EHS-COVID (483) Q1 What have we learned? (8) Lessons learned from Nigeria

28 November, 2021

This paper in Pan African Medical Journal surveyed health workers in Nigeria and found that 'fear of nosocomial infection, fear of stigmatization, and misconception/misinformation on COVID-19 diseases and care' are the main causes for reduced utlisation of health services. Citation, abstract and two comments from me below.

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CITATION: Perceived impact of coronavirus pandemic on uptake of healthcare services in South West Nigeria

Olamide Olajumoke Afolalu et al.

Pan Afr Med J 2021 Sep 9;40:26. doi: 10.11604/pamj.2021.40.26.28279. eCollection 2021.

PMID: 34733394 PMCID: PMC8531964 DOI: 10.11604/pamj.2021.40.26.28279

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8531964/

ABSTRACT

Introduction: the COVID-19 pandemic since its emergence has posed a great danger to the health of the general populace while impacting the Nigerian healthcare delivery significantly. Since its emergence, the health system has been stretched with overwhelming responsibilities. The study assessed health providers´ perceived impact of coronavirus pandemic on the uptake of health care services in South West Nigeria.

Methods: a descriptive cross-sectional design using an online structured survey was used to elicit responses from 385 Nigerian health workers selected by convenience sampling technique. Data analysis was done with the Statistical Package for Social Sciences (SPSS) version 26. Comparison of the uptake of healthcare before and during the COVID-19 pandemic was performed using the Chi-square test.

Results: findings revealed a significant difference between the uptake of health care prior and during the COVID-19 pandemic (χ2= 92.77, p=0.000) as 253 respondents (65.7%) reported that the hospital recorded a low turn-out of patients during the pandemic and 184 (47.8%) indicated that some of the facility units/departments were temporarily closed due to COVID-19 pandemic. Similarly, there was a significant difference between health-related conditions requiring hospital admission before and during COVID-19 pandemic (χ2=3.334 p=0.046). Factors influencing uptake of health services during the COVID-19 pandemic are: fear of nosocomial infection, fear of stigmatization, and misconception/misinformation on COVID-19 diseases and care.

Conclusion: the Nigerian health system in the past months has been remarkably impacted by the pandemic. This calls for immediate restructuring to maintain an equitable distribution of care, while minimizing risk to patients and health providers.

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COMMENTS (NPW):

1. Can anyone say more about 'fear of stigmatization'? Is there actual stigmatisation of patients with COVID-19 and if so, why? How might this be addressed?

2. The authors note that 'the Nigerian health system in the past months has been remarkably impacted by the pandemic'. This is despite the fact that the caseload has (to date) been relatively low as compared with other countries. A caseload similar to that seen in Europe, the Americas or South Asia could therefore be devastating in Nigeria. What needs to be done to strenghtne the resilience of Nigeria to future pandemics?

Neil Pakenham-Walsh, HIFA Coordinator, neil@hifa.org www.hifa.org