Browsing by Author "Amponsah, F."
Now showing 1 - 2 of 2
Results Per Page
Sort Options
Item COVID-19 and resilience of healthcare systems in ten countries(nature, 2022) Arsenault, C.; Gage, A.; Kim, M.K.; Kapoor, N.R.; Akweongo, P.; Amponsah, F.; Aryal, A.; Asai, D.; Awoonor-Williams, J.K.; Ayele, W.; Bedregal, P.; Doubova, S.V.; Dulal, M.; Gadeka, D.D.; Gordon-Strachan, G.; Mariam, D.H.; Hensman, D.; Joseph, J.P.; Kaewkamjornchai, P.; Eshetu, M.K.; Gelaw, S.K.; Kubota, S.; Leerapan, B.; Margozzini, P.; Mebratie, A.D.; Mehata, S.; Moshabela, M.; Mthethwa, L.; Nega, A.; Oh, J.; Park, S.; Passi-Solar, Á.; Pérez-Cuevas, R.; Phengsavanh, A.; Reddy, T.; Rittiphairoj, T.; Sapag, J.C.; Thermidor, R.; Tlou, B.; Guiñez, F.V.; Bauhoff, S.; Kruk, M.E.Declines in health service use during the Coronavirus Disease 2019 (COVID-19) pandemic could have important effects on population health. In this study, we used an interrupted time series design to assess the immediate effect of the pandemic on 31 health services in two low-income (Ethiopia and Haiti), six middle-income (Ghana, Lao People’s Democratic Republic, Mexico, Nepal, South Africa and Thailand) and high-income (Chile and South Korea) countries. Despite efforts to maintain health services, disruptions of varying magnitude and duration were found in every country, with no clear patterns by country income group or pandemic intensity. Disruptions in health services often preceded COVID-19 waves. Cancer screenings, TB screening and detection and HIV testing were most affected (26–96% declines). Total outpatient visits declined by 9–40% at national levels and remained lower than predicted by the end of 2020. Maternal health services were disrupted in approximately half of the countries, with declines ranging from 5% to 33%. Child vaccinations were disrupted for shorter periods, but we estimate that catch-up campaigns might not have reached all children missed. By contrast, provision of antiretrovirals for HIV was not affected. By the end of 2020, substantial disruptions remained in half of the countries. Preliminary data for 2021 indicate that disruptions likely persisted. Although a portion of the declines observed might result from decreased needs during lockdowns (from fewer infectious illnesses or injuries), a larger share likely reflects a shortfall of health system resilience. Countries must plan to compensate for missed healthcare during the current pandemic and invest in strategies for better health system resilience for future emergencies.Item Tracking health system performance in times of crisis using routine health data: lessons learned from a multicountry consortium(Health Research Policy and Systems, 2023) Turcotte‑Tremblay, A-M.; Leerapan, B.; Akweongo, P.; Amponsah, F.; Aryal, A.; et al.COVID-19 has prompted the use of readily available administrative data to track health system performance in times of crisis and to monitor disruptions in essential healthcare services. In this commentary we describe our experience working with these data and lessons learned across countries. Since April 2020, the Quality Evidence for Health Sys‑ tem Transformation (QuEST) network has used administrative data and routine health information systems (RHIS) to assess health system performance during COVID-19 in Chile, Ethiopia, Ghana, Haiti, Lao People’s Democratic Republic, Mexico, Nepal, South Africa, Republic of Korea and Thailand. We compiled a large set of indicators related to common health conditions for the purpose of multicountry comparisons. The study compiled 73 indicators. A total of 43% of the indicators compiled pertained to reproductive, maternal, newborn and child health (RMNCH). Only 12% of the indicators were related to hypertension, diabetes or cancer care. We also found few indicators related to mental health services and outcomes within these data systems. Moreover, 72% of the indicators compiled were related to volume of services delivered, 18% to health outcomes and only 10% to the quality of processes of care. While several datasets were complete or near-complete censuses of all health facilities in the country, others excluded some facility types or population groups. In some countries, RHIS did not capture services delivered through non-visit or nonconventional care during COVID-19, such as telemedicine. We propose the following recommendations to improve the analysis of administrative and RHIS data to track health system performance in times of crisis: ensure the scope of health condi‑ tions covered is aligned with the burden of disease, increase the number of indicators related to quality of care and health outcomes; incorporate data on nonconventional care such as telehealth; continue improving data quality and expand reporting from private sector facilities; move towards collecting patient-level data through electronic health records to facilitate quality-of-care assessment and equity analyses; implement more resilient and standardized health information technologies; reduce delays and loosen restrictions for researchers to access the data; complement routine data with patient-reported data; and employ mixed methods to better understand the underlying causes of service disruptions.