scholarly journals Impact of the COVID-19 pandemic and response on the utilisation of health services in public facilities during the first wave in Kinshasa, the Democratic Republic of the Congo

2021 ◽  
Vol 6 (7) ◽  
pp. e005955
Author(s):  
Celestin Hategeka ◽  
Simone E Carter ◽  
Faustin Mukalenge Chenge ◽  
Eric Nyambu Katanga ◽  
Grégoire Lurton ◽  
...  
Keyword(s):  
Time Series ◽  
Maternal Health ◽  
Health Service ◽  
Health Services ◽  
Infectious Diseases ◽  
Service Use ◽  
Democratic Republic ◽  
Health Service Use ◽  
Outpatient Visits ◽  
Republic Of The Congo

IntroductionHealth service use among the public can decline during outbreaks and had been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the government of the Democratic Republic of the Congo (DRC) started implementing public health measures across Kinshasa, including strict lockdown measures in the Gombe health zone.MethodsUsing monthly time series data from the DRC Health Management Information System (January 2018 to December 2020) and interrupted time series with mixed effects segmented Poisson regression models, we evaluated the impact of the pandemic on the use of essential health services (outpatient visits, maternal health, vaccinations, visits for common infectious diseases and non-communicable diseases) during the first wave of the pandemic in Kinshasa. Analyses were stratified by age, sex, health facility and lockdown policy (ie, Gombe vs other health zones).ResultsHealth service use dropped rapidly following the start of the pandemic and ranged from 16% for visits for hypertension to 39% for visits for diabetes. However, reductions were highly concentrated in Gombe (81% decline in outpatient visits) relative to other health zones. When the lockdown was lifted, total visits and visits for infectious diseases and non-communicable diseases increased approximately twofold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected.ConclusionThe COVID-19 pandemic resulted in important reductions in health service utilisation in Kinshasa, particularly Gombe. Lifting of lockdown led to a rebound in the level of health service use but it remained lower than prepandemic levels.

scholarly journals Impact of the COVID-19 pandemic and response on the utilisation of health services during the first wave in Kinshasa, the Democratic Republic of the Congo

2021 ◽  
Author(s):  
Celestin Hategeka ◽  
Simone Elyse Carter ◽  
Faustin Mukalenge Chenge ◽  
Eric Nyambu Katanga ◽  
Gregoire Lurton ◽  
...  
Keyword(s):  
Maternal Health ◽  
Health Service ◽  
Health Services ◽  
Infectious Diseases ◽  
Service Use ◽  
Democratic Republic ◽  
Communicable Diseases ◽  
Health Service Use ◽  
Non Communicable Diseases ◽  
Republic Of The Congo

Introduction: Health service use among the general public can decline during infectious disease outbreaks and has been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the government of the Democratic Republic of the Congo (DRC) implemented public health measures across Kinshasa, including strict lockdown measures in the Gombe health zone, to mitigate impact of the pandemic. Methods: Using data from the Health Management Information System (January 2018 - December 2020), we evaluated the impact of the pandemic on the use of essential health services (total visits, maternal health, vaccinations, visits for common infectious diseases, and diagnosis of non-communicable diseases) using interrupted time series with mixed effects segmented Poisson regression models during the first wave of the pandemic. Analyses were stratified by age, sex, health facility, and neighbourhood. Results: Health service use dropped rapidly following the start of the pandemic and ranged from 16% for hypertension diagnoses to 39% for diabetes diagnoses. However, reductions were highly concentrated in Gombe (81% decline in total visits) relative to health zones without lockdown. When the lockdown was lifted, total visits, visits for infectious diseases, and diagnoses for non-communicable diseases increased approximately two-fold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected. Conclusion: The COVID-19 pandemic resulted in important reductions in health service utilisation in Kinshasa, particularly Gombe. Lifting of lockdown led to a rebound in the level of health service use but it remained lower than pre-pandemic levels.

