Management Science, 3527University of Strathclyde, Glasgow, SL, UK.
J Health Serv Res Policy. 2023 Jan;28(1):58-65. doi: 10.1177/13558196221111708. Epub 2022 Jul 4.
The barriers to delivering clinical non-communicable disease services in low- and middle-income countries have risen with the onset of COVID-19. Using Ghana as a case study, this article examines the changes COVID-19 has brought to diabetes service delivery and considers policy responses to deal with future such outbreaks.
We conducted 18 interviews between November 2020 and February 2021 with health professionals and administrators from primary, secondary and tertiary facilities within the Ghana Health Service. The analysis was performed using deductive and inductive methods.
There were six general themes in interviewees' responses: (1) COVID-19 had exacerbated the problems of high medicine and service costs and medicine shortages, (2) the pandemic had exacerbated problems of poor patient record keeping, (3) COVID-19 had reduced the availability of suitably trained health providers, (4) staff had become demoralized by management's unwillingness to make innovative changes to cope with the pandemic, (5) COVID-19 led to a reorganization of diabetes services, and (6) the country's national health insurance scheme lacked flexibility in dealing with the pandemic.
Access to resources is limited in LMICs. However, our study highlights practical policy responses that can improve health providers' response to COVID-19 and future pandemics.
随着 COVID-19 的爆发,中低收入国家提供临床非传染性疾病服务的障碍有所增加。本文以加纳为例,考察了 COVID-19 给糖尿病服务提供带来的变化,并考虑了应对未来此类疫情爆发的政策应对措施。
我们于 2020 年 11 月至 2021 年 2 月期间对加纳卫生服务部门内的初级、中级和三级医疗机构的卫生专业人员和管理人员进行了 18 次访谈。分析采用演绎和归纳法进行。
受访者的回答中有六个主题:(1)COVID-19 加剧了药品和服务费用高、药品短缺的问题,(2)疫情加剧了患者病历记录不良的问题,(3)COVID-19 减少了合格卫生服务提供者的供应,(4)管理层不愿意做出创新改变以应对疫情,导致工作人员士气低落,(5)COVID-19 导致糖尿病服务重新组织,(6)国家健康保险计划缺乏应对疫情的灵活性。
资源获取在中低收入国家受到限制。然而,我们的研究强调了一些实用的政策应对措施,这些措施可以改善卫生服务提供者应对 COVID-19 和未来大流行的能力。