Use of health care services during the Covid-19 pandemic in Ethiopia: Evidence from a health facility survey

Abstract

Introduction: In recent years Ethiopia has made enormous strides in enhancing access to health care, especially, maternal and child health care (MCH). With the onset and spread of Covid-19, the attention of the health care system has pivoted to handling the disease, potentially at the cost of other health care needs. This paper explores whether this shift has come at the cost of non Covid related health care, especially the use of MCH services. Methods: Graphs, descriptive statistics and paired t-tests of significance are used to compare levels of inpatient and outpatient health care service utilization before and after the onset and spread of the virus. The analysis is based on a survey of 59 health centers and 29 public hospitals located in urban Ethiopia, the most acutely affected region of the country. Data on the use of health care services for a period of 24 months was gathered from the health management information systems (HMIS) of these facilities. Results: There is a sharp reduction in the use of both inpatient (20-27%) and outpatient (27-34%) care, particularly in Addis Ababa, which has been most acutely affected by the virus. However, the decline does not come at the cost of MCH services. The use of several MCH components (skilled birth attendant deliveries, immunization, post-natal care) remains unaffected throughout the period while others (family planning services, ante-natal care) experience a decline (8-17%) in the immediate aftermath but recover soon after. Conclusion: Concerns about the crowding out of MCH services due to the focus on Covid 19 are unfounded. Pro-active measures taken by the government and health care facilities to ring-fence the use of essential health care services have mitigated service disruptions. The results underline the resilience and agility displayed by one of the worlds most resource-constrained health care systems.

Impact of COVID-19 pandemic on utilization of essential maternal healthcare services in Ethiopia: A systematic review and meta-analysis

“…Out of twenty-one selected studies; thirteen studies were quantitative cross-sectional studies, five were mixed (quantitative and qualitative) studies, two were pre-post studies, and one was a qualitative study. Sixteen studies were published [39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54] while the other five studies were unpublished [55][56][57][58][59]. Seven studies were conducted in Addis Ababa administrative city [39,42,43,46,47,55,58], three studies were conducted in Southern Nations Nationalities and People (SNNPR) [44,51,59], four studies were from Amhara region [40,45,49,57], four studies were nationwide surveys [48,50,52,56], one study was in Oromia region [53], one study was from Tigray region [54], and one study was conducted in Somali region [41].…”

“…Sixteen studies were published [39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54] while the other five studies were unpublished [55][56][57][58][59]. Seven studies were conducted in Addis Ababa administrative city [39,42,43,46,47,55,58], three studies were conducted in Southern Nations Nationalities and People (SNNPR) [44,51,59], four studies were from Amhara region [40,45,49,57], four studies were nationwide surveys [48,50,52,56], one study was in Oromia region [53], one study was from Tigray region [54], and one study was conducted in Somali region [41]. Eleven studies reported quantitative findings on the reduction of antenatal care, ten studies reported the reduction of family planning, six studies reported a decrease in facility delivery, four studies reported the reduction of abortion care, and three studies reported a reduction in postnatal care services.…”

Essential maternal health service disruptions in Ethiopia during COVID 19 pandemic: a systematic review

“…At the same time, the MOH ensured the continuation of essential services, such as reproductive, maternal, neonatal, child, and adolescent health services, and the management of major communicable and noncommunicable diseases, surgical care, and emergency and critical care [12]. Despite several studies conducted on the impact of COVID 19 on maternal health services in different regions of the country [13][14][15][16][17][18][19][20], there is a lack of evidence that can recapitulate the extent of impact as a nation and which essential maternal health service is most affected. Thus this systematic review aims to summarize the extent of disruption of essential maternal health services and identify the most significantly affected service in the era of the COVID pandemic in Ethiopia.…”