scholarly journals Disruptions in maternal health service use during the COVID-19 pandemic in 2020: experiences from 37 health facilities in low-income and middle-income countries

2022 ◽  
Vol 7 (1) ◽  
pp. e007247
Author(s):  
Zeus Aranda ◽  
Thierry Binde ◽  
Katherine Tashman ◽  
Ananya Tadikonda ◽  
Bill Mawindo ◽  
...  
Keyword(s):  
Maternal Health ◽  
Health Service ◽  
Health Services ◽  
Sierra Leone ◽  
Service Use ◽  
Maternal Health Services ◽  
Health Facilities ◽  
Maternal Health Service ◽  
Health Service Use ◽  
The Impact

The COVID-19 pandemic has heterogeneously affected use of basic health services worldwide, with disruptions in some countries beginning in the early stages of the emergency in March 2020. These disruptions have occurred on both the supply and demand sides of healthcare, and have often been related to resource shortages to provide care and lower patient turnout associated with mobility restrictions and fear of contracting COVID-19 at facilities. In this paper, we assess the impact of the COVID-19 pandemic on the use of maternal health services using a time series modelling approach developed to monitor health service use during the pandemic using routinely collected health information systems data. We focus on data from 37 non-governmental organisation-supported health facilities in Haiti, Lesotho, Liberia, Malawi, Mexico and Sierra Leone. Overall, our analyses indicate significant declines in first antenatal care visits in Haiti (18% drop) and Sierra Leone (32% drop) and facility-based deliveries in all countries except Malawi from March to December 2020. Different strategies were adopted to maintain continuity of maternal health services, including communication campaigns, continuity of community health worker services, human resource capacity building to ensure compliance with international and national guidelines for front-line health workers, adapting spaces for safe distancing and ensuring the availability of personal protective equipment. We employ a local lens, providing prepandemic context and reporting results and strategies by country, to highlight the importance of developing context-specific interventions to design effective mitigation strategies.

scholarly journals Higher Rates of Untreated Distress in Older Versus Younger Adults With Indolent Lymphoma

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 466-466
Author(s):  
Kelly Trevino ◽  
Peter Martin ◽  
John Leonard
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Service Use ◽  
Mental Health Service Use ◽  
Health Service Use ◽  
Younger Adults

Abstract Indolent lymphomas are incurable but slow-growing cancers, resulting in a large number of older adults living with these diseases. Patients typically live with their illness for years with the knowledge that disease progression is likely. Yet, little is known about psychological distress in this population. This study examined rates of and the relationship between distress and mental health service use in older and younger adults with indolent lymphomas. Adult patients diagnosed with an indolent lymphoma (e.g., follicular lymphoma, marginal zone lymphoma) within the past six months completed self-report surveys of distress (Hospital Anxiety and Depression Scale; HADS) and mental health service use since the cancer diagnosis (yes/no). Descriptive statistics, t-tests, and chi-square analyses were used to examine study questions. The sample (n=84) included 35 patients 65 years or older. Across the entire sample, 21.4% screened positive for distress on the HADS; 58.8% of these patients did not receive mental health services. Older adults reported lower distress levels than younger adults (17.1% v. 24.5%; p=.038). Among younger adults, 50% of distressed patients received mental health services; only 20% of distressed older adults received mental health services. Distress was associated with mental health service use in younger adults (p=.004) but not in older adults (p=.17). Older adults with indolent lymphomas have higher levels of untreated distress than younger adults. Research on the mechanisms underlying these age differences (e.g., stigma toward mental health services, ageism) would inform interventions to increase rates of mental health service use and reduce care disparities due to age.

scholarly journals Mental Health Services in Childhood: The Role of Family Adversity

2019 ◽  
Vol 134 (2) ◽  
pp. 180-188
Author(s):  
Héctor E. Alcalá ◽  
Rajesh Balkrishnan
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Service Use ◽  
Childhood Adversity ◽  
Mental Health Service Use ◽  
Health Service Use ◽  
Continuous Measure

