1
|
Millimouno TM, Dioubaté N, Niane H, Diallo MC, Maomou C, Sy T, Diallo IS, Semaan A, Delvaux T, Beňová L, Delamou A. Effect of the COVID-19 pandemic on maternal and neonatal health services in three referral hospitals in Guinea: an interrupted time-series analysis. Reprod Health 2023; 20:50. [PMID: 36966343 PMCID: PMC10039677 DOI: 10.1186/s12978-023-01599-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 03/21/2023] [Indexed: 03/27/2023] Open
Abstract
INTRODUCTION In sub-Saharan Africa, there is limited evidence on the COVID-19 health-related effect from front-line health provision settings. Therefore, this study aimed to analyse the effect of the COVID-19 pandemic on routine maternal and neonatal health services in three referral hospitals. MATERIALS AND METHODS We conducted an observational study using aggregate monthly maternal and neonatal health services routine data for two years (March 2019-February 2021) in three referral hospitals including two maternities: Hôpital National Ignace Deen (HNID) in Conakry and Hôpital Regional de Mamou (HRM) in Mamou and one neonatology ward: Institut de Nutrition et de Santé de l'Enfant (INSE) in Conakry. We compared indicators of health service utilisation, provision and health outcomes before and during the COVID-19 pandemic periods. An interrupted time-series analysis (ITSA) was performed to assess the relationship between changes in maternal and neonatal health indicators and COVID-19 through cross-correlation. RESULTS During COVID-19, the mean monthly number (MMN) of deliveries decreased significantly in HNID (p = 0.039) and slightly increased in HRM. In the two maternities, the change in the MMN of deliveries were significantly associated with COVID-19. The ITSA confirmed the association between the increase in the MMN of deliveries and COVID-19 in HRM (bootstrapped F-value = 1.46, 95%CI [0.036-8.047], p < 0.01). We observed an increasing trend in obstetric complications in HNID, while the trend declined in HRM. The MMN of maternal deaths increased significantly (p = 0.011) in HNID, while it slightly increased in HRM. In INSE, the MMN of neonatal admissions significantly declined (p < 0.001) and this decline was associated with COVID-19. The MMN of neonatal deaths significantly decreased (p = 0.009) in INSE and this decrease was related to COVID-19. CONCLUSION The pandemic negatively affected the maternal and neonatal care provision, health service utilisation and health outcomes in two referral hospitals located in Conakry, the COVID-19 most-affected region.
Collapse
Affiliation(s)
- Tamba Mina Millimouno
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea.
- Centre d'Excellence d'Afrique pour la Prévention et le Contrôle des Maladies Transmissibles (CEA-PCMT), Faculté des Sciences et Techniques de la Santé, Université Gamal Abdel Nasser de Conakry, Conakry, Guinea.
