Health Information System, Universal Health Coverage Life Course, WHO Regional Office for Africa, Harare, Zimbabwe.
Data, Analytics and Knowledge Management, WHO Regional Office for Africa, Brazzaville, Democratic Republic of Congo.
Front Public Health. 2023 Jun 22;11:1144150. doi: 10.3389/fpubh.2023.1144150. eCollection 2023.
The Coronavirus disease 2019 (COVID-19) resulted in the disruption of Sexual and Reproductive Health Rights (SRHR) services in the Eastern and Southern Africa region. To date, studies estimating the impact of COVID-19 disruptions have mainly focused on SRHR services without estimating the economic implication.
We used national service coverage data on the effectiveness of interventions from the lives saved tool (LiST), a mathematical modeling tool that estimates the effects of service coverage change in mortality. We computed years lost due to COVID-19 disruption on SRHR using life expectancy at birth, number of years of life lost due to child mortality, and life expectancy at average maternal death. We calculated the economic value of the lives saved, using the values of statistical life year for each of the countries, comparing 2019 (pre-COVID-19) to 2020 (COVID-19 era).
The total life-years lost were 1,335,663, with 1,056,174 life-years lost attributed to child mortality and 279,249 linked to maternal mortalities, with high case-fatality rates in the Democratic Republic of Congo, Burundi, and Tanzania. The findings show COVID-19 disruptions on SRHR services between 2019 and 2020 resulted in US$ 3.6 billion losses, with the highest losses in Angola (USD 777 million), South Africa (USD 539 million), and Democratic Republic of Congo (USD 361 million).
The monetized value of disability adjusted life years can be used as evidence for advocacy, increased investment, and appropriate mitigation strategies. Countries should strengthen their health systems functionality, incorporating and transforming lessons learned from shock events.
2019 年冠状病毒病（COVID-19）导致东非和南非地区的性健康和生殖健康权利（SRHR）服务中断。迄今为止，评估 COVID-19 中断影响的研究主要集中在 SRHR 服务上，而没有评估其经济影响。
我们使用来自生命保存工具（LiST）的干预措施有效性的国家服务覆盖数据，LiST 是一种数学建模工具，用于估计服务覆盖变化对死亡率的影响。我们使用出生时预期寿命、因儿童死亡而损失的年数和平均产妇死亡时的预期寿命来计算因 COVID-19 中断而导致的 SRHR 损失的年数。我们使用各国统计生命年的价值计算了因 COVID-19 而节省的生命的经济价值，将 2019 年（COVID-19 前）与 2020 年（COVID-19 年）进行了比较。
总生命年损失为 1335663 年，其中 1056174 年生命年归因于儿童死亡，279249 年生命年归因于产妇死亡，刚果民主共和国、布隆迪和坦桑尼亚的病死率较高。研究结果表明，2019 年至 2020 年期间，SRHR 服务因 COVID-19 中断而导致 36 亿美元的损失，其中损失最大的国家是安哥拉（7.77 亿美元）、南非（5.39 亿美元）和刚果民主共和国（3.61 亿美元）。
残疾调整生命年的货币价值可作为宣传、增加投资和适当缓解策略的证据。各国应加强其卫生系统功能，从中吸取冲击事件的经验教训并加以转化。