Objective: Much of the research on the effects of childhood adversity on mental health has focused on adults. The objective of our study was to examine the individual and cumulative effect of childhood adversity on mental health service use among children. Methods: We used data from the 2011-2012 National Survey of Children’s Health (n = 79 834) to determine the use of mental health services in the past 12 months among children aged 2-17. The independent variables of interest were experiencing any 1 of 9 adverse family experiences (AFEs). We used logistic regression models to determine if each AFE was associated with mental health service use. We also examined AFEs as a continuous measure, representing the number of AFEs (ranging from 0 to 9) that summed them individually, and we examined age-by-AFE and age-by-need interaction terms. We adjusted all models for confounders. Results: Compared with not experiencing an AFE, experiencing all AFEs was associated with higher odds of mental health service use. Neighborhood violence was associated with the greatest increase in odds of mental health service use (adjusted odds ratio [aOR] = 2.35; 95% confidence interval [CI], 2.00-2.77). When measured as a continuous scale, each additional AFE was associated with higher odds of mental health service use (aOR = 1.33; 95% CI, 1.28-1.37). The effect of AFEs on mental health service use decreased with age. Conclusions: The observed association between AFEs and use of mental health services may be attributable to more severe or poorly managed mental illness among these children. Efforts are needed to increase access to and quality of mental health care among children affected by AFEs.

scholarly journals Timing of Health Service Use Among Truck Drivers After a Work-Related Injury or Illness

2021 ◽  
Author(s):  
Ting Xia ◽  
Alex Collie ◽  
Sharon Newnam ◽  
Dan I. Lubman ◽  
Ross Iles
Keyword(s):  
Mental Health ◽  
Health Service ◽  
Health Services ◽  
Service Use ◽  
Truck Drivers ◽  
Health Service Use ◽  
Work Related ◽  
Work Related Injury ◽  
Service Type ◽  
Compensation Claims

AbstractPurposes Timely delivery of treatment and rehabilitation is generally acknowledged to support injury recovery. This study aimed to describe the timing of health service use by injured truck drivers with work-related injury and to explore the association between demographic and injury factors and the duration of health service use. Methods Retrospective cohort study of injured truck drivers with accepted workers’ compensation claims in the state of Victoria, Australia. Descriptive analyses examined the percentage of injured truck drivers using health services by service type. Logistic regression model examined predictors of any service use versus no service use, and predictors of extended service use (≥ 52 weeks) versus short-term use. Results The timing of health service use by injured truck drivers with accepted workers’ compensation claims varies substantially by service type. General practitioner, specialist physician, and physical therapy service use peaks within the 14 weeks after compensation claim lodgement, whilst the majority of mental health services were accessed in the persistent phase beyond 14 weeks after claim lodgement. Older age, being employed by small companies, and claiming compensation for mental health conditions were associated with greater duration of health service use. Conclusions Injured truck drivers access a wide range of health services during the recovery and return to work process. Delivery of mental health services is delayed, including for those making mental health compensation claims. Health service planning should take into account worker and employer characteristics in addition to injury type.

scholarly journals Gendering Neighbourhood Marginalization Metrics in Mental Health Services Research: A Cross-Sectional Exploration of a Rural and Small Urban Population

2021 ◽  
Vol 18 (21) ◽  
pp. 11197
Author(s):  
Neeru Gupta ◽  
Dan Lawson Crouse ◽  
Ismael Foroughi ◽  
Thalia Nikolaidou
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Service Use ◽  
Mental Health Service Use ◽  
Health Service Use ◽  
Cross Sectional ◽  
Neighbourhood Characteristics

Background: Little is known about the extent to which socioenvironmental characteristics may influence mental health outcomes in smaller population centres or differently among women and men. This study used a gender-based analysis approach to explore individual- and neighbourhood-level sex differences in mental health service use in a context of uniquely smaller urban and rural settlements. Methods: This cross-sectional analysis leveraged multiple person-based administrative health datasets linked with geospatial datasets among the population aged 1 and over in the province of New Brunswick, Canada. We used multinomial logistic regression to examine associations between neighbourhood characteristics with risk of service contacts for mood and anxiety disorders in 2015/2016, characterizing the areal measures among all residents (gender neutral) and by males and females separately (gender specific), and controlling for age group. Results: Among the province’s 707,575 eligible residents, 10.7% (females: 14.0%; males: 7.3%) used mental health services in the year of observation. In models adjusted for gender-neutral neighbourhood characteristics, service contacts were significantly more likely among persons residing in the most materially deprived areas compared with the least (OR = 1.09 [95% CI: 1.05–1.12]); when stratified by individuals’ sex, the risk pattern held for females (OR = 1.13 [95% CI: 1.09–1.17]) but not males (OR = 1.00 [95% CI: 0.96–1.05]). Residence in the most female-specific materially deprived neighbourhoods was independently associated with higher risk of mental health service use among individual females (OR = 1.08 [95% CI: 1.02–1.14]) but not among males (OR = 1.02 [95% CI: 0.95–1.10]). Conclusion: These findings emphasize that research needs to better integrate sex and gender in contextual measures aiming to inform community interventions and neighbourhood designs, notably in small urban and rural settings, to reduce socioeconomic inequalities in the burden of mental disorders.

scholarly journals Cry for health: a quantitative evaluation of a hospital-based advocacy intervention for domestic violence and abuse

2019 ◽  
Author(s):  
Gemma Halliwell ◽  
Sandi Dheensa ◽  
Elisabetta Fenu ◽  
Sue K Jones ◽  
Jessica Asato ◽  
...  
Keyword(s):  
Domestic Violence ◽  
Health Service ◽  
Health Services ◽  
Service Use ◽  
Cost Savings ◽  
Health Service Use ◽  
Potential Cost ◽  
Safety Outcomes ◽  
The Cost ◽  
Domestic Violence And Abuse

Abstract Background Domestic violence and abuse damages the health of survivors and increases use of healthcare services. We report findings from a multi-site evaluation of hospital-based advocacy services, designed to support survivors attending emergency departments and maternity services. Methods Independent Domestic Violence Advisors (IDVA) were co-located in five UK hospitals. Case-level data were collected at T1 (initial referral) and T2 (case closure) from survivors accessing hospital (T1 N = 692; T2 N = 476) and community IDVA services (T1 N = 3,544; T2 N = 2,780), used as a comparator. Measures included indicators of sociodemographic characteristics, experience of abuse, health service use, health and safety outcomes. Multivariate analyses tested for differences in changes in abuse, health and factors influencing safety outcomes. Health service use data in the six months pre-and post- intervention were compared to generate potential cost savings by hospital IDVA services. Results Hospital IDVAs worked with survivors less visible to community IDVA services and facilitated intervention at an earlier point. Hospital IDVAs received higher referrals from health services and enabled access to a greater number of health resources. Hospital survivors were more likely to report greater reductions in and cessation of abuse. No differences were observed in health outcomes for hospital survivors. The odds of safety increased two-fold if hospital survivors received over five contacts with an IDVA or accessed six or more resources / programmes over a longer period of time. Six months preceding IDVA intervention, hospital survivors cost on average £2,463 each in use of health services; community survivors cost £533 each. The cost savings observed among hospital survivors amounted to a total of £2,050 per patient per year. This offset the average cost of providing hospital IDVA services. Conclusions Hospital IDVAs can identify survivors not visible to other services and promote safety through intensive support and access to resources. The co-location of IDVAs within the hospital encouraged referrals to other health services and wider community agencies. Further research is required to establish the cost-effectiveness of hospital IDVA services, however our findings suggest these services could be an efficient use of health service resources.

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