The provision and utilization of essential health services in Afghanistan during COVID-19 pandemic
IntroductionThe COVID-19 pandemic has disrupted provision of essential health services and overwhelmed even robust health systems worldwide. The Afghanistan health system has suffered both from the pandemic, as well as from political upheaval and regime change.MethodsWe evaluated essential service d...
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Language: | English |
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Frontiers Media S.A.
2023-01-01
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Series: | Frontiers in Public Health |
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Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2022.1097680/full |
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author | Narges Neyazi Christina Lindan Saber Perdes Abdul Ghani Ibrahimi Dirk Horemans Deena Al Afsoor |
author_facet | Narges Neyazi Christina Lindan Saber Perdes Abdul Ghani Ibrahimi Dirk Horemans Deena Al Afsoor |
author_sort | Narges Neyazi |
collection | DOAJ |
description | IntroductionThe COVID-19 pandemic has disrupted provision of essential health services and overwhelmed even robust health systems worldwide. The Afghanistan health system has suffered both from the pandemic, as well as from political upheaval and regime change.MethodsWe evaluated essential service delivery using data collected from a cross-sectional survey of health care facilities in Afghanistan based on administration of a World Health Organization standardized assessment of frontline service readiness. A multi-stage sampling scheme was used to identify a representative sample of 92 health facilities (68 clinics and 24 hospitals) providing essential health services in five provinces. Facility managers were asked to report on changes in health service delivery in late 2021 and early 2022 (corresponding to the end of a significant national COVID-19 surge in infections) compared to the same period one year earlier.ResultsAmong health facilities evaluated; 29 were in urban and 63 were in rural settings. Most facilities reported an increase in the provision of outpatient care particularly in maternal and child health services as well as for tuberculosis, chronic respiratory diseases, mental health, and substance abuse; the number of in-patients also increased. In contrast, provision of services for malaria, neglected tropical diseases, and community outreach programs decreased. Nearly all facilities used strategies to maintain services, including targeting high-risk patients, promoting self-care, and redirecting patients to alternative health care sites. Nearly three fourth (70.6%) of facilities provided no training about COVID-19 to staff; only 65.2% referred COVID-19 patients to designated hospitals and 44.6% had safe transportation for these patients.DiscussionIncreased demand for services during this period was likely due to a backlog in need generated during the preceding COVID-19 surge and the political changes happened a few months earlier to this survey. Facilities used various methods to maintain services, although the decrease in provision of community outreach was concerning. Facilities appeared to be able to maintain essential health services, despite an increase in demand. However, awareness and training of COVID-19 protocols and appropriate and safe referrals need to be improved. In general, these series of surveys are informative and helpful to identify any changes in provision of essential health services and can facilitate recovery of health systems during and after pandemics. |
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format | Article |
id | doaj.art-31fd0b881ddf4344820e2a6398a5a28b |
institution | Directory Open Access Journal |
issn | 2296-2565 |
language | English |
last_indexed | 2024-04-10T23:30:25Z |
publishDate | 2023-01-01 |
publisher | Frontiers Media S.A. |
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series | Frontiers in Public Health |
spelling | doaj.art-31fd0b881ddf4344820e2a6398a5a28b2023-01-12T06:23:48ZengFrontiers Media S.A.Frontiers in Public Health2296-25652023-01-011010.3389/fpubh.2022.10976801097680The provision and utilization of essential health services in Afghanistan during COVID-19 pandemicNarges Neyazi0Christina Lindan1Saber Perdes2Abdul Ghani Ibrahimi3Dirk Horemans4Deena Al Afsoor5Health System Development Department, World Health Organization, Kabul, AfghanistanDepartment of Epidemiology and Biostatistics, and Institute of Global Health Sciences, University of California, San Francisco, San Francisco, CA, United StatesNezarat Consulting Ltd., Ottawa, ON, CanadaHealth System Development Department, World Health Organization, Kabul, AfghanistanDepartment of Universal Health Coverage, World Health Organization, Geneva, SwitzerlandDepartment of Universal Health Coverage, Eastern Mediterranean Regional Office, World Health Organization, Cairo, EgyptIntroductionThe COVID-19 pandemic has disrupted provision of essential health services and overwhelmed even robust health systems worldwide. The Afghanistan health system has suffered both from the pandemic, as well as from political upheaval and regime change.MethodsWe evaluated essential service delivery using data collected from a cross-sectional survey of health care facilities in Afghanistan based on administration of a World Health Organization standardized assessment of frontline service readiness. A multi-stage sampling scheme was used to identify a representative sample of 92 health facilities (68 clinics and 24 hospitals) providing essential health services in five provinces. Facility managers were asked to report on changes in health service delivery in late 2021 and early 2022 (corresponding to the end of a significant national COVID-19 surge in infections) compared to the same period one year earlier.ResultsAmong health facilities evaluated; 29 were in urban and 63 were in rural settings. Most facilities reported an increase in the provision of outpatient care particularly in maternal and child health services as well as for tuberculosis, chronic respiratory diseases, mental health, and substance abuse; the number of in-patients also increased. In contrast, provision of services for malaria, neglected tropical diseases, and community outreach programs decreased. Nearly all facilities used strategies to maintain services, including targeting high-risk patients, promoting self-care, and redirecting patients to alternative health care sites. Nearly three fourth (70.6%) of facilities provided no training about COVID-19 to staff; only 65.2% referred COVID-19 patients to designated hospitals and 44.6% had safe transportation for these patients.DiscussionIncreased demand for services during this period was likely due to a backlog in need generated during the preceding COVID-19 surge and the political changes happened a few months earlier to this survey. Facilities used various methods to maintain services, although the decrease in provision of community outreach was concerning. Facilities appeared to be able to maintain essential health services, despite an increase in demand. However, awareness and training of COVID-19 protocols and appropriate and safe referrals need to be improved. In general, these series of surveys are informative and helpful to identify any changes in provision of essential health services and can facilitate recovery of health systems during and after pandemics.https://www.frontiersin.org/articles/10.3389/fpubh.2022.1097680/fullAfghanistanCOVID-19 pandemicmaintainingessentialhealth servicesresilience |
spellingShingle | Narges Neyazi Christina Lindan Saber Perdes Abdul Ghani Ibrahimi Dirk Horemans Deena Al Afsoor The provision and utilization of essential health services in Afghanistan during COVID-19 pandemic Frontiers in Public Health Afghanistan COVID-19 pandemic maintaining essential health services resilience |
title | The provision and utilization of essential health services in Afghanistan during COVID-19 pandemic |
title_full | The provision and utilization of essential health services in Afghanistan during COVID-19 pandemic |
title_fullStr | The provision and utilization of essential health services in Afghanistan during COVID-19 pandemic |
title_full_unstemmed | The provision and utilization of essential health services in Afghanistan during COVID-19 pandemic |
title_short | The provision and utilization of essential health services in Afghanistan during COVID-19 pandemic |
title_sort | provision and utilization of essential health services in afghanistan during covid 19 pandemic |
topic | Afghanistan COVID-19 pandemic maintaining essential health services resilience |
url | https://www.frontiersin.org/articles/10.3389/fpubh.2022.1097680/full |
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