responsive primary health-care facilities are the foundation of resilient health systems, yet little is known about facility-level processes that contribute to the continuity of essential services during a crisis. This paper describes the aspects of primary health-care facility resilience to coronavirus disease 2019 (COVID-19) in eight countries. Rapid-cycle phone surveys were conducted with health facility managers in Bangladesh, Burkina Faso, Chad, Guatemala, Guinea, Liberia, Malawi and Nigeria between August 2020 and December 2021. Responses were mapped to a validated health facility resilience framework and coded as binary variables for whether a facility demonstrated capacity in eight areas: removing barriers to accessing services, infection control, workforce, surge capacity, financing, critical infrastructure, risk communications, and medical supplies and equipment. These self-reported capacities were summarized nationally and validated with the ministries of health. The analysis of service volume data determined the outcome: maintenance of essential health services. Of primary health-care facilities, 1,453 were surveyed. Facilities maintained between 84% and 97% of the expected outpatient services, except for Bangladesh, where 69% of the expected outpatient consultations were conducted between March 2020 and December 2021. For Burkina Faso, Chad, Guatemala, Guinea and Nigeria, critical infrastructure was the largest constraint in resilience capabilities (47%, 14%, 51%, 9% and 29% of facilities demonstrated capacity, respectively). Medical supplies and equipment were the largest constraints for Liberia and Malawi (15% and 48% of facilities demonstrating capacity, respectively). In Bangladesh, the largest constraint was workforce and staffing, where 44% of facilities experienced moderate to severe challenges with human resources during the pandemic. The largest constraints in facility resilience during COVID-19 were related to health systems building blocks. These challenges likely existed before the pandemic, suggesting the need for strategic investments and reforms in core capacities of comprehensive primary health-care systems to improve resilience to future shocks.

    Keywords: COVID-19; Resilience; essential health services; health facility; primary health care.

Working...
X