The impact of COVID-19 on health care accessibility and financial risk protection in Sri Lanka.

IF 0.3 Q3 MEDICINE, GENERAL & INTERNAL

Ceylon Medical Journal Pub Date : 2023-08-24 DOI:10.4038/cmj.v68iSI1.9729

Sumal Nandasena, A U Gamage, Nithershini Periyasamy, Mohammad Rismy, Kumarendran Balachandran, Kasturiratne Anuradhani

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Abstract

Introduction: The COVID-19 pandemic negatively impacted the global economy, disrupted essential health services, and distorted social determinants of health, reducing healthcare accessibility and increasing financial risk.

Aim: we aimed to assess the impact of COVID-19 on healthcare accessibility and financial risk protection in Sri Lanka.

Methodology: We conducted a cross-sectional study on a representative sample (multi-stage sampling process) of 3151 households in 105 clusters representing all the districts of Sri Lanka. The data collection was conducted using an interviewer-administered questionnaire in early November 2021. This was important to classify three periods of interest, namely: (1) the pre-lockdown period (2) the nationwide lockdown period, and (3) the new normal period. (After Oct 1 to early November 2021).

Results: Among 11,463 household occupants, 12.6% reported having chronic diseases, with 76.5% diagnosed prior to six months. The majority had heart disease, high blood pressure, or diabetes. Of them, 53.7% have been followed up during the lockdown, increasing to 80.8% in the new normal period. Provincial variations in expenses were observed, with the highest food expenses in the Western Province. Catastrophic health expenditures affected 9.5% and 3.4% of households at 10% and 25%, respectively.

Conclusions: A considerable proportion of those having heart disease, high blood pressure, high blood sugar or diabetes mellitus were not followed up in the lockdown period and the first month of the new normal period. Antenatal care and family planning were the least affected. Participants had incurred high out-of-pocket expenditures for healthcare during the entire period.

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2019冠状病毒病对斯里兰卡卫生保健可及性和金融风险保护的影响

导言:2019冠状病毒病大流行对全球经济产生了负面影响，扰乱了基本卫生服务，扭曲了健康的社会决定因素，降低了卫生保健的可及性，增加了金融风险。目的:我们旨在评估COVID-19对斯里兰卡医疗保健可及性和金融风险保护的影响。方法:我们对代表斯里兰卡所有地区的105个集群中的3151个家庭的代表性样本(多阶段抽样过程)进行了横断面研究。数据收集于2021年11月初通过访谈者填写的问卷进行。重要的是要划分三个关注时期，即:(1)封城前时期(2)全国封城时期和(3)新常态时期。(2021年10月1日至11月初)。结果:在11,463名住户中，12.6%的人报告患有慢性疾病，其中76.5%的人在6个月前被诊断出来。大多数人患有心脏病、高血压或糖尿病。其中，封锁期间随访率为53.7%，新常态时期随访率为80.8%。各省的费用差异也被观察到，西部省份的食品费用最高。灾难性的医疗支出影响了9.5%和3.4%的家庭，分别为10%和25%。结论:有相当比例的心脏病、高血压、高血糖或糖尿病患者在封锁期和新常态期的第一个月没有随访。产前保健和计划生育受到的影响最小。在整个期间，参与者在医疗保健方面的自付费用很高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Ceylon Medical Journal MEDICINE, GENERAL & INTERNAL-

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期刊介绍： The Ceylon Medical Journal, is the oldest surviving medical journal in Australasia. It is the only medical journal in Sri Lanka that is listed in the Index Medicus. The CMJ started life way back in 1887 as the organ of the Ceylon Branch of the British Medical Association. Except for a brief period between 1893 and 1904 when it ceased publication, the CMJ or its forbear, the Journal of the Ceylon Branch of the British Medical Association, has been published without interruption up to now. The journal"s name changed to the CMJ in 1954.