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Journal article

Impact of the COVID-19 pandemic and response on the utilisation of health services in public facilities during the first wave in Kinshasa, the Democratic Republic of the Congo

Abstract:
Introduction: Health service use among the public can decline during outbreaks and had been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the government of the Democratic Republic of the Congo (DRC) started implementing public health measures across Kinshasa, including strict lockdown measures in the Gombe health zone. Methods: Using monthly time series data from the DRC Health Management Information System (January 2018 to December 2020) and interrupted time series with mixed effects segmented Poisson regression models, we evaluated the impact of the pandemic on the use of essential health services (outpatient visits, maternal health, vaccinations, visits for common infectious diseases and non-communicable diseases) during the first wave of the pandemic in Kinshasa. Analyses were stratified by age, sex, health facility and lockdown policy (ie, Gombe vs other health zones). Results: Health service use dropped rapidly following the start of the pandemic and ranged from 16% for visits for hypertension to 39% for visits for diabetes. However, reductions were highly concentrated in Gombe (81% decline in outpatient visits) relative to other health zones. When the lockdown was lifted, total visits and visits for infectious diseases and non-communicable diseases increased approximately twofold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected. Conclusion: The COVID-19 pandemic resulted in important reductions in health service utilisation in Kinshasa, particularly Gombe. Lifting of lockdown led to a rebound in the level of health service use but it remained lower than prepandemic levels.published_or_final_versio
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1136/bmjgh-2021-005955

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Author
ORCID:
0000-0001-7808-4652
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Author
ORCID:
0000-0003-3818-3538
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Author
ORCID:
0000-0001-7679-2065
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Author
ORCID:
0000-0002-3714-6893


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Funder identifier:
10.13039/501100000193
Grant:
108966-002


Publisher:
BMJ Publishing Group
Journal:
BMJ Global Health More from this journal
Volume:
6
Issue:
7
Pages:
e005955-e005955
Publication date:
2021-07-27
Acceptance date:
2021-06-24
DOI:
EISSN:
2059-7908
ISSN:
2059-7908


Language:
English
Keywords:
Pubs id:
1932578
Local pid:
pubs:1932578
Source identifiers:
W3186771862
Deposit date:
2026-06-10
ARK identifier:
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