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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

Bibliographic Data

ID19593274
AuthorsAnagaw Derseh Mebratie (0000-0002-6489-335X, Addis Ababa University, corresponding author), Adiam Nega (0000-0001-7648-6332, Addis Ababa University), Anna D Gage (0000-0002-4422-0545, Harvard Global Health Institute), Damen Haile Mariam (0000-0002-3229-5259, Addis Ababa University), Munir Kassa Eshetu (Government of Ethiopia), Catherine Arsenault (0000-0003-2410-3015, Harvard Global Health Institute)
EditorsPrashanth Nuggehalli Srinivas (0000-0003-0968-0826)
Year2022
Volume2
Issue9
Pagese0000843
Publication date2022-09-12
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0000843
PMID36962800
OpenAlexW4295879743
LanguageEN
Citations received6
References cited19

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

Economic growth · Environmental health · Geography · Health care · Health services · Malnutrition · Pandemic · Population · Public health · Socioeconomics · COVID-19 and healthcare impacts · COVID-19 epidemiological studies · Demography · Global Maternal and Child Health · Medicine · Nursing

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    Open Access•Nazrul Islam, Stephen J Sharp et al.•BMJ•2020

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Citations per year2
Citation span2023 - 2024 (2)
Highly citedNo

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