| | - Nafissatou Dioubaté
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea
| | - Harissatou Niane
- Institut de Nutrition et de Santé de l'Enfant, Hôpital National Donka, Conakry, Guinea
| | | | - Cécé Maomou
- Service de Maternité de l'Hôpital Régional de Mamou, Mamou, Guinea
| | - Telly Sy
- Service de Maternité de l'Hôpital National Ignace Deen, Conakry, Guinea
| | - Ibrahima Sory Diallo
- Institut de Nutrition et de Santé de l'Enfant, Hôpital National Donka, Conakry, Guinea
| | - Aline Semaan
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Thérèse Delvaux
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Lenka Beňová
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Alexandre Delamou
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea
- Centre d'Excellence d'Afrique pour la Prévention et le Contrôle des Maladies Transmissibles (CEA-PCMT), Faculté des Sciences et Techniques de la Santé, Université Gamal Abdel Nasser de Conakry, Conakry, Guinea
| |
Collapse
|
2
|
Kolié D, Keita FN, Delamou A, Dossou JP, Van Damme W, Agyepong IA. Learning from the COVID-19 pandemic for future epidemics and pandemics preparedness and response in Guinea: Findings from a scoping review. Front Public Health 2022; 10:879850. [PMID: 36324458 PMCID: PMC9618875 DOI: 10.3389/fpubh.2022.879850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 09/22/2022] [Indexed: 01/21/2023] Open
Abstract
The outbreak of the novel coronavirus (SARS-CoV-2) in December 2019 prompted a response from health systems of countries across the globe. The first case of COVID-19 in Guinea was notified on 12 March 2020; however, from January 2020 preparations at policy and implementation preparedness levels had already begun. This study aimed to assess the response triggered in Guinea between 27th January 2020 and 1st November 2021 and lessons for future pandemic preparedness and response. We conducted a scoping review using three main data sources: policy documents, research papers and media content. For each of these data sources, a specific search strategy was applied, respectively national websites, PubMed and the Factiva media database. A content analysis was conducted to assess the information found. We found that between January 2020 and November 2021, the response to the COVID-19 pandemic can be divided into five phases: (1) anticipation of the response, (2) a sudden boost of political actions with the implementation of strict restrictive measures, (3) alleviation of restrictive measures, (4) multiple epidemics period and (5) the COVID-19 variants phase, including the strengthening of vaccination activities. This study provides several learning points for countries with similar contexts including: (1) the necessity of setting up, in the pre-epidemic period, an epidemic governance framework that is articulated with the country's health system and epidemiological contexts; (2) the importance of mobilizing, during pre-epidemic period, emergency funds for a rapid health system response whenever epidemics hit; (3) each epidemic is a new experience as previous exposure to similar ones does not necessarily guarantee population and health system resilience; (4) epidemics generate social distress because of the restrictive measures they require for their control, but their excessive securitization is counterproductive. Finally, from a political point of view, decision-making for epidemic control is not always disinterested; it is sometimes rooted in political computations, and health system actors should learn to cope with it while, at the same time, safeguarding trusted and efficient health system responses. We conclude that health system actors anticipated the response to the COVID-19 pandemic and (re-) adapted response strategies as the pandemic evolved in the country. There is a need to rethink epidemics governance and funding mechanisms in Guinea to improve the health system response to epidemics.
Collapse
Affiliation(s)
- Delphin Kolié
- African Centre of Excellence in the Prevention and Control of Communicable Diseases, University of Conakry, Conakry, Guinea,Ministry of Health, Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea,*Correspondence: Delphin Kolié ;
| | - Fatoumata Namaren Keita
- African Centre of Excellence in the Prevention and Control of Communicable Diseases, University of Conakry, Conakry, Guinea
| | - Alexandre Delamou
- African Centre of Excellence in the Prevention and Control of Communicable Diseases, University of Conakry, Conakry, Guinea,Ministry of Health, Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea
| | - Jean-Paul Dossou
- Centre de Recherche en Reproduction Humaine et en Démographie, Cotonou, Benin
| | - Wim Van Damme
- Public Health Department, Institute of Tropical Medicine, Antwerp, Belgium
| | - Irene Akua Agyepong
- Ghana College of Physicians and Surgeons, Faculty of Public Health, Accra, Ghana,Research and Development Division, Ghana Health Service, Dodowa Health Research Centre, Accra, Ghana
| |
Collapse
|
3
|
Imam T, Uddin S. How do economic and public finance statuses affect policy responses during a pandemic? - learning from the COVID-19 first wave. BMC Public Health 2022; 22:785. [PMID: 35440081 PMCID: PMC9016378 DOI: 10.1186/s12889-022-13209-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 02/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the time of a pandemic, it is typical for public health bodies to collaborate with epidemiologists to design health policies both at national and international levels for controlling the spread. A point largely overlooked in literature is the extent economic capability and public finance status can influence the policy responses of countries during a pandemic situation. This article fills this gap by considering 12 public health and 7 economic measures (i.e., policies) in 200 countries during the COVID-19 first wave, with countries grouped across income categories. METHODS We apply statistical analysis, inclusive of regression models, to assess the impact of economic capability and public finance status on policy responses. Multiple open-access datasets are used in this research, and information from the hybrid sources are cumulated as samples. In our analysis, we consider variables including population characteristics (population size, density) and economic and public finance status (GDR, current account balance, government surplus/deficit) further to policy responses across public health and economic measures. Additionally, we consider infection rates across countries and the institution of the measures relative to infection rate. RESULTS Results suggest that countries from all income groups have favoured public health measures like school closures and travel bans, and economic measures like influencing interest rates. However, strong economy countries have more adopted technological monitoring than low-income countries. Contrarily, low-income countries have preferred traditional measures like curfew and obligatory mask-wearing. GDP per capita was a statistically significant factor influencing the institution of both public health and economic measures. Government finance statuses like current account balance and surplus/deficit were also significant factors influencing economic measures. CONCLUSIONS Overall, the research reveals that, further to biological characteristics, policymakers and epidemiologists can consider the economic and public finance contexts when suggesting health responses to a pandemic. This, in turn, calls for more international cooperation on economic terms further to public health terms.
