Mitigating the impact of Covid-19 on primary healthcare interventions for the reduction of under-5 mortality in Bangladesh

Lessons learned through implementation research

Dados Bibliográficos

ID19591306
AutoresAlemayehu Amberbir (0000-0002-7071-520X, University of Global Health Equity, autor correspondente), Fauzia Akhter Huda (0000-0001-8342-0366, International Centre for Diarrhoeal Disease Research, autor correspondente), Amelia VanderZanden (0000-0001-6984-2132, University of Global Health Equity, autor correspondente), Kedest Mathewos (0000-0001-6525-3517, University of Global Health Equity, autor correspondente), Jovial Thomas Ntawukuriryayo (0000-0002-1397-2752, University of Global Health Equity, autor correspondente), Agnes Binagwaho (0000-0002-6779-3151, University of Global Health Equity, autor correspondente), Lisa R Hirschhorn (0000-0002-4355-7437, Northwestern University, autor correspondente)
EditoresOrvalho Augusto (0000-0002-0005-3968)
Ano2024
Volume4
Fascículo3
Páginase0002997
Data de publicação2024-03-06
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoPLOS Global Public Health (JOURNAL)
Identificadores do periódicoISSN: 2767-3375 • E-ISSN: 2767-3375
EditoraPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0002997
PMID38446832
OpenAlexW4392502996
IdiomaEN
Citações recebidas2
Referências citadas21

The COVID-19 pandemic posed unprecedented challenges and threats to health systems, particularly affecting delivery of evidence-based interventions (EBIs) to reduce under-5 mortality (U5M) in resource-limited settings such as Bangladesh. We explored the level of disruption of these EBIs, strategies and contextual factors associated with preventing or mitigating service disruptions, and how previous efforts supported the work to maintain EBIs during the pandemic. We utilized a mixed methods implementation science approach, with data from: 1) desk review of available literature; 2) existing District Health Information System 2 (DHIS2) in Bangladesh; and 3) key informant interviews (KIIs), exploring evidence on changes in coverage, implementation strategies, and contextual factors influencing primary healthcare EBI coverage during March–December 2020. We used interrupted time series analysis (timeframe January 2019 to December 2020) using a Poisson regression model to estimate the impact of COVID-19 on DHIS2 indicators. We audio recorded, transcribed, and translated the qualitative data from KIIs. We used thematic analysis of coded interviews to identify emerging patterns and themes using the implementation research framework. Bangladesh had an initial drop in U5M-oriented EBIs during the early phase of the pandemic, which began recovering in June 2020. Barriers such as lockdown and movement restrictions, difficulties accessing medical care, and redirection of the health system’s focus to the COVID-19 pandemic, resulted in reduced health-seeking behavior and service utilization. Strategies to prevent and respond to disruptions included data use for decision-making, use of digital platforms, and leveraging community-based healthcare delivery. Transferable lessons included collaboration and coordination of activities and community and civil society engagement, and investing in health system quality. Countries working to increase EBI implementation can learn from the barriers, strategies, and transferable lessons identified in this work in an effort to reduce and respond to health system disruptions in anticipation of future health system shocks

Business · Health care · Pandemic · Political science · Psychological intervention · Public health · Qualitative research · Service delivery framework · Sociology · Thematic analysis · Global Maternal and Child Health · Health Policy Implementation Science · Medicine · Nursing · Primary Care and Health Outcomes · Health Informatics · Marketing