亚的斯亚贝巴基层单位2019冠状病毒病大流行期间卫生服务利用趋势及面临的挑战:一项混合方法研究

IF 1.5 Q3 HEALTH POLICY & SERVICES
Health Services Research and Managerial Epidemiology Pub Date : 2021-07-08 eCollection Date: 2021-01-01 DOI:10.1177/23333928211031119
Tariku Shimels
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引用次数: 5

摘要

导言:2019冠状病毒病大流行给全球各国的卫生和社会经济方面带来了巨大挑战。卫生设施在控制各级服务提供方面遇到了巨大挑战。本研究旨在评估埃塞俄比亚亚的斯亚贝巴基层单位在2019冠状病毒病大流行期间卫生服务利用趋势和面临的挑战。方法:2020年8月1日至30日在亚的斯亚贝巴进行了一项基于多设施的横断面研究。采用混合方法设计,在5个卫生中心收集定量和定性数据。在5个副城市中随机选择设施,有目的地招募受访者。使用结构化问卷收集来自每个设施的HMIS单位的定量数据。采用半结构化的关键信息访谈指南收集定性数据。使用Microsoft Excel对定量数据进行分析,生成10个月时间序列趋势。定性数据采用定性数据分析(QDA-minor)软件。结果:疫情前与疫情期间负荷的时间序列比较显示,卫生机构的服务提供能力存在较大差异。在2019冠状病毒病爆发后,一些单位(如PICT、VCT、计划生育服务)和门诊的大多数亚单位的住院人数大幅下降。对关键信息提供者的访谈还显示,这些挑战,如对感染和耻辱的恐惧、基础设施差、与人力资源有关的挑战以及与预防和治疗投入的供应有关的挑战,在保健中心都明显遇到。结论:新冠肺炎疫情对研究环境中的许多服务提供点产生了负面影响。人们提到,基础设施薄弱、缺乏ppe、对感染和污名的恐惧以及工作人员工作量是疫情期间面临的主要挑战。卫生当局应安排多方面的支持,以确保初级卫生保健单位不间断地提供服务。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

The Trend of Health Service Utilization and Challenges Faced During the COVID-19 Pandemic at Primary Units in Addis Ababa: A Mixed-Methods Study.

The Trend of Health Service Utilization and Challenges Faced During the COVID-19 Pandemic at Primary Units in Addis Ababa: A Mixed-Methods Study.

The Trend of Health Service Utilization and Challenges Faced During the COVID-19 Pandemic at Primary Units in Addis Ababa: A Mixed-Methods Study.

The Trend of Health Service Utilization and Challenges Faced During the COVID-19 Pandemic at Primary Units in Addis Ababa: A Mixed-Methods Study.

Introduction: The COVID-19 pandemic has imposed an extraordinary challenge to the health and socio-economic facet of nations globally. Health facilities have encountered tremendous challenges to contain service delivery at all levels. This study aims to assess the trend of health service utilization and challenges faced during the COVID-19 pandemic at primary units in Addis Ababa, Ethiopia.

Method: A multi-facility-based cross-sectional study was conducted in Addis Ababa between 1 and 30 of August 2020. A mixed-methods design was employed, and both quantitative and qualitative data were collected at 5 health centers. Facilities were selected randomly from 5 sub-cities while interviewees were recruited purposively. A structured questionnaire was used to collect quantitative data from the HMIS units of each facility. Qualitative data was collected using a semi-structured key-informant interview guide. Quantitative data were analyzed using Microsoft Excel, and a 10-month time-series trend was generated. For the qualitative data, qualitative data analysis (QDA-minor) software was used.

Results: Time-series comparison of the pre-COVID-19 era loads with the COVID-19 period showed that there was an extensive disparity in the service delivery capacity of the health facilities. A huge drop in inpatient flow of some units such as PICT, VCT, FP services, and most sub-units of the OPDs has been recorded following the COVID-19 outbreak. The key-informant interview also revealed that such challenges, as fear of infection and stigma, poor infrastructure, challenges related to human resources, and challenges related to the supply of prevention and treatment inputs were prominently encountered at the health centers.

Conclusion: The COVID-19 wave has negatively impacted many service delivery points in the study settings. The presence of weak infrastructure, lack of PPEs, fear of the infection and stigma, and staff workload have been mentioned as the predominant challenges faced during the outbreak. Health authorities should arrange multifaceted supports to ensure uninterrupted service delivery at primary healthcare units.

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CiteScore
1.60
自引率
6.20%
发文量
32
审稿时长
12 weeks
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