Collapse
Affiliation(s)
- Tasadduq Imam
- School of Business and Law, CQUniversity (Melbourne Campus), Melbourne, VIC, 3000, Australia.
| | - Shahadat Uddin
- School of Project Management, Faculty of Engineering, The University of Sydney, Forest Lodge, NSW, 2037, Australia
| |
Collapse
|
4
|
LY BA, Ahmed MAAG, TRAORE FB, DIARRA NH, DEMBELE M, DIARRA D, KANDÉ IF, SANGHO H, DOUMBIA S. CHALLENGES AND DIFFICULTIES IN IMPLEMENTING AND ADOPTING ISOLATION AND QUARANTINE MEASURES AMONG INTERNALLY DISPLACED PEOPLE DURING THE COVID-19 PANDEMIC IN MALI (161/250). J Migr Health 2022; 5:100104. [PMID: 35434677 PMCID: PMC8994677 DOI: 10.1016/j.jmh.2022.100104] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 03/19/2022] [Accepted: 04/09/2022] [Indexed: 11/18/2022] Open
Abstract
The lack of facilities for quarantine and isolation in the sites for internally displaced people (IDPs) was found to be a barrier to the adoption of isolation and quarantine measures by IDPs. Changes in social behavior and practices to adopt isolation and quarantine were found to be difficult for IDPs. Financial vulnerability and fear of stigma were identified as barriers to the adoption of isolation and quarantine measures by IDPs. Endogen solutions to adopt isolation and quarantine measures include strengthening IDPs’ awareness on COVID-19 by IDPs.
Introduction Isolation and quarantine are among the key measures that protect internally displaced people (IDPs) against COVID-19. This study aims to identify the challenges encountered by humanitarian actors, and health, political, and administrative stakeholders in implementing these measures. It also describes the difficulties faced by IDPs when adopting them, and the local initiatives developed to overcome those difficulties. Method We conducted a qualitative survey consisting of individual interviews and focus groups among IDPs, humanitarian actors, and health, political, and administrative stakeholders. The data was collected between November and December 2020 in the Bamako and Ségou Regions of Mali. Interviews were recorded with audio recorders, then transcribed and thematically analyzed using the NVivo 13 software. Findings The study involved 36 individual interviews and eight focus groups with 68 participants of whom IDPs represented 72.3%. The main challenges reported on IDP sites included difficulties in contacting positive cases, a lack of facilities for quarantine and isolation, a lack of physical space for building new facilities, and a lack of financial resources to support IDPs during isolation and quarantine. The difficulties reported included: changes in social behavior and practices, fear of stigma, a poor level of literacy, and language barriers. To address those difficulties, the local initiatives developed by IDPs included strengthening the awareness of IDPs on COVID-19, early warning of sites’ leaders about positive and suspected cases, and setting up a toll-free number to facilitate access to appropriate information on COVID-19. Conclusion The findings of this study could be used as evidence to guide policy, adjust current strategies and take into account with more focus IDPs, a group with increased vulnerability, in COVID-19 response, more precisely during the implementation of isolation and quarantine measures. By doing so, they will help improve the response to COVID-19, IDPs health, and population health.
