BOOK: THE IMPACT OF COVID-19 ON HIV, TB AND MALARIA SERVICES AND SYSTEMS FOR HEALTH: A SNAPSHOT FROM 502 HEALTH FACILITIES ACROSS AFRICA AND ASIA

 

THE IMPACT OF COVID-19 ON HIV, TB AND MALARIA SERVICES AND SYSTEMS FOR HEALTH: A SNAPSHOT FROM 502 HEALTH FACILITIES ACROSS AFRICA AND ASIA

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Access to services

As COVID-19 rapidly spread in 2020, outpatient

consultations at health facilities declined considerably

compared to 2019. All health facilities surveyed in the

spot-checks describe changes in attendance, highlighting

the widespread reach of COVID-19 and its impact. The

main reason patients were no longer coming to health

facilities was due to their fear of catching COVID-19,

according to 85% of facilities surveyed. Patients were

also no longer able to reach health facilities because of

disruption to public transportation services, as well as

lockdown and stay-at-home orders. These trends were

slightly more acute in urban settings. Some patients

also delayed seeking care, while others no longer visited

clinics due to changes in recommendations for mild

illness and elective care.

Overall, facilities appear to have put considerable effort

into keeping services open, despite the challenging

circumstances. Where this was not possible, facilities

redirected patients to and from other facilities, and some

specific services were reduced or no longer offered, which

affected patient attendance. Other factors influencing

patient access to services included more patients

presenting with respiratory infection symptoms and other

services being disrupted. In addition, as everyone’s focus

became consumed by COVID-19, there was a reduction in

general health communication campaigns to encourage

people to seek out health care.

The change in attendance and access to services is

particularly dangerous for mothers and children. Early

childhood is a particularly vulnerable time for health

issues, and the impact of COVID-19 is not sparing the

young. Antenatal care first visits (ANC1) fell by 5% across

Africa, and by a staggering 66% across facilities surveyed

in seven countries across Asia. Services for children

under 5 were also badly impacted by the pandemic.

Facilities across Africa experienced a decrease of 23%

in consultations for under-5 services in 2020 relative to

2019, while in seven countries across Asia these services

fell 74%, resulting in significantly fewer children being

seen by health care workers and receiving lifesaving

care. If mothers and children’s access to essential health

services is reduced, mortality among children under 5

could be expected to rise.


HIV

Access to services

As COVID-19 rapidly spread in 2020, outpatient

consultations at health facilities declined considerably

compared to 2019. All health facilities surveyed in the

spot-checks describe changes in attendance, highlighting

the widespread reach of COVID-19 and its impact. The

main reason patients were no longer coming to health

facilities was due to their fear of catching COVID-19,

according to 85% of facilities surveyed. Patients were

also no longer able to reach health facilities because of

disruption to public transportation services, as well as

lockdown and stay-at-home orders. These trends were

slightly more acute in urban settings. Some patients

also delayed seeking care, while others no longer visited

clinics due to changes in recommendations for mild

illness and elective care.

Overall, facilities appear to have put considerable effort

into keeping services open, despite the challenging

circumstances. Where this was not possible, facilities

redirected patients to and from other facilities, and some

specific services were reduced or no longer offered, which

affected patient attendance. Other factors influencing

patient access to services included more patients

presenting with respiratory infection symptoms and other

services being disrupted. In addition, as everyone’s focus

became consumed by COVID-19, there was a reduction in

general health communication campaigns to encourage

people to seek out health care.

The change in attendance and access to services is

particularly dangerous for mothers and children. Early

childhood is a particularly vulnerable time for health

issues, and the impact of COVID-19 is not sparing the

young. Antenatal care first visits (ANC1) fell by 5% across

Africa, and by a staggering 66% across facilities surveyed

in seven countries across Asia. Services for children

under 5 were also badly impacted by the pandemic.

Facilities across Africa experienced a decrease of 23%

in consultations for under-5 services in 2020 relative to

2019, while in seven countries across Asia these services

fell 74%, resulting in significantly fewer children being

seen by health care workers and receiving lifesaving

care. If mothers and children’s access to essential health

services is reduced, mortality among children under 5

could be expected to rise.




Page 6


Facilities also noted that prevention of mother-tochild

transmission (PMTCT) services and deliveries of

prevention packages through outreach or drop-in visits

were also lower between April to September 2020

compared to the same period in 2019. These disruption

patterns caused by COVID-19 risk reversing the progress

made in the fight against HIV. Fewer mothers being

referred and fewer people being tested means that they

will not be diagnosed or treated, and without treatment,

they could get sick or die. Moreover, more babies will be

born with HIV when PMTCT services are disrupted, which

could wipe out years of progress in making sure that

babies are born HIV-free.

Disruption to HIV prevention services, including referrals,

testing, and PMTCT, means that people are running a

higher risk of not knowing their HIV status, and therefore

of not accessing the treatment they need, as well as

running the risk of unknowingly infecting others. Trends

indicate that services are progressively resuming, but we

must significantly increase our efforts to regain progress

lost in 2020 and get back on track to ending HIV as an

epidemic by 2030.


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