Covid-19 epidemiology, health services utilisation and health care seeking behaviour during the first year of the Covid-19 pandemic in Mweso health zone, Democratic Republic of Congo

Bibliographic Data

ID19550545
AuthorsChiara Altare (0000-0002-3410-0427, Johns Hopkins University), Natalya Kostandova (0000-0002-6184-531X, Johns Hopkins University), Linda Matadi Basadia (Ministry of Public Health), Marie Petry (Ministry of Public Health), Gbètoho Fortuné Gankpe (Ministry of Public Health), Hannah Crockett (Johns Hopkins University), Natalia Hernandez Morfin (0009-0002-3499-5547, Johns Hopkins University), Sophie Bruneau (Action Contre la Faim), Caroline Antoine (0000-0001-7419-8425, Action Contre la Faim), Paul Spiegel (0000-0002-6158-6661, Johns Hopkins University), Paul B Spiegel, IMPACT DRC Team
Year2024
Volume14
Pages05016-05016
Publication date2024-04-26
Open AccessYes
TypeARTICLE
VenueJournal of Global Health (JOURNAL)
Journal identifiersISSN: 2047-2978 • E-ISSN: 2047-2986
PublisherInternational Society of Global Health (PUBLISHER • GB)
DOI10.7189/jogh.14.05016
PMID38665056
OpenAlexW4395677702
LanguageEN
Citations received1
References cited46

Background: Although the evidence about coronavirus disease 2019 (COVID-19) has increased exponentially since the beginning of the pandemic, less is known about the direct and indirect effects of the pandemic in humanitarian settings. In the Democratic Republic of the Congo (DRC), most studies occurred in Kinshasa and other cities. Limited research was conducted in remote conflict-affected settings. We investigated the COVID-19 epidemiology, health service utilisation, and health care-seeking behaviour during the first year of the pandemic (March 2020-March 2021) in the Mweso health zone, North Kivu, DRC. Methods: This mixed-methods study includes a descriptive epidemiological analysis of reported COVID-19 cases data extracted from the provincial line list, interrupted time series analysis of health service utilisation using routine health service data, qualitative perceptions of health care workers about how health services were affected, and community members' health care seeking behaviour from a representative household survey and focus group discussions. Results: The COVID-19 epidemiology in North Kivu aligns with evidence reported globally, yet case fatality rates were high due to underreporting. Testing capacity was limited and initially mainly available in the province's capital. Health service utilisation showed different patterns - child measles vaccinations experienced a decrease at the beginning of the pandemic, while outpatient consultations, malaria, and pneumonia showed an increase over time. Such increases might have been driven by insecurity and population displacements rather than COVID-19. Community members continued seeking care during the first months of the COVID-19 pandemic and visited the same health facilities as before COVID-19. Financial constraints, not COVID-19, were the main barrier reported to accessing health care. Conclusions: The first year of the COVID-19 pandemic in the Mweso health zone was characterised by low testing capacity and an underestimation of reported COVID-19 infections. The increase in health care utilisation should be further explored to understand the role of factors unrelated to COVID-19, such as insecurity, population displacement, and poverty, which remain major challenges to successfully providing health services and improving the population's health. Measles vaccination coverage dropped, which exacerbated the ongoing measles outbreak. Improved decentralised testing capacity will be crucial for future epidemics and enhanced efforts to maintain child vaccination coverage

Case fatality rate · Disease · Economic growth · Environmental health · Health care · Pandemic · Population · Public health · COVID-19 epidemiological studies · Global Maternal and Child Health · Medicine · Nursing · Viral Infections and Outbreaks Research · Epidemiology

Tools

Open DOIOpen Access