Collapse
|
5
|
Ag Ahmed MA, Ly BA, Diarra NH, Traore FB, Diarra D, Kande IF, Dembele M, Doumbia S, Alami H. Challenges to the implementation and adoption of physical distancing measures against COVID-19 by internally displaced people in Mali: a qualitative study. Confl Health 2021; 15:88. [PMID: 34863236 PMCID: PMC8642860 DOI: 10.1186/s13031-021-00425-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 11/15/2021] [Indexed: 11/29/2022] Open
Abstract
Background For almost a decade now, Mali has been facing a security crisis that led to the displacement of thousands of people within the country. Since March 2020, a health crisis linked to the COVID-19 pandemic also surfaced. To overcome this health crisis, the government implemented some physical distancing measures but their adoption proved difficult, particularly among internally displaced people (IDPs). The objective of this study is to identify the challenges relating to the implementation and adoption of physical distancing measures and to determine the main mitigation measures taken by IDPs to adjust to these new policies.
Methods An exploratory qualitative research was conducted in Bamako and Ségou, two of the ten regions of Mali. The study counted 68 participants including 50 IDPs, seven administrative and health authorities, and 11 humanitarian actors. Sampling was guided by the principle of saturation and diversification, and data was collected through semi-structured individual interviews (n = 36) and focus groups (n = eight). Analysis was based on thematic content analysis through NVivo software.
Results The main challenges identified concerning the implementation and adoption of physical distancing measures include the proximity in which IDPs live, their beliefs and values, the lack of toilets and safe water on sites, IDPs habits and economic situation, humanitarian actors’ lack of financial resources and authority, and social pressure from religious leaders. Implemented mitigation measures include the building of new shelters or their compartmentalization, the creation of income-generating activities and food banks, psychosocial support, promoting awareness of IDPs, and nightly police patrols and surveillance to discourage IDPs from going out. Finally, a call for action is suggested for the actors involved in IDPs support and management. Conclusions The study demonstrates the difficulty for IDPs to follow most of the physical distancing measures and informs about the risk of disease spreading among IDPs with its potential consequences. It also shows the inability of mitigation measures to control the outbreak and suggests actions to be considered.
Collapse
Affiliation(s)
- Mohamed Ali Ag Ahmed
- Institute of Tropical Medicine, Antwerp, Belgium. .,Faculty of Medicine and Odontostomalogy, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali.
| | - Birama Apho Ly
- Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Niélé Hawa Diarra
- Faculty of Medicine and Odontostomalogy, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | | | - Djeneba Diarra
- Faculty of Medicine and Odontostomalogy, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | | | - Mahamadou Dembele
- Faculty of Medicine and Odontostomalogy, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Seydou Doumbia
- Faculty of Medicine and Odontostomalogy, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | | |
Collapse
|
6
|
Dente MG, Resti CV, Declich S, Putoto G. The Reported Few Cases and Deaths of Covid-19 Epidemic in Africa Are Still Data Too Questionable to Reassure About the Future of This Continent. Front Public Health 2021; 9:613484. [PMID: 33614582 PMCID: PMC7892606 DOI: 10.3389/fpubh.2021.613484] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 01/07/2021] [Indexed: 12/13/2022] Open
Affiliation(s)
- Maria Grazia Dente
- National Center for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | | | - Silvia Declich
- National Center for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | - Giovanni Putoto
- Planning and Operational Research Department, Doctors With Africa Collegio Aspiranti e Medici Missionari (CUAMM), Padova, Italy
| |
Collapse
|