Reported Barriers to Healthcare Access and Service Disruptions Caused by COVID-19 in Burkina Faso, Ethiopia, and Nigeria: A Telephone Survey

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  • 1 College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia;
  • 2 Nouna Health Research Center, Nouna, Burkina Faso;
  • 3 Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts;
  • 4 Jegula Hospital, Harar, Ethiopia;
  • 5 Institut Supérieur des Sciences de la Population, University of Ouagadougou, Ouagadougou, Burkina Faso;
  • 6 Department of Statistics, University of Ibadan, Ibadan, Nigeria;
  • 7 Department of Epidemiology and Biostatics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia;
  • 8 Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts;
  • 9 Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany;
  • 10 Africa Health Research Institute, KwaZulu-Natal, South Africa;
  • 11 Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts;
  • 12 Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts;
  • 13 University of Ibadan Research Foundation, University of Ibadan, Ibadan, Nigeria

The coronavirus disease 2019 (COVID-19) pandemic may have short-term and long-term impacts on health services across sub-Saharan African countries. A telephone survey in Burkina Faso, Ethiopia, and Nigeria was conducted to assess the effects of the pandemic on healthcare services from the perspectives of healthcare providers (HCPs) and community members. A total of 900 HCPs (300 from each country) and 1,797 adult community members (approximately 600 from each country) participated in the study. Adjusted risk ratios (ARRs) and 95% confidence intervals (CIs) were computed using modified Poisson regression. According to the HCPs, more than half (56%) of essential health services were affected. Child health services and HIV/surgical/other services had a slightly higher percentage of interruption (33%) compared with maternal health services (31%). A total of 21.8%, 19.3%, and 7.7% of the community members reported that their family members and themselves had difficulty accessing childcare services, maternal health, and other health services, respectively. Nurses had a lower risk of reporting high service interruptions than physicians (ARR, 0.85; 95% CI, 0.56–0.95). HCPs at private facilities (ARR, 0.71; 95% CI, 0.59–0.84) had a lower risk of reporting high service interruptions than those at governmental facilities. Health services in Nigeria were more likely to be interrupted than those in Burkina Faso (ARR, 1.38; 95% CI, 1.19–1.59). Health authorities should work with multiple stakeholders to ensure routine health services and identify novel and adaptive approaches to recover referral services, medical care, maternal and child health, family planning, immunization and health promotion, and prevention during the COVID-19 era.

Author Notes

Address correspondence to Nega Assefa, Bote Street, Harar Campus, SGS building, Harar, Ethiopia, or Wafaie W. Fawzi, 665 Huntington Avenue, Building 1, Room 1102, Boston, MA 02115. E-mails: negaassefa@yahoo.com or mina@hsph.harvard.edu.

Financial support: The Bill & Melinda Gates Foundation grant OPP1179606, as well as institutional support from the Heidelberg Institute of Global Health, Germany, and the Harvard T.H. Chan School of Public Health, USA, supported this work.

Authors’ addresses: Nega Assefa, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia, E-mail: negaassefa@yahoo.com. Ali Sié and Ourohiré Millogo, Nouna Health Research Center, Nouna, Burkina Faso, E-mails: sieali@yahoo.fr and ourohire2001@yahoo.fr. Dongqing Wang, Michelle L. Korte, Elena C. Hemler, and Wafaie W. Fawzi, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, E-mails: dqwang@hsph.harvard.edu, mkorte@hsph.harvard.edu, ehemler@hsph.harvard.edu, and mina@hsph.harvard.edu. Yasir Y. Abdullahi, Jegula Hospital, Harar, Ethiopia, E-mail: yasdire@gmail.com. Bruno Lankoande, Institut Supérieur des Sciences de la Population, University of Ouagadougou, Ouagadougou, Burkina Faso, E-mail: blankoande@issp.bf. Angela Chukwu, Department of Statistics, University of Ibadan, Ibadan, Nigeria, E-mail: unnachuks2002@yahoo.co.uk. Firehiwot Workneh and Yemane Berhane, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia, E-mails: firehiwotwaciph@gmail.com and yemaneberhane@gmail.com. Phyllis Kanki, Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, E-mail: pkanki@hsph.harvard.edu. Till Baernighausen, Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany, and Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, E-mail: till.baernighausen@uni-heidelberg.de. Ayoade Oduola, University of Ibadan Research Foundation, University of Ibadan, Ibadan, Nigeria, E-mail: amjoduola@hotmail.com.

These authors contributed equally as first authors.

These authors contributed equally as last authors.

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