2022
DOI: 10.1093/heapol/czac024
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Foregone healthcare during the COVID-19 pandemic: early survey estimates from 39 low- and middle-income countries

Abstract: In addition to the direct health effects of the COVID-19 pandemic, the pandemic has increased the risks of foregone non-COVID-19 health care. Likely, these risks are greatest in low- and middle-income countries (LMICs), where health systems are less resilient and economies more fragile. However, there are no published studies on the prevalence of foregone health care during the pandemic in LMICs. We used pooled data from phone surveys conducted between April and August 2020, covering 73,638 households in 39 LM… Show more

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Cited by 18 publications
(16 citation statements)
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References 24 publications
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“…The primary concern is the possible differential change in utilization between reporting and nonreporting facilities. Findings from household surveys and interviews with key health system stakeholders during the pandemic confirm that private facilities and community programs did not compensate for the disruptions in the public sector, and there were substantial levels of foregone care in the population [ 17 , 20 ].…”
Section: Methodsmentioning
confidence: 99%
See 1 more Smart Citation
“…The primary concern is the possible differential change in utilization between reporting and nonreporting facilities. Findings from household surveys and interviews with key health system stakeholders during the pandemic confirm that private facilities and community programs did not compensate for the disruptions in the public sector, and there were substantial levels of foregone care in the population [ 17 , 20 ].…”
Section: Methodsmentioning
confidence: 99%
“…In Nepal, a large cohort study of women found decreases of more than half in institutional delivery rates, poorer quality of care, and increases in stillbirth and neonatal mortality rates [ 19 ]. Phone surveys of households in 39 low- and middle-income countries in April to August 2020 found that a substantial proportion of households reported forgone care [ 20 ]. While there is clear evidence that service disruptions have occurred, there is substantial variation across countries, levels of care, and service types.…”
Section: Introductionmentioning
confidence: 99%
“…Mental health problems were also found to correlate with foregone healthcare [60,61]. There also appears to be evidence of avoidance related to concerns about contracting the disease [62], with more foregone care in more highly developed areas [59]. While there are a host of articles documenting avoidance, this article is the first to our knowledge that examines evidence for crises to lead to increased avoidance behaviors through emotional mediators, such as hopelessness.…”
Section: Discussionmentioning
confidence: 91%
“…While we lack the data to establish causal links, foregone/delayed healthcare has been widely documented during the COVID-19 pandemic in high-, medium-, and low-income populations within and across countries [58][59][60][61][62]. Studies have found that lack of financial means to access care is important in explaining foregone medical care-just as in our results-though the published literature finds that income is primarily cited as a barrier among low-income populations [60,62]. Mental health problems were also found to correlate with foregone healthcare [60,61].…”
Section: Discussionmentioning
confidence: 99%
“…COVID-19 causes uncertainty for many people (Sodi et al, 2021). Individuals missed or had late diagnoses with potentially serious health consequences as a result of forgoing health care during the pandemic for financial reasons or fear of acquiring COVID-19 (Anderson et al, 2021; Gonzalez et al, 2021; Kakietek et al, 2022). Along with avoiding primary care visits, individuals avoided potentially life-saving emergency department care to avoid exposure to COVID-19 (Gale et al, 2021).…”
mentioning
confidence: 99%