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.
Factors influencing the capacity of women to voice their concerns about maternal health services in the Muanda and Bolenge Health Zones, Democratic Republic of the Congo: a multi-method study
