Effect of the COVID-19 pandemic on health service utilization across regions of Ethiopia: An interrupted time series analysis of health information system data from 2019-2020.
The spread of COVID-19 and associated deaths have remained low in Ethiopia. However, the pandemic could pose a public health crisis indirectly through disruptions in essential health services. The aim of this study was to examine disruptions in health service utilization during the first nine months...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2022-01-01
|
| Series: | PLOS Global Public Health |
| Online Access: | https://doi.org/10.1371/journal.pgph.0000843 |
| _version_ | 1797703643683618816 |
|---|---|
| author | Anagaw Derseh Mebratie Adiam Nega Anna Gage Damen Haile Mariam Munir Kassa Eshetu Catherine Arsenault |
| author_facet | Anagaw Derseh Mebratie Adiam Nega Anna Gage Damen Haile Mariam Munir Kassa Eshetu Catherine Arsenault |
| author_sort | Anagaw Derseh Mebratie |
| collection | DOAJ |
| description | The spread of COVID-19 and associated deaths have remained low in Ethiopia. However, the pandemic could pose a public health crisis indirectly through disruptions in essential health services. The aim of this study was to examine disruptions in health service utilization during the first nine months of the COVID-19 pandemic across 10 regions in Ethiopia. We analyzed utilization of 21 different health services across all of Ethiopia (except the Tigray region) for the period of January 2019 to December 2020. Data were extracted from the Ethiopian district health information system (DHIS2). Monthly visits in 2020 were graphed relative to the same months in 2019. Interrupted time series analysis was used to estimate the effect of the pandemic on service utilization in each region. We found that disruptions in health services were generally higher in urban regions which were most affected by COVID. Outpatient visits declined by 52%, 54%, and 58%, specifically in Dire Dawa, Addis Ababa and Harari, the three urban regions. Similarly, there was a 47% reduction in inpatient admissions in Addis Ababa. In agrarian regions, the pandemic caused an 11% to 17% reduction in outpatient visits and a 10% to 27% decline in inpatient admissions. Visits for children with diarrhea, pneumonia and malnutrition also declined substantially while maternal health services were less affected. Our study indicates that disruptions in health services were more pronounced in areas that were relatively harder hit by the pandemic. Our results show that the Ethiopian health system has a limited capacity to absorb shocks. During future waves of COVID or future pandemics, the Ethiopian health system must be better prepared to maintain essential services and mitigate the indirect impact of the pandemic on public health, particularly in urban areas. |
| first_indexed | 2024-03-12T05:07:34Z |
| format | Article |
| id | doaj.art-3f283e970f654f8b90e3068245a2f2a9 |
| institution | Directory Open Access Journal |
| issn | 2767-3375 |
| language | English |
| last_indexed | 2024-03-12T05:07:34Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLOS Global Public Health |
| spelling | doaj.art-3f283e970f654f8b90e3068245a2f2a92023-09-03T08:50:31ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752022-01-0129e000084310.1371/journal.pgph.0000843Effect of the COVID-19 pandemic on health service utilization across regions of Ethiopia: An interrupted time series analysis of health information system data from 2019-2020.Anagaw Derseh MebratieAdiam NegaAnna GageDamen Haile MariamMunir Kassa EshetuCatherine ArsenaultThe spread of COVID-19 and associated deaths have remained low in Ethiopia. However, the pandemic could pose a public health crisis indirectly through disruptions in essential health services. The aim of this study was to examine disruptions in health service utilization during the first nine months of the COVID-19 pandemic across 10 regions in Ethiopia. We analyzed utilization of 21 different health services across all of Ethiopia (except the Tigray region) for the period of January 2019 to December 2020. Data were extracted from the Ethiopian district health information system (DHIS2). Monthly visits in 2020 were graphed relative to the same months in 2019. Interrupted time series analysis was used to estimate the effect of the pandemic on service utilization in each region. We found that disruptions in health services were generally higher in urban regions which were most affected by COVID. Outpatient visits declined by 52%, 54%, and 58%, specifically in Dire Dawa, Addis Ababa and Harari, the three urban regions. Similarly, there was a 47% reduction in inpatient admissions in Addis Ababa. In agrarian regions, the pandemic caused an 11% to 17% reduction in outpatient visits and a 10% to 27% decline in inpatient admissions. Visits for children with diarrhea, pneumonia and malnutrition also declined substantially while maternal health services were less affected. Our study indicates that disruptions in health services were more pronounced in areas that were relatively harder hit by the pandemic. Our results show that the Ethiopian health system has a limited capacity to absorb shocks. During future waves of COVID or future pandemics, the Ethiopian health system must be better prepared to maintain essential services and mitigate the indirect impact of the pandemic on public health, particularly in urban areas.https://doi.org/10.1371/journal.pgph.0000843 |
| spellingShingle | Anagaw Derseh Mebratie Adiam Nega Anna Gage Damen Haile Mariam Munir Kassa Eshetu Catherine Arsenault Effect of the COVID-19 pandemic on health service utilization across regions of Ethiopia: An interrupted time series analysis of health information system data from 2019-2020. PLOS Global Public Health |
| title | Effect of the COVID-19 pandemic on health service utilization across regions of Ethiopia: An interrupted time series analysis of health information system data from 2019-2020. |
| title_full | Effect of the COVID-19 pandemic on health service utilization across regions of Ethiopia: An interrupted time series analysis of health information system data from 2019-2020. |
| title_fullStr | Effect of the COVID-19 pandemic on health service utilization across regions of Ethiopia: An interrupted time series analysis of health information system data from 2019-2020. |
| title_full_unstemmed | Effect of the COVID-19 pandemic on health service utilization across regions of Ethiopia: An interrupted time series analysis of health information system data from 2019-2020. |
| title_short | Effect of the COVID-19 pandemic on health service utilization across regions of Ethiopia: An interrupted time series analysis of health information system data from 2019-2020. |
| title_sort | effect of the covid 19 pandemic on health service utilization across regions of ethiopia an interrupted time series analysis of health information system data from 2019 2020 |
| url | https://doi.org/10.1371/journal.pgph.0000843 |
| work_keys_str_mv | AT anagawdersehmebratie effectofthecovid19pandemiconhealthserviceutilizationacrossregionsofethiopiaaninterruptedtimeseriesanalysisofhealthinformationsystemdatafrom20192020 AT adiamnega effectofthecovid19pandemiconhealthserviceutilizationacrossregionsofethiopiaaninterruptedtimeseriesanalysisofhealthinformationsystemdatafrom20192020 AT annagage effectofthecovid19pandemiconhealthserviceutilizationacrossregionsofethiopiaaninterruptedtimeseriesanalysisofhealthinformationsystemdatafrom20192020 AT damenhailemariam effectofthecovid19pandemiconhealthserviceutilizationacrossregionsofethiopiaaninterruptedtimeseriesanalysisofhealthinformationsystemdatafrom20192020 AT munirkassaeshetu effectofthecovid19pandemiconhealthserviceutilizationacrossregionsofethiopiaaninterruptedtimeseriesanalysisofhealthinformationsystemdatafrom20192020 AT catherinearsenault effectofthecovid19pandemiconhealthserviceutilizationacrossregionsofethiopiaaninterruptedtimeseriesanalysisofhealthinformationsystemdatafrom20192020 |