Musoke David, Nalinya Sarah, Lubega Grace Biyinzika, Deane Kevin, Ekirapa-Kiracho Elizabeth, McCoy David
Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.
The Open University, Milton Keynes, United Kingdom.
PLOS Glob Public Health. 2023 Jan 23;3(1):e0001494. doi: 10.1371/journal.pgph.0001494. eCollection 2023.
Many countries across the world instituted lockdowns as a measure to prevent the spread of COVID-19. However, these lockdowns had consequences on health systems. This study explored effects of the COVID-19 lockdown measures on health and healthcare services in Uganda. The qualitative study employed focus group discussions (FGDs), household interviews, and key informant interviews (KIIs) in both an urban (Kampala district) and rural (Wakiso district) setting in central Uganda. Fourteen FGDs were conducted among community members, local leaders, community health workers, and health practitioners. Interviews were conducted among 40 households, while 31 KIIs were held among various stakeholders including policy makers, non-governmental organisations, and the private sector. Data was analysed by thematic analysis with the support of NVivo 2020 (QSR International). Findings from the study are presented under four themes: maternal and reproductive health; child health; chronic disease services; and mental health. Maternal and reproductive health services were negatively affected by the lockdown measures which resulted in reduced utilisation of antenatal, postnatal and family planning services. These effects were mainly due to travel restrictions including curfew, and fear of contracting COVID-19. The effects on child health included reduced utilisation of services which was a result of difficulties faced in accessing health facilities because of the travel restrictions. Patients with chronic conditions could not access health facilities for their routine visits particularly due to suspension of public transport. Depression, stress and anxiety were common due to social isolation from relatives and friends, loss of jobs, and fear of law enforcement personnel. There was also increased anxiety among health workers due to fear of contracting COVID-19. The COVID-19 lockdown measures negatively affected health, and reduced access to maternal, reproductive and child health services. Future interventions in pandemic response should ensure that their effects on health and access to health services are minimised.
世界上许多国家实施封锁措施以防止新冠病毒传播。然而，这些封锁措施对卫生系统产生了影响。本研究探讨了新冠疫情封锁措施对乌干达卫生和医疗服务的影响。这项定性研究在乌干达中部的一个城市（坎帕拉区）和一个农村（瓦基索区）地区采用了焦点小组讨论、家庭访谈和关键 informant 访谈。在社区成员、地方领导人、社区卫生工作者和卫生从业人员中进行了 14 次焦点小组讨论。对 40 户家庭进行了访谈，同时在包括政策制定者、非政府组织和私营部门在内的各利益相关者中进行了 31 次关键 informant 访谈。在 NVivo 2020（QSR International）的支持下，通过主题分析对数据进行了分析。该研究的结果分为四个主题呈现：孕产妇和生殖健康；儿童健康；慢性病服务；以及心理健康。封锁措施对孕产妇和生殖健康服务产生了负面影响，导致产前、产后和计划生育服务的利用率下降。这些影响主要是由于包括宵禁在内的出行限制以及对感染新冠病毒的恐惧。对儿童健康的影响包括服务利用率下降，这是由于出行限制导致难以获得医疗设施造成的。慢性病患者无法前往医疗设施进行常规就诊，特别是由于公共交通的暂停。由于与亲戚和朋友的社会隔离、失业以及对执法人员的恐惧，抑郁、压力和焦虑很常见。由于担心感染新冠病毒，卫生工作者的焦虑也有所增加。新冠疫情封锁措施对健康产生了负面影响，并减少了获得孕产妇、生殖和儿童健康服务的机会。未来应对疫情的干预措施应确保将其对健康和获得医疗服务的影响降至最低。
