Continued disruptions in health care services and mental health among health care providers during the COVID-19 pandemic in five sub-Saharan African countries

Nega Assefa, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
Yasir Younis Abdullahi, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
Elena Cori Hemler, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America.
Bruno Lankoande, Institut Supérieur des Sciences de la Population, University of Ouagadougou, Ouagadougou, Burkina Faso.
Dongqing Wang, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America.
Isabel Madzorera, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America.
Ourohiré Millogo, Nouna Health Research Center, Burkina Faso.
Livesy Naafoe Abokyi, Kintampo Health Research Center, Kintampo, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana.
Dielbeogo Dasmane, Institut Supérieur des Sciences de la Population, University of Ouagadougou, Ouagadougou, Burkina Faso.
Kassoum Dianou, Institut Supérieur des Sciences de la Population, University of Ouagadougou, Ouagadougou, Burkina Faso.
Angela Chukwu, Department of Statistics, University of Ibadan, Ibadan, Nigeria.
Firehiwot Workneh, Addis Continental Institute of Public Health, Ethiopia.
Frank Mapendo, Africa Academy for Public Health, Dar es Salaam, Tanzania.
Abbas Ismail, College of Natural and Mathematical Sciences, University of Dodoma, Dodoma, Tanzania.
Sulemana Watara Abubakari, Kintampo Health Research Center, Kintampo, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana.
Emily Smith, Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States of America.
Ayo Oduola, University of Ibadan Research Foundation, University of Ibadan, Ibadan, Nigeria.
Abdramane Soura, Institut Supérieur des Sciences de la Population, University of Ouagadougou, Ouagadougou, Burkina Faso.
Ali Sie, Nouna Health Research Center, Burkina Faso.
Japhet Killewo, Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Mary Mwanyika-Sando, Africa Academy for Public Health, Dar es Salaam, Tanzania.
Said Ali Vuai, College of Natural and Mathematical Sciences, University of Dodoma, Dodoma, Tanzania.
Till Baernighausen, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America.
Kwaku Poku Asante, Kintampo Health Research Center, Kintampo, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana.
Tajudeen Raji, Division of Public Health Institutes and Research, Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia.
Yemane Berhane, Addis Continental Institute of Public Health, Ethiopia.
Wafaie Wahib Fawzi, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America.

Document Type

Journal Article

Publication Date

11-12-2022

Journal

Journal of global health

Volume

12

DOI

10.7189/jogh.12.05046

Abstract

BACKGROUND: Continuous monitoring of the pandemic's impact on health service provision and mental health, COVID-19 perceptions, and compliance with prevention measures among health care providers (HCPs) can help with mitigating the pandemic's negative effects. METHODS: A computer-assisted telephone interviewing (CATI) survey was conducted among 1499 HCPs in Burkina Faso (Ouagadougou), Ethiopia (Addis Ababa), Nigeria (Lagos and Ibadan), Tanzania (Dar es Salaam), and Ghana (Kintampo). Self-reported mental health, perceptions of the COVID-19 pandemic, and prevention measures available in the workplace were assessed. HCPs' responses to questions regarding the impact of COVID-19 on nine essential health services were summed into a score; high service disruption was defined as a score higher than the total average score across all sites. Modified Poisson regression was used to identify potential factors related to high service disruption. RESULTS: Overall, 26.9% of HCPs reported high service disruption, with considerable differences across sites (from 1.6% in Dar es Salaam to 45.0% in Addis Ababa). A considerable proportion of HCPs reported experiencing mild psychological distress (9.4%), anxiety (8.0%), and social avoidance or rejection (13.9%) due to their profession. Participants in Addis Ababa (absolute risk ratio (ARR) = 2.10; 95% confidence interval (CI) = 1.59-2.74), Lagos (ARR = 1.65; 95% CI = 1.24-2.17), and Kintampo (ARR = 2.61; 95% CI = 1.94-3.52) had a higher likelihood of reporting high service disruption compared to those in Ouagadougou. Reporting ever-testing for COVID-19 (ARR = 0.82; 95% CI = 0.69-0.97) and the presence of COVID-19 guidelines in the workplace (ARR = 0.63; 95% CI = 0.53-0.77) were both associated with lower reported health service disruption among HCPs. CONCLUSION: The COVID-19 pandemic continues to disrupt essential health services and present a challenge to HCPs' mental health, with important differences across countries and settings; interventions are needed to mitigate these negative effects of the pandemic.

Department

Global